Long Term Study of Solifenacin Succinate and Tamsulosin Hydrochloride Oral Controlled Absorption System (OCAS) in Males With Lower Urinary Tract Symptoms
- Conditions
- Benign Prostatic HyperplasiaLower Urinary Tract Symptoms
- Interventions
- Registration Number
- NCT01021332
- Lead Sponsor
- Astellas Pharma Europe B.V.
- Brief Summary
Clinical study to examine the safety, tolerability and efficacy of long-term combination therapy of tamsulosin and solifenacin in the treatment of males with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) with a substantial storage component.
- Detailed Description
This is an open-label extension study following the double blind 905-CL-055 study
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 1067
- Completion of 12 weeks double-blind treatment in Study 905-CL-055
- Any significant PVR volume (>150 mL)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Total Group tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/6 mg) Participants who received at least one dose of open-label fixed dose combination (FDC) treatment Total Group tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/9 mg) Participants who received at least one dose of open-label fixed dose combination (FDC) treatment
- Primary Outcome Measures
Name Time Method Number of Participants With Adverse Events (AEs) From first dose of double-blind study drug (if on FDC in 905-CL-055) or first open-label dose up to 30 days after last dose of open-label study drug (in 905-CL-057) (up to 56 weeks) Safety is monitored by collecting AEs, which include abnormal lab parameters, vital signs or ECG data if the abnormality induced clinical signs or symptoms, needed active intervention, interruption or discontinuation of study drug or was clinically significant. A serious AE (SAE) was an AE resulting in death, persistent or significant disability/incapacity or congenital anomaly/birth defect, was life-threatening, required or prolonged hospitalization or was considered medically important. AEs were assessed by the Investigator for intensity (mild-no disruption of normal daily activities, moderate-affected normal daily activities or severe-inability to perform daily activities) and for causal relationship to study drug. A treatment-emergent adverse event (TEAE) was defined as an AE that occurred after the intake of first dose of double-blind study drug (if on FDC in 905-CL-055) or after first open-label dose until 30 days after the last dose of open-label study drug (in 905-CL-057).
Change From Baseline to End of Treatment in Post Void Residual (PVR) Volume Baseline and up to 52 weeks of FDC treatment PVR volume is the volume of urine retained after voiding. PVR volume was assessed by ultrasonography or bladder scan.
Change From Baseline to End of Treatment in Maximum Flow Rate (Qmax) Baseline and up to 52 weeks of FDC treatment Qmax during a micturition (urination) was recorded using uroflowmetry.
Change From Baseline to End of Treatment in Average Flow Rate (Qmean) Baseline and up to 52 weeks of FDC treatment Qmean during a micturition (urination) was recorded using uroflowmetry.
Change From Baseline to End of Treatment in Total International Prostate Symptom Score (IPSS) Baseline and up to 52 weeks of FDC treatment The International Prostate Symptom Score (IPSS) is a validated global questionnaire to assess the degree of urinary symptoms, based on answers to 7 questions concerning urinary symptoms: • Incomplete emptying of the bladder • Intermittency • Weak stream • Hesitancy • Frequency • Urgency • Nocturia Each question is assigned points from 0 to 5 indicating increasing severity of the symptom. Total score can range from 0 to 35 (mildly symptomatic to severely symptomatic).
Change From Baseline to End of Treatment in Total Urgency Frequency Score (TUFS) (Previously Known as Total Urgency Score [TUS]) Baseline and up to 52 weeks of FDC treatment The Patient Perception of the Intensity of Urgency Scale (PPIUS) is a validated scale completed as part of the micturition diary. For each micturition and/or incontinence episode, the participant rated the degree of associated urgency according to the following 5-point categorical scale: • 0. No urgency; • 1. Mild urgency; • 2. Moderate urgency; • 3. Severe urgency; • 4. Urgency incontinence TUS/TUFS was calculated as the sum of the PPIUS gradings from the 3-day diary divided by the number of days on which urgency grading was recorded. Higher scores indicate more severe urgency.
