Efficacy and Safety of Desmopressin Melt for the Treatment of Nocturia
A Randomized, Double Blind, Placebo Controlled, Parallel Group, Multi-Center Study With a Double Blind Extension Investigating the Efficacy and Safety of a Fast- Dissolving ("Melt") Formulation of Desmopressin for the Treatment of Nocturia in Adults
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
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British Columbia
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Kelowna, British Columbia, Canada, V1Y-2H4
- Southern Interior Medical Center
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Victoria, British Columbia, Canada, V8T 5G1
- Can-Med Clinical Research Inc.
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Victoria, British Columbia, Canada, V8V 3N1
- Investigational site - Clinical Research
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New Brunswick
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Fredericton, New Brunswick, Canada, E3B 5B8
- Investigational site - Professional Corporation
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Ontario
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Barrie, Ontario, Canada, L4M 7G1
- The Male/Female Health and Reserach
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Brantford, Ontario, Canada, N3R 4N3
- Brantford Urology Research
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Guelph, Ontario, Canada, N1H 5J1
- Guelph Urology Associates
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North Bay, Ontario, Canada, P1B 4Z2
- Investigational Site
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Oakville, Ontario, Canada, L6H 3P1
- The Fe/Male Health Centres
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Toronto, Ontario, Canada, M4N 3M5
- Sunnybrook Health Sciences Centre
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Alabama
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Birmingham, Alabama, Forenede Stater, 35209
- Radiant Research
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Arizona
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Scottsdale, Arizona, Forenede Stater, 85251
- Radiant Research
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Arkansas
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Little Rock, Arkansas, Forenede Stater, 72204
- Arkansas Primary Care Clinic
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California
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Anaheim, California, Forenede Stater, 92801
- Advanced Urology Medical Center
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Beverly Hills, California, Forenede Stater, 90211
- Impact Clinical Trials
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Long Beach, California, Forenede Stater, 90806
- Atlantic Urology Medical Group
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Newport Beach, California, Forenede Stater, 92660
- California Professional Research
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San Diego, California, Forenede Stater, 92103
- San Diego Uro-Research
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Santa Rosa, California, Forenede Stater, 95404
- Radiant Research
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Tarzana, California, Forenede Stater, 91356
- West Coast Clinical Research
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Torrance, California, Forenede Stater, 90505
- Western Clinical Research
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Colorado
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Denver, Colorado, Forenede Stater, 80218
- Downtown Women's Health Care
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Denver, Colorado, Forenede Stater, 80220
- Genitourinary Surgical Consultants
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Denver, Colorado, Forenede Stater, 80210
- Urology Associates PC
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Connecticut
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Middlebury, Connecticut, Forenede Stater, 06762
- Connecticut Clinical Research Center, LLC
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Florida
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Aventura, Florida, Forenede Stater, 33180
- South Florida Medical Research
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Clearwater, Florida, Forenede Stater, 33759
- Women's Medical Research Group, LLC
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Miami, Florida, Forenede Stater, 33145
- Medsearch Professional Group
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Plantation, Florida, Forenede Stater, 33324
- Sunrise Medical Research
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Stuart, Florida, Forenede Stater, 34996
- Radiant Research
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Tallahassee, Florida, Forenede Stater, 32308
- Southeastern Research Group, Inc.
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Tampa, Florida, Forenede Stater, 33607
- Tampa Bay Urology
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West Palm Beach, Florida, Forenede Stater, 33407
- Radiant Research
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Georgia
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Columbus, Georgia, Forenede Stater, 31904
- Southeastern Medical Research Institute
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Dunwoody, Georgia, Forenede Stater, 30338
- Investigational site - PC
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Illinois
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Peoria, Illinois, Forenede Stater, 61602
- Accelovance
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Kansas
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Overland park, Kansas, Forenede Stater, 66202
- Radiant Research, Kansas City
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Louisiana
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Metairie, Louisiana, Forenede Stater, 70006
- Benchmark Research
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Shreveport, Louisiana, Forenede Stater, 71106
- Regional Urology, LLC
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Shreveport, Louisiana, Forenede Stater, 71111
- Pierremont Women's Clinic
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Massachusetts
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Springfield, Massachusetts, Forenede Stater, 01103
- FutureCare Studies, Inc.
