- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03817931
Higher Neural Changes Following Anticholinergic, Beta 3 Agonist, or Placebo in Patients With Overactive Bladder
Higher Neural and Cognitive Changes Following Anticholinergic Versus Beta 3 Agonist Versus Placebo Treatments in Female Patients With Overactive Bladder: a Multicenter Randomized Controlled Pilot Trial
Study Overview
Status
Detailed Description
Women presenting to the urology clinic with complaints of urinary urgency, frequency in the absence of urinary tract infection or other obvious pathology will be screened for inclusion/exclusion criteria. Qualifying subjects will be consented.
Baseline health information, bladder symptom questionnaires (Overactive Bladder-questionnaire(OABq), Patient Perception of Bladder Condition (PPBC)), Personal Health Questionnaire-9 (PHQ-9),Hamilton Anxiety Rating Scale (HAM-A), Montreal cognitive assessment (MoCA) will be given. If baseline depression (PHQ-9 score 15 or greater),dementia (MoCA score 25 or less), anxiety (HAM-A score 25-30) are noted the subject is excluded. 15 patients will be recruited from Baylor Scott & White Health Urology clinic, and 15 patients will be recruited from Houston Methodist Urology clinic.
They will schedule a date within 1 month for the Rey Auditory Verbal Learning Test (RAVLT) and brain functional MRI (fMRI). RAVLT test is performed, followed by resting state fMRI and memory task during fMRI. Vials of medication will be distributed. Vials will be labeled 1-30 and will contain 30 tablets each. The anticholinergic and beta-3 agonist tablets will be encapsulated to look identical to the placebo tablet. Subjects will be reimbursed at this visit. fMRI images at baseline and post-intervention will be analyzed by a radiologist for incidental findings.
One week and two weeks after initiating their tablets, phone interviews will inquire about pill count, side effects, and any new medications. Follow up testing date will be scheduled during the call. The same questions will be repeated at completion of the tablets (30 days after initiation).
At completion of the tablets, subjects return to Houston Methodist for repeat RAVLT and fMRI. Subjects will be reimbursed the other half of their compensation at this visit.
An expert physicist will analyze the BOLD signal intensity and FC pattern in a priori selected regions of interest before and after interventions.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Jill M Danford, MD
- Phone Number: 2547621857
- Email: highr077@gmail.com
Study Contact Backup
- Name: Rachel High, DO
- Phone Number: 4025257006
- Email: highr077@gmail.com
Study Locations
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Texas
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Houston, Texas, United States, 77030
- Houston Methodist Hospital
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Temple, Texas, United States, 75608
- Baylor Scott and White Health
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Female patients of age 50 to 90 years old with OAB as defined by the International Continence Society (Urgency with or without urge incontinence, usually with frequency and nocturia in the absence of urinary tract infection or other obvious pathology) who report that symptoms cause moderate problems using the PPBC.
- English-speaking and able to consent
Exclusion Criteria:
- Males are excluded to eliminate prostate pathology and urethral strictures, as well as possible bias of gender differences on fMRI.
- Subjects with moderately severe or severe depression (screening score of 15 or more) on the Personal Health Questionnaire-9 (PHQ-9)
- Subjects with moderate to severe anxiety (screening score 25-30) on the Hamilton Anxiety Rating Scale (HAM-A)
- A screening score indicating below normal cognitive function at baseline (score of 25 or less) on the montreal cognitive assessment.
- Subjects with neurologic disorders, dementia, prior cerebrovascular accident, neurogenic bladder or post-void residual greater than 250 mL
- Anticholinergics for OAB or beta 3 agonists use for treatment of OAB in the preceding six months prior to enrollment
- Pregnant or planning to become pregnant in the next six months, or current breastfeeding
- The inability to undergo MRI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
Placebo pill identical will be identical to tablets in the other 2 arms.
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All subjects have fMRI at baseline and again after 30 days
All subjects have RAVLT at baseline and again after 30 days.
RAVLT evaluates: short-term auditory-verbal memory, rate of learning, learning strategies, retroactive, and proactive interference, presence of confabulation of confusion in memory processes, retention of information, and differences between learning and retrieval.
Other Names:
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Active Comparator: Anticholinergic
Solifenacin 5 mg tablet orally once daily for 30 days
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All subjects have fMRI at baseline and again after 30 days
All subjects have RAVLT at baseline and again after 30 days.
RAVLT evaluates: short-term auditory-verbal memory, rate of learning, learning strategies, retroactive, and proactive interference, presence of confabulation of confusion in memory processes, retention of information, and differences between learning and retrieval.
Other Names:
Tablet taken once daily.
Other Names:
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Active Comparator: Beta-3 agonists, adrenergic
Mirabegron 25 mg tablet orally once daily for 30 days
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All subjects have fMRI at baseline and again after 30 days
All subjects have RAVLT at baseline and again after 30 days.
RAVLT evaluates: short-term auditory-verbal memory, rate of learning, learning strategies, retroactive, and proactive interference, presence of confabulation of confusion in memory processes, retention of information, and differences between learning and retrieval.
Other Names:
Tablet taken once daily.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional connectivity on MRI
Time Frame: 29 +/-1 days
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Functional connectivity during a word recognition task will be compared within subjects from baseline and after 29+/- 1 day of intervention medication.
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29 +/-1 days
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Resting state blood oxygenation level dependent (BOLD)changes
Time Frame: 29 +/-1 days
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During resting state, BOLD changes will be compared within subjects from baseline and after 29+/- 1 day of intervention medication.
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29 +/-1 days
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Diffusion tensor imaging
Time Frame: 29 +/-1 days
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Fractional anisotropy and mean diffusivity from diffusion tensor images will be compared within subjects from baseline and after 29+/- 1 day of intervention medication.
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29 +/-1 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Score on Rey Auditory Verbal Learning Test (RAVLT)
Time Frame: 30 days
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Baseline testing will be compared with post-intervention testing
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30 days
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Overactive bladder questionnaire (OAB-q)
Time Frame: 30 days
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Baseline score of this validated questionnaire will be compared with post-intervention score
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30 days
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Patient Perception of Bladder Condition (PPBC)
Time Frame: 30 days
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Baseline score of this validated questionnaire will be compared with post-intervention score
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30 days
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jill Danford, MD, Baylor Scott and White Health
- Principal Investigator: Rachel High, DO, Baylor Scott and White Health
- Principal Investigator: Rose Khavari, MD, The Methodist Hospital Research Institute
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Urologic Diseases
- Urinary Bladder Diseases
- Urological Manifestations
- Urination Disorders
- Urinary Incontinence
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Male Urogenital Diseases
- Urinary Bladder, Overactive
- Lower Urinary Tract Symptoms
- Urinary Incontinence, Urge
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Muscarinic Antagonists
- Cholinergic Agents
- Urological Agents
- Adrenergic beta-Agonists
- Adrenergic Agonists
- Mirabegron
- Solifenacin Succinate
- Adrenergic Agents
- Cholinergic Antagonists
- Adrenergic beta-3 Receptor Agonists
Other Study ID Numbers
- 160362
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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