- Secondary Outcome Measures
Name Time Method Change From Baseline to End of Treatment in Mean Number of Micturitions Per 24 Hours Baseline and up to 52 weeks of FDC treatment A micturition is any voluntary urination, excluding episodes of incontinence only.The mean number of micturitions per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Voided Volume Per Micturition Baseline and up to 52 weeks of FDC treatment A micturition is any voluntary urination, excluding episodes of incontinence only. The mean volume voided per micturition was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Maximum Volume Voided Per Micturition Baseline and up to 52 weeks of FDC treatment A micturition is any voluntary urination, excluding episodes of incontinence only. The maximum volume voided per micturition was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Number of Urgency Episodes (PPIUS Grade 3 or 4) Per 24 Hours Baseline and up to 52 weeks of FDC treatment An urgency episode is defined as an episode of strong desire to void accompanied by fear of leakage or pain. The mean number of urgency episodes with PPIUS grade 3 (Severe urgency) or 4 (Urgency incontinence) per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Number of Urgency Incontinence Episodes Per 24 Hours Baseline and up to 52 weeks of FDC treatment An urgency incontinence episode is defined as an episode with any involuntary leakage of urine accompanied by or immediately preceded by urgency. The mean number of urgency incontinence episodes with PPIUS grade 3 (Severe incontinence) or 4 (Urgency incontinence) per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Number of Incontinence Episodes Per 24 Hours Baseline and up to 52 weeks of FDC treatment An incontinence episode is defined as an episode with any involuntary loss of urine. The mean number of incontinence episodes per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Number of Nocturia Episodes Per 24 Hours Baseline and up to 52 weeks of FDC treatment A nocturia episode is defined as waking up at night to void (i.e., any voiding associated with sleep disturbance between the time the participant goes to bed with the intention to sleep until the time the patient gets up in the morning with the intention to stay awake). The mean number of nocturia episodes per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in Mean Number of Pads Used Per 24 Hours Baseline and up to 52 weeks of FDC treatment The mean number of pads per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.
Change From Baseline to End of Treatment in IPSS Voiding Score Baseline and up to 52 weeks of FDC treatment The IPSS is a validated global questionnaire to assess the degree of urinary symptoms based on answers to 7 questions. Each question is assigned points from 0 to 5 indicating increasing severity of the particular symptom. The voiding score is the sum of the responses to 4 voiding questions (incomplete emptying of the bladder, intermittency, weak stream, hesitancy) and ranges from 0 to 20 (mildly symptomatic to severely symptomatic).
Change From Baseline to End of Treatment in IPSS Storage Score Baseline and up to 52 weeks of FDC treatment The IPSS is a validated global questionnaire to assess the degree of urinary symptoms based on answers to 7 questions concerning urinary symptoms. Each question is assigned points from 0 to 5 indicating increasing severity of the particular symptom. The storage symptom score is the sum of the responses to 3 storage questions (frequency,urgency and nocturia) and ranges from 0 to 15 (mildly symptomatic to severely symptomatic).
Change From Baseline to End of Treatment in IPSS Quality of Life (QoL) Score Baseline and up to 52 weeks of FDC treatment The QoL assessment was a single question asking the participant how he would feel about tolerating his current level of symptoms for the rest of his life. The answers ranged from 0 to 6 (delighted to terrible).
Change From Baseline to End of Treatment in Individual IPSS Scores Baseline and up to 52 weeks of FDC treatment The IPSS is a validated global questionnaire to assess the degree of urinary symptoms, based on answers to 7 questions concerning urinary symptoms: • Incomplete emptying of the bladder • Intermittency • Weak stream • Hesitancy • Frequency • Urgency • Nocturia Each question is assigned points from 0 to 5 indicating increasing severity of the symptom.
Change From Baseline to End of Treatment in Symptom Bother Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The Symptom Bother portion consists of an 8-item scale scored from 1 to 6.The total symptom bother score was calculated from the 8 answers and then transformed to range from 0 to 100, with 100 indicating worst severity. A negative change from baseline indicates an improvement.
Change From Baseline to End of Treatment in Health-related Quality of Life (HRQoL) Subscale: Coping Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6: • coping • concern • sleep • social interaction Coping score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.
Change From Baseline to End of Treatment in Health-related Quality of Life (HRQoL) Subscale: Concern Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6: • coping • concern • sleep • social interaction Concern score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.
Change From Baseline to End of Treatment in