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Missouri
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St. Louis, Missouri, Forenede Stater, 63141
- Radiant Research Inc.
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Nebraska
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Lincoln, Nebraska, Forenede Stater, 68510
- Women's Clinic of Lincoln, P.C
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Nevada
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Las Vegas, Nevada, Forenede Stater, 89109
- Investigational Site
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New Jersey
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Lawrenceville, New Jersey, Forenede Stater, 08648
- Lawrenceville Urology
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Lawrenceville, New Jersey, Forenede Stater, 08648
- AdvanceMed Research
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Morristown, New Jersey, Forenede Stater, 07960
- Morristown Urology
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New Mexico
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Albuquerque, New Mexico, Forenede Stater, 87109
- Urology Group of New Mexico, PC
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New York
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Albany, New York, Forenede Stater, 12206
- Upstate Urology
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Carmel, New York, Forenede Stater, 10512
- Investigational site - Adult & Pediatric Urology
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Garden City, New York, Forenede Stater, 11530
- AccuMed Research Associates
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New York, New York, Forenede Stater, 10016
- University Urology Associates
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Suffern, New York, Forenede Stater, 10901
- Ferring Pharmaceutical Inc
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North Carolina
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Concord, North Carolina, Forenede Stater, 28025
- Northeast Urology Research
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Greensboro, North Carolina, Forenede Stater, 27401
- PharmQuest
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Wilmington, North Carolina, Forenede Stater, 28401
- New Hanover Medical Research
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Winston-Salem, North Carolina, Forenede Stater, 27103
- Piedmont Medical Research Associates
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Ohio
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Cincinnati, Ohio, Forenede Stater, 45249
- Radiant Research
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Mogadore, Ohio, Forenede Stater, 44260
- Radiant Research - Akron
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Pennsylvania
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Bala Cynwyd, Pennsylvania, Forenede Stater, 19004
- Urologic Consultants of SE PA
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Philadelphia, Pennsylvania, Forenede Stater, 19115
- Radiant Research
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Philadelphia, Pennsylvania, Forenede Stater, 19114
- Philadelphia Clinical Research, LLC
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Reading, Pennsylvania, Forenede Stater, 19611
- Advanced Clinical Concepts
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South Carolina
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Greenville, South Carolina, Forenede Stater, 29605
- University Medical Group
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Greer, South Carolina, Forenede Stater, 29651
- Radiant Research, Greer
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Mt. Pleasant, South Carolina, Forenede Stater, 29464
- Palmetto Medical Research
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Myrtle Beach, South Carolina, Forenede Stater, 29572
- Carolina Urologic Research Center
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Tennessee
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Kingsport, Tennessee, Forenede Stater, 37660
- Holston Medical Group
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Nashville, Tennessee, Forenede Stater, 37232
- Vanderbilt University Medical Center
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Texas
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Corpus Christi, Texas, Forenede Stater, 78414
- Advanced Research Associates
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Dallas, Texas, Forenede Stater, 75231
- Health Central Women's Care
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Houston, Texas, Forenede Stater, 77024
- Accelovance
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Humble, Texas, Forenede Stater, 77338
- Regional Medical Center and Diagnostic
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San Antonio, Texas, Forenede Stater, 78229
- Urology San Antonio Research, PA
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San Antonio, Texas, Forenede Stater, 78228
- Radiant Research San Antonio
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Virginia
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Richmond, Virginia, Forenede Stater, 23235
- Virginia Urology Center
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Virginia Beach, Virginia, Forenede Stater, 23454
- Urology of Virginia PC
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Washington
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Seattle, Washington, Forenede Stater, 98105
- Women's Clinical Research Center
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Seattle, Washington, Forenede Stater, 98166
- Seattle Urology Research Center
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Seattle, Washington, Forenede Stater, 98166
- Investigational site - Medical Professional
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria
- Written informed consent prior to the performance of any study-related activity.
