A Study to Evaluate the Pharmacokinetics, Safety and Tolerability of Mirabegron OCAS (Oral Controlled Absorption System) in Pediatric Subjects With Neurogenic Detrusor Overactivity or Overactive Bladder

A Multicentre, Open-label, Single Ascending Dose Phase 1 Study to Evaluate the Pharmacokinetics, Safety and Tolerability of Mirabegron OCAS Tablets in Pediatric Subjects From 5 to Less Than 18 Years of Age With Neurogenic Detrusor Overactivity (NDO) or Overactive Bladder (OAB)

The purpose of this study is to evaluate the pharmacokinetics as well as the safety and tolerability of mirabegron OCAS tablets after single-dose administration at different dose levels in children and adolescents with NDO or OAB.

Study Overview

• Status: Completed
• Conditions: Overactive Bladder; Pharmacokinetics of Mirabegron; Neurogenic Detrusor Overactivity
• Intervention / Treatment: Drug: Mirabegron

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Phase 1

Contacts and Locations

Study Locations

• Belgium
  • Edegem, Belgium, 2650
    • Site BE32009 Univ.Ziekenhuis Antwerpen
  • Gent, Belgium, 9000
    • Site BE32003 Gent University Hospital
  • Kortrijk, Belgium, 8500
    • Site BE32004 AZ Groeninge, Campus Vercruyss
  • Leuven, Belgium, 3000
    • Site BE32011 U.Z. Leuven
• Denmark
  • Aalborg, Denmark, 9000
    • Site DK45003 Aalborg Sygehus Nord
  • Aarhus, Denmark, 8200
    • Site DK45001 Uni Hosp of Aarhus, Skejby
  • Copenhagen, Denmark, 2100
    • Site DK45005 Rigshospitalet
  • Koege, Denmark, 4600
    • Site DK45004 Børnelægen i Køge
  • Kolding, Denmark, 6000
    • Site DK45002 Kolding Sygehus
• Norway
  • Bergen, Norway, 5021
    • Site NO47001 Haukeland Sykehus
• Poland
  • Gdansk, Poland, 80-952
    • Site PL48003 Uniwersyteckie Centrum Kliniczne
  • Warsaw, Poland, 04-730
    • Site PL48001 Pomnik-Centrum Zdrowia Dziecka
• Serbia
  • Belgrade, Serbia, 11000
    • Site RS38010 Mother and Child Health Care

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subject has a documented diagnosis of:

  • Neurogenic detrusor overactivity (NDO), or
  • Idiopathic overactive bladder (OAB) according to International Children's Continence Society (ICCS) criteria.

• Subject's weight/height:

  • Subject should have a body weight of ≥ 20.0 kg (all cohorts).
  • For NDO: subject is not suffering from malnutrition and is not severely overweight, in the opinion of the Investigator.
  • For OAB: subject's weight and height are within the normal percentiles (3rd to 97th percentile) according to Centers for Disease Control and Prevention (CDC) growth charts.
• Subject is able to swallow the study medication in accordance with the protocol.

• Female subject must either:

  • Be of non-childbearing potential:
  • Clearly pre-menarchal or in the judgment of the Investigator is pre-menarchal
  • Documented surgically sterile.
  • Or, if of childbearing potential: Agree not to try to become pregnant during the study and for 28 days after the final study drug administration,
  • And have a negative urine pregnancy test pre-dose Day 1,
  • And, if heterosexually active agree to consistently use two forms of highly effective form of birth control starting at screening and throughout the study period and for 28 days after the final study drug administration.
• Female subjects must agree not to breastfeed starting at screening and throughout the study period, and for 28 days after the last study drug administration.
• Female subject must not donate ova starting at screening and throughout the study period, and for 28 days after the final study drug administration.
• Male subject and their female spouse/partner who are of childbearing potential must be using a highly effective form of contraception consisting of two forms of birth control (one of which must be a barrier method) starting at screening and continuing throughout the study period, and for 28 days after the final study drug administration.
• Male subject must not donate sperm starting at Screening and throughout the study period, and for 90 days after study drug administration.
• Subject and subject's parent(s)/legal guardian agree that the subject will not participate in another interventional study while on treatment.
• Subject and subject's parent(s)/legal guardian are willing and able to comply with the study requirements and with the concomitant medication restrictions

Exclusion Criteria At Screening:

• Subject is pregnant.
• Subject has a known history of QTc prolongation or risk of QT prolongation (e.g. hypokalemia, family history of Long QT Syndrome).
• Subject has an abnormal (mean) pulse rate according to the ranges specified below: age 5 to less than 8 years: < 60 bpm or > 110 bpm; age 8 to less than 12 years: < 55 bpm or > 100 bpm; age 12 to less than 18 years: < 50 bpm or > 100 bpm.
• Subject has any clinically significant ECG abnormality.
• Subject has mean systolic blood pressure greater than the 95th percentile according to age and height and/or greater than 140 mmHg [National Institute of Health, 2005].
• Subject has any clinically significant or unstable medical condition or disorder which, in the opinion of the Investigator, precludes the subject from participating in the study.
• Subject has aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than or equal to 2 times the upper limit of normal (ULN) or total bilirubin greater than or equal to 1.5 times the ULN.
• Subject has severe renal impairment (estimated glomerular filtration rate (MDRD) < 30 mL/min).
• Subject has any other clinically significant out of range results of urinalysis, biochemistry or hematology.
• Subject has a history or current diagnosis of any malignancy.
• Subject has known or suspected hypersensitivity to mirabegron, other ß3-agonists, any of the excipients used in the OCAS tablet formulation or previous severe hypersensitivity to any drug.
• Subject meets any of the contra-indications or precautions for use of mirabegron as mentioned in the Investigator's Brochure (IB).
• Subject has used mirabegron in the past (last intake less than 12 days before planned reference day (Day -4 to Day -1).

