- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01613170
Premarin Versus Toviaz for Treatment of Overactive Bladder
A Combined Treatment Program for the Symptoms of Urinary Urgency and Frequency With Toviaz and Premarin Vaginal Cream
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Participants will be randomized to two treatment arms with 45 patients enrolled in each study arm: Toviaz and Premarin Vaginal Cream and Toviaz and Placebo Premarin Vaginal Cream. The Toviaz will be dosed at 4mg tablet given as a once daily dose. Premarin vaginal cream will be dosed at 1 gram per vagina twice weekly. Compliance will be assessed at the 4-week mark and again at completion of the study, 8 weeks after the commencement of treatment.
The questionnaires chosen for this study have been designed and validated as effective tools to assess and evaluate OAB. Patients will be asked to complete three symptoms questionnaires and a 3-day voiding dairy. The questionnaires include Overactive Bladder Questionnaire (OAB-q), The Patient Perception of Bladder Condition, and Urgency Severity and Impact Questionnaire. The voiding diary and questionnaires will be filled out and collected at the initial visit and again at the end of the study which is defined as 8 weeks after the commencement of treatment.
Additionally, patients will be asked to rate their symptoms associated with urogenital atrophy at the start of the study and then again at 8 weeks. The severity of each symptom will be graded based on a four-point scale (0=none, 1=mild, 2= moderate, 3=severe) and a composite score will then be generated. Examiners will also rate the severity of signs of urogenital atrophy at the first visit and at the conclusion of the study.
An objective evaluation of the effectiveness of the estrogen cream treatment will be accomplished by a pathological evaluation of the vaginal cell samples at the beginning of treatment and then again at the 8 week point. These cells will be collected and analyzed by an independent pathologist to determine the percentage of parabasal, intermediate, and superficial cells and to document the change in these three categories of cells as a result of the vaginal estrogen treatment. A 3-Day voiding diary will be used to document changes from baseline for urinary urgency, frequency, and incontinence episodes. Based on previous studies we predict there will be a 45% improvement on urinary frequency from baseline when using both Toviaz and vaginal Premarin cream. Secondary outcomes will be measured using the following validated questionnaires given at the start of the study and again at completion: OAB-q, Patient Perception of Bladder Condition, Urgency Severity and Impact Questionnaire.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Alexandriah Alas, MD
- Phone Number: 954-659-6342
- Email: alasa@ccf.org
Study Contact Backup
- Name: Eric Hurtado, MD
- Phone Number: 954-659-5559
- Email: hurtade@ccf.org
Study Locations
-
-
Florida
-
Weston, Florida, United States, 33331
- Recruiting
- Cleveland Clinic Florida
-
Contact:
- Alexandriah Alas, MD
- Phone Number: 954-659-6342
- Email: alasa@ccf.org
-
Sub-Investigator:
- GW Davila, MD
-
Sub-Investigator:
- Leon Plowright, MD
-
Sub-Investigator:
- Vivian Aguilar, MD
-
Sub-Investigator:
- Alexandriah Alas, MD
-
Sub-Investigator:
- Luis Espaillat, MD
-
Principal Investigator:
- Eric Hurtado, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Postmenopausal Women defined as at least 12 months since last menstrual period
- OAB symptoms for 6 months or longer with complaints of frequency (8 or more voids in a 24 hour period), and either 6 or more urgency episodes in 24 hours, and either 3 or more urge urinary incontinence episodes per 24 hours.
Exclusion Criteria:
- Current or recent treatment (within the last 6 months) with estrogens
- Past or present history of estrogen dependent neoplasm
- Undiagnosed genital tract bleeding
- Current urinary or vaginal infection
- History of thromboembolic disorders associated with estrogen use
- Commencement or alteration of diuretic therapy within three months of study enrollment
- No contraindications for anticholinergic medical therapy
- No contraindications to estrogen therapy
- Symptoms must not have commenced more than three years prior to menopause
- Post Void Residual must be under or equal to 150 ml
- Recurrent Urinary Tract Infections (3 culture proven UTI's within the past 12 months)
- Not on any other anticholinergic medications for the last 4 weeks
- Painful Bladder Syndrome
- Chronic Pelvic Pain
- Vaginal Prolapse POPQ > stage 2/ maximal prolapse point greater than +1 cm
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Toviaz and Premarin Vaginal Cream
Toviaz 4 mg PO q day and premarin cream 1 g per vagina 2 times a week.
|
Toviaz 4mg daily
Other Names:
Premarin cream 1 g per vagina twice weekly
Other Names:
|
Placebo Comparator: Toviaz , Placebo Premarin Vaginal Cream
Toviaz 4 mg PO q day and placebo cream 1 g per vagina 2 times a week.
|
Toviaz 4mg daily
Other Names:
Placebo cream 1 g per vagina twice weekly, to mimic Premarin cream
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Urinary frequency as measured by a 3 day voiding diary
Time Frame: 1 year
|
number of voids per day
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Lifestyle Impact of Overactive Bladder as measured using 3 validated questionnaires: OAB-Q, PPBC, and Urgency Severity and Impact Questionnaire
Time Frame: 1 year
|
quality of life assessment via questionnaire
|
1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Eric Hurtado, MD, Cleveland Clinic Florida
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 11074
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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