- Patients 18 years and older with an average of ≥ 2 nocturnal voids per night as determined by a 3 day frequency-volume chart during the screening period.
Exclusion Criteria:
Males:
- Clinical suspicion of bladder outlet obstruction and/or urine flow < 5 ml/s. If medical history and/or physical examination suggest bladder outlet obstruction, uroflowmetry should be performed to confirm the diagnosis
Surgical treatment for bladder outlet obstruction/benign prostatic hyperplasia performed within the past 6 months
Females:
- Pregnancy. Females of reproductive age must have documentation of a reliable method of contraception.
- Use of pessary for pelvic prolapse.
Unexplained pelvic mass.
Males and Females:
- Clinical suspicion of urinary retention and/or post void residual volume > 150 ml. If medical history and/or physical examination suggest urinary retention, bladder ultrasound or catheterization should be performed to confirm the diagnosis.
- Current or past urologic malignancy (e.g., bladder cancer, prostate cancer).
- Clinical evidence of current genitourinary tract pathology that could interfere with voiding.
- History of neurogenic detrusor activity (previously known as detrusor hyperreflexia).
- Suspicion or evidence of cardiac failure.
- Uncontrolled hypertension.
- Uncontrolled diabetes mellitus.
- Renal insufficiency. Serum creatinine must be within normal limits and estimated glomerular filtration rate (eGFR) >=60 mL/min.
- Active hepatic and/or biliary disease. Aspartate transaminase (AST) or alanine transaminase (ALT) should not be >2 times the upper limit of normal. Total bilirubin should not be > 1.5 mg/dL.
- Hyponatremia. Serum sodium level must be within normal limits
- Syndrome of Inappropriate antidiuretic hormone secretion (SIADH).
- Diabetes insipidus (urine output > 40 ml/kg over 24 hours) as determined by the 3-day voiding diary.
- Psychogenic or habitual polydipsia
Obstructive sleep apnea
Other
- Known alcohol or substance abuse
- Work or lifestyle potentially interfering with regular nighttime sleep (e.g., shift workers)
- Previous desmopressin treatment for nocturia.
- Any other medical condition, laboratory abnormality, psychiatric condition, mental incapacity or language barrier that, in the judgment of the investigator, could impair patient participation in the trial.
- Use of loop diuretics (furosemide, torsemide, ethacrynic acid). Other classes of diuretics (thiazides, triamterene, chlorthalidone, amiloride, indapamide) were permitted, either as monotherapy or combination therapy. Subjects using a diuretic were to be encouraged to take it in the morning, if medically feasible.
- Use of any other investigational drug within 30 days of screening.
Concomitant Medications
The following medications are permitted provided that the subject has been on a stable dose for the 3 months prior to the screening date (i.e. treatment has not been initiated or discontinued and there has been no change in dose):
- Alpha-blockers: Cardura (doxazosin); Flomax (tamsulosin); Hytrin (terazosin); Uroxatral (alfuzosin)
- 5 alpha-reductase inhibitors: Avodart (dutasteride); Proscar (finasteride)
- Antispasmodic, anticholinergic, antimuscarinic therapy for overactive bladder: Detrol, Detrol LA (tolterodine); Ditropan, Ditropan XL (oxybutynin); Enablex (darifenacin); Levsin(hyoscyamine); Oxytrol transdermal (oxybutynin); Sanctura (trospium); Vesicare (solifenacin)
- Sedative/hypnotic medications for sleep disorders
- Selective serotonin and mixed norepinephrine/serotonin reuptake inhibitors: Celexa (citalopram); Cymbalta (duloxetine); Effexor (venlafaxine); Lexapro (escitalopram); Paxil(paroxetine); Prozac (fluoxetine); Zoloft (sertraline)
- Chronic use of nonsteroidal anti-inflammatory agents
- Diabinese (chlorpropamide)
- Carbamazepine (carbatrol/tegretol)
- Amiodarone
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Placebo komparator: Placebo
Participants took a placebo 'melt' for 28 days to complete part 1 of the study.
