Ancillary Nocturnal Urinary Symptoms Analyses for TRIUMPH
Ancillary Nocturnal Urinary Symptom Investigation in the TRIUMPH Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ann Chang
- E-mail: ann.chang@ucsf.edu
Undersøgelse Kontakt Backup
- Navn: Alison Huang, MD, MAS, MPhil
- Telefonnummer: (415) 514-8697
- E-mail: alison.huang@ucsf.edu
Studiesteder
-
-
California
-
San Francisco, California, Forenede Stater, 94115
- Rekruttering
- University of California San Francisco
-
Kontakt:
- Claudia Vila Manes
- Telefonnummer: 415-885-7547
- E-mail: claudia.vilamanes@ucsf.edu
-
Kontakt:
- Amy Zhang
- Telefonnummer: (415) 885-7547
- E-mail: amy.zhang4@ucsf.edu
-
Ledende efterforsker:
- Alison Huang, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Aged 60 years or older at the time of enrollment
- Female sex at birth, without surgical or hormonal gender re-assignment therapy
- Able to walk to the bathroom and use the toilet without assistance
- Report urinary incontinence starting at least 3 months prior to screening
- Report that at least half of incontinence episodes occur with a sudden or strong sensation of urgency
- Report 2 or more urgency incontinence episodes over a 7-day period
- Willing to provide informed consent and adhere to study procedures throughout the length of the study
Exclusion Criteria:
- Prior clinician diagnosis of dementia, or a Montreal Cognitive Assessment (MOCA) score of 17 or lower on screening cognitive evaluation
- Current use of anticholinergic, beta-3-adrenergic agonist, or other medication designed to improve urgency incontinence symptoms, or use in the past 1 month
- Initiation, discontinuation, or dose change of dementia medications (such as donepezil, galantamine, memantine, rivastigmine) in the past 1 month (but candidates on stable doses are eligible)
- Initiation, discontinuation, or dose change of other drugs with strong anticholinergic effects (based on the Beers List) in the past 1 month (but candidates on stable doses are eligible)
- Initiation, discontinuation, or dose change of other drugs that can affect urinary frequency, including diuretics, in the past 1 month (but candidates on stable doses are eligible)
- Current urinary tract infection (UTI) based on screening urinalysis and culture (but candidates can re-present for re-screening after undergoing treatment for UTI)
- History of allergy or sensitivity to either of the study medications or an ingredient in the placebo or study medication capsule
- Severe hepatic impairment (Child-Pugh score B or greater) or renal impairment (creatinine clearance <30 mL/min) as a contraindication to both study medications
- Current bladder obstruction or urinary retention (defined by symptoms suggesting difficulty emptying the bladder in addition to postvoid residual urine volume greater than 150 cc by portable bladder ultrasound)
- Uncontrolled hypertension (based on measured systolic blood pressure greater than 180 or diastolic blood pressure greater than 110 mmHg) as a contraindication to beta-3-adrenergic therapy
- Self-reported history of gastric retention, uncontrolled narrow angle glaucoma, myasthenia gravis, severe ulcerative colitis, or toxic megacolon as contraindications for anticholinergic bladder therapy
- Use of drugs with adverse interactions with one of the study medications in the past 1 month, including potent CYP3A4 inhibitors, hepatic enzyme metabolism inducers, narrow therapeutic index drugs metabolized by CYP2D6, or intention to start taking one of these medications during the study treatment period
- History of bladder surgery, invasive intra-vesical therapy, or bulk bladder injections in the past 3 months (more remote surgery will not be exclusionary), or intention to undergo one of these procedures in the study treatment period
- Use of other specialized incontinence therapy (electrostimulation, pelvic physiotherapy, formal behavioral therapy overseen by certified practitioners) in the past 3 months (more remote therapy will not be exclusionary), or intention to undergo one of these procedures in the study treatment period
- Inability to sign informed consent or complete questionnaires, interviews, or study testing in English
- Other condition that would prevent the participant from completing study procedures, in the opinion of the investigators (e.g., uncontrolled psychosis)
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 |
|---|---|
|
Aktiv komparator: Anticholinergic bladder medication plusbehavioral self-management education
Tolterodine tartrate is a muscarinic receptor antagonist designed to treat urgency incontinence, urgency, and frequency associated with overactive bladder.