• Subject requires ongoing treatment with any of the following prohibited medications:

  • Any anticholinergic/antimuscarinic drugs within 5 half-lives prior to planned reference day (Day -4 to Day -1).
  • Any drugs that are sensitive CYP2D6 substrates with a narrow therapeutic index (such as thioridazine, flecainide, propafenone, imipramine, desipramine) and sensitive P-gp substrates (such as digoxin, dabigatran) within 5 half-lives prior to the planned reference day (Day -4 to Day -1).
  • Any moderate or strong cytochrome CYP3A4/5 or P-gp inhibitors or inducers including natural and herbal remedies (such as itraconazole, rifampicin, phenytoin, carbamazepine, St. John's Wort, grapefruit, Seville orange) within 5 half-lives prior to the planned reference day (Day -4 to Day -1).
• Subject has a positive urinary drug screen test for drugs of abuse.
• Subject donated blood or blood products within 3 months prior to planned Day 1.
• Subject has participated in another clinical trial and/or has taken an investigational drug within 30 days (or 5 half-lives of the investigational drug, whichever is longer) prior to the planned reference day (Day -4 to Day -1).
• Subject's parent(s)/legal guardian is an employee of the Astellas Group, any Contract Research Organization (CRO) involved, or the Investigator site executing the study.
• Subject has current, untreated constipation (or fecal impaction for NDO patients). If the constipation is being consistently treated for the last month, the subject can be included.
• Subject has been administered intradetrusor botulinum toxin injections; except if given > 4 months prior to screening and symptoms reappeared comparable to those before botulinum toxin injections.

Exclusion Criteria At day 1:

• Subject has a positive urinary drug screen test for drugs of abuse.
• Subject has a positive alcohol breath test.
• Subject has used mirabegron in the past (last intake less than 24 days before planned reference day (Day -4 to Day -1).

• Subject requires ongoing treatment with any of the following prohibited medications:

  • Any anticholinergics/antimuscarinics within 5 half-lives prior to intake of the reference day (Day -4 to Day -1).
  • Any drugs that are sensitive CYP2D6 substrates with a narrow therapeutic index (such as thioridazine, flecainide, propafenone, imipramine, desipramine) and sensitive P-gp substrates (such as digoxin, dabigatran) within 5 half-lives prior to the reference day (Day -4 to Day -1).
  • Any moderate or strong cytochrome CYP3A4/5 or P-gp inhibitors or inducers including natural and herbal remedies (such as itraconazole, rifampicin, phenytoin, carbamazepine, St. John's Wort) within 5 half-lives prior to reference day (Day -4 to Day -1).
• Subject donated blood or blood products within 3 months prior to Day 1.
• Subject (female subjects of childbearing potential) has a positive urinary pregnancy test.
• Subject has a current symptomatic urinary tract infection.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Mirabegron; Administered under fed and fasted conditions	Drug: Mirabegron; oral; Other Names: Myrbetriq; Betanis; Betmiga

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pharmacokinetic parameter of mirabegron: Cmax	Maximum concentration (Cmax)	Day 1-7
Pharmacokinetic parameter of mirabegron: tmax	The time after dosing when Cmax occurs (tmax)	Day 1-7
Pharmacokinetic parameter of mirabegron: AUCinf	Area under the curve extrapolated until time is infinity (AUCinf)	Day 1-7
Pharmacokinetic parameter of mirabegron: t1/2	Apparent terminal elimination half-life (t1/2 )	Day 1-7

Secondary Outcome Measures

Outcome Measure	Time Frame
Safety as assessed by adverse events, clinical laboratory evaluations, vital signs (including 24-h Holter for heart rate), electrocardiogram (ECG), physical examination, post-void residual volume (PVR)	up to Day 7

Collaborators and Investigators

• Sponsor: Astellas Pharma Inc
• Collaborators: Astellas Pharma Europe B.V.
• Investigators: Study Director: Clinical Research Physician, Astellas Global Development

Publications and helpful links

Helpful Links

• Link to results on the Astellas Clinical Study Results website.

Study record dates

Study Major Dates

• Study Start (Actual): September 21, 2014
• Primary Completion (Actual): September 21, 2015
• Study Completion (Actual): September 21, 2015

Study Registration Dates

• First Submitted: August 6, 2014
• First Submitted That Met QC Criteria: August 6, 2014
• First Posted (Estimate): August 8, 2014

Study Record Updates

• Last Update Posted (Actual): July 15, 2021
• Last Update Submitted That Met QC Criteria: July 13, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: Pharmacokinetics; Mirabegron; Overactive bladder (OAB); Neurogenic detrusor overactivity (NDO)
• Additional Relevant MeSH Terms: Urologic Diseases; Urinary Bladder Diseases; Lower Urinary Tract Symptoms; Urological Manifestations; Urinary Bladder, Overactive; Physiological Effects of Drugs; Adrenergic Agents; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Urological Agents; Adrenergic Agonists; Adrenergic beta-Agonists; Adrenergic beta-3 Receptor Agonists; Mirabegron
• Other Study ID Numbers: 178-CL-202; 2014-000340-15 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."