In part 2, placebo patients were randomized to one of the other 4 treatment arms based on assignments predetermined at the initial randomization, to receive active desmopressin melt for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).
|
Oral placebo placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime.
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Eksperimentel: desmopressin melt 10 μg
Participants took desmopressin melt 10 μg for 28 days to complete part 1 of the study.
Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).
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Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg
Andre navne:
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Eksperimentel: desmopressin melt 25 μg
Participants took desmopressin melt 25 μg for 28 days to complete part 1 of the study.
Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).
|
Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg
Andre navne:
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Eksperimentel: desmopressin melt 50 μg
Participants took desmopressin melt 50 μg for 28 days to complete part 1 of the study.
Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).
|
Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg
Andre navne:
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Eksperimentel: desmopressin melt 100 μg
Participants will take desmopressin melt 100 μg for 28 days to complete part 1 of the study.
Participants will continue on this dose in part 2 of the study for between 1-6 months (until the database for part 1 is locked and treatment is unblinded).
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Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Part I: Change From Baseline in Mean Number of Nocturnal Voids at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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The number of nocturnal voids was the average over 3 consecutive 24-hours periods prior to Day 1 and prior to the week 4 visit as recorded in participant diaries. This was the first co-primary outcome. |
- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Percentage of Participants With Greater Than 33 Percent Reduction From Baseline in Mean Number of Nocturnal Voids at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Percentage of participants in each treatment arm that had a greater than 33% reduction from baseline to the end of Part I (week 4) in mean number of nocturnal voids. Nocturnal void data were recorded in participant diaries. This was the second co-primary outcome. |
- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Part II: Change From Baseline in Mean Number of Nocturnal Voids to Days 29, 57, 113 and 169
Tidsramme: - Week 3 to Day 1 (Baseline), Days 29, 57, 113 and 169
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Part II outcomes tested the durability of the effect observed in Part I.
The number of nocturnal voids was the average over 3 consecutive 24-hours periods prior to Part I baseline and prior to the Part II visit as recorded in participant diaries.
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- Week 3 to Day 1 (Baseline), Days 29, 57, 113 and 169
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Part II: Percentage of Participants With Greater Than 33 Percent Reduction From Baseline in Mean Number of Nocturnal Voids to Days 29, 57, 113 and 169
Tidsramme: - Week 3 to Day 1 (Baseline), Days 29, 57, 113 and 169
|
Part II outcomes tested the durability of the effect observed in Part I. Percentage of participants in each treatment arm that had a greater than 33% reduction from baseline to Days 29, 57, 113 and 169 in mean number of nocturnal voids.
Nocturnal void data were recorded in participant diaries.
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- Week 3 to Day 1 (Baseline), Days 29, 57, 113 and 169
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Part I: Change From Baseline in Total Reported Sleep Time at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Total sleep time was recorded by participants in study diaries.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Change From Baseline in Initial Period of Undisturbed Sleep at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Initial period of undisturbed sleep was the time elapsed from first falling asleep until either first void or morning arising.
Data were captured in patient diaries.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Change From Baseline in Quality of Life Assessed by The International Consultation on Incontinence Modular Questionnaire - Nocturia (ICIQ-N) at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
|
The ICIQ-N is a self-administered questionnaire designed to assess the frequency and bother of daytime and nighttime urination.
Subjects were asked to rate the degree of bother of daytime urination and nighttime urination on a scale ranging from 0 (not at all) to 10 (a great deal).
Higher numbers indicate lower quality of life.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Change From Baseline in the Two Domain Scores of the Nocturia Quality of Life (NQoL) Questionnaire at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
|
The NQoL questionnaire is a self-administered questionnaire designed to assess the impact of nocturia on quality of life.