Behavioral self-management education includes written education about timed urge suppression
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Anticholinergic
|
|
Aktiv komparator: Beta-3-adrenergic agonist medication plusbehavioral self-management education
Mirabegron, currently sold under the brand name Mybetriq by Astellas Pharma, is a selective beta-3-adrenergic receptor agonist approved for treatment of urgency urinary incontinence, urgency, and frequency associated with overactive bladder.
Behavioral self-management education includes written education about timed urination, lifestyle changes, pelvic floor muscle exercises, and urge suppression.
|
Beta-3-adrenerg agonist
|
|
Placebo komparator: Placebo medication plus behavioral self-management education
Microcrystalline cellulose placebo encapsulated to appear identical to tolterodine and mirabegron medication will be prepared by a compounding pharmacy.
Behavioral self-management education includes written education about time duration, lifestyle changes, pelvic floor muscle exercises, and urge suppression.
|
matchende placebo-pille
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in nocturnal urination frequency over 6 months (24 weeks) of treatment, based on a validated voiding diary.
Tidsramme: Baseline to 6 months
|
Frequency of nocturnal urination will be assessed using a standardized, 7-day voiding diary.
|
Baseline to 6 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Ændring i sammensat kognitiv funktion over 6 måneders (24 uger) behandling, ved hjælp af en sammensat kognitiv score, der inkorporerer normaliserede data fra alle domænespecifikke kognitive tests.
Tidsramme: Baseline til 6 måneder
|
Den sammensatte kognitive score vil blive beregnet som gennemsnittet af Z-score fra følgende individuelle kognitive tests: a) Auditiv Verbal Learning Test (AVLT); b) Oral Trail Making Test (OTMT) del A; c) OTMT del B; d) Digit Span Test; og e) Digit Symbol Substitution Test (DSST).
Det normative gennemsnit for hver kognitiv test vil blive trukket fra hver deltagers komponenttestscore, og denne forskel vil blive divideret med standardafvigelsen for den relevante normative prøve.
Efter at score fra individuelle test er transformeret til Z-score som en fælles metrik baseret på normative data, vil den gennemsnitlige Z-score fra alle tilgængelige tests blive beregnet for at give en sammensat Z-score.
|
Baseline til 6 måneder
|
|
Change in nocturnal urinary incontinence frequency over 6 months (24 weeks) of treatment, based on a validated voiding diary.
Tidsramme: Baseline to 6 months
|
Frequency of nocturnal urination will be assessed using a standardized, 7-day voiding diary.
|
Baseline to 6 months
|
|
Change in global sleep quality score over 6 months (24 weeks) of treatment.
Tidsramme: Baseline to 6 months
|
Perceived sleep quality will be assessed using the Pittsburgh Sleep Quality Index(PSQI), an 18-item validated questionnaire designed to assess sleep quality, latency, efficiency, and problems over a one-week period.
|
Baseline to 6 months
|
|
Change in daytime sleepiness score over 6 months (24 weeks) of treatment.
Tidsramme: Baseline to 6 months
|
Daytime sleepiness will be assessed using the Epworth Sleepiness Scale (ESS), an 8-item questionnaire assessing the level of general sleepiness during real life situationsin order to distinguish excessive daytime sleepiness from normal daytime sleepiness.
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Baseline to 6 months
|
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Change in sleep efficiency over 6 months (24 weeks) of treatment, based on the PSQI sleep efficiency score.
Tidsramme: Baseline to 6 months
|
Sleep efficiency will be assessed based on questions 1, 3, and 4 of the Pittsburgh Sleep Quality Index (PSQI).
|
Baseline to 6 months
|
|
Change in depression symptoms over 6 months (24 weeks) of treatment.
Tidsramme: Baseline to 6 months
|
Depression symptoms will be assessed using the 15-item short form of the GeriatricDepression Scale-15 (GDS-15), which assesses symptoms of depression over a 1-week period.
|
Baseline to 6 months
|
|
Change in anxiety symptoms over 6 months (24 weeks) of treatment.
Tidsramme: Baseline to 6 months
|
Anxiety symptoms will be assessing using the Generalized Anxiety Disorder-7 (GAD7),7-item short form, questionnaire to assess severity of anxiety symptoms over a 2-weekperiod.
|
Baseline to 6 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Alison Huang, MD, University of California, San Francisco
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
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
- 2K24AG068601 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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