It contains a sleep/energy domain (6 questions), a bother/concern domain (6 questions), and 1 global QoL question.
The twelve core questions are scored on a 0 to 4 scale with higher numbers indicating a better quality of life.
Domain summary scores were calculated by transforming the raw score into a 0-100 scale with higher numbers indicating a better quality of life.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Change From Baseline in Quality of Sleep as Assessed by the Global Score of the Pittsburgh Sleep Quality Index (PSQI) at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
|
The PSQI is a self-administered 19-item questionnaire designed to assess sleep quality and disturbances.
The global score ranges from 0 (better sleep quality) to 21 (worse sleep quality).
Higher numbers indicate lower quality of life.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Change From Baseline in the Mental Health Summary and the Physical Health Summary of the Short Form-12 Version 2 (SF-12v2) at Week 4
Tidsramme: - Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
|
The SF-12v2 was used to measure the impact of nocturia and lack of sleep on general quality of life.
The SF-12 consists of 12 questions.
Data were analyzed using norm-based scoring and summarized along 2 dimensions: Physical Health Summary and Mental Health Summary.
Each summary has a range from 0 (poor health) to 100 (highest level of health).
Higher numbers indicate better quality of life.
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- Week 3 to Day 1 (Baseline), Week 4 (end of Part I)
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Part I: Participants With Treatment-Emergent Adverse Events (AEs) During Study Part I
Tidsramme: Day 1 up to Week 4 (end of Part I)
|
A treatment-emergent adverse event (AE) was any AE occurring during the treatment period or a pretreatment AE that worsened in intensity during the treatment period.
The treatment period was the period during which a subject received investigational medicinal product.
If a subject discontinued the investigational medicinal product, the date of last dose was the last day of the treatment period.
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Day 1 up to Week 4 (end of Part I)
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Part II: Participants With Treatment-Emergent Adverse Events (AEs) During Study Part II
Tidsramme: Week 5 up to Day 169
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A treatment-emergent adverse event (AE) was any AE occurring during the treatment period or a pretreatment AE that worsened in intensity during the treatment period.
The treatment period was the period during which a subject received investigational medicinal product.
If a subject discontinued the investigational medicinal product, the date of last dose was the last day of the treatment period.
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Week 5 up to Day 169
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Publikationer og nyttige links
Generelle publikationer
- Juul KV, Klein BM, Norgaard JP. Long-term durability of the response to desmopressin in female and male nocturia patients. Neurourol Urodyn. 2013 Apr;32(4):363-70. doi: 10.1002/nau.22306. Epub 2012 Sep 12.
- Weiss JP, Zinner NR, Klein BM, Norgaard JP. Desmopressin orally disintegrating tablet effectively reduces nocturia: results of a randomized, double-blind, placebo-controlled trial. Neurourol Urodyn. 2012 Apr;31(4):441-7. doi: 10.1002/nau.22243. Epub 2012 Mar 22.
- Juul KV, Malmberg A, van der Meulen E, Walle JV, Norgaard JP. Low-dose desmopressin combined with serum sodium monitoring can prevent clinically significant hyponatraemia in patients treated for nocturia. BJU Int. 2017 May;119(5):776-784. doi: 10.1111/bju.13718. Epub 2016 Dec 10.
- Bliwise DL, Holm-Larsen T, Goble S. Increases in duration of first uninterrupted sleep period are associated with improvements in PSQI-measured sleep quality. Sleep Med. 2014 Oct;15(10):1276-8. doi: 10.1016/j.sleep.2014.05.013. Epub 2014 Jun 13.
- Juul KV, Klein BM, Sandstrom R, Erichsen L, Norgaard JP. Gender difference in antidiuretic response to desmopressin. Am J Physiol Renal Physiol. 2011 May;300(5):F1116-22. doi: 10.1152/ajprenal.00741.2010. Epub 2011 Mar 2.
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- FE992026 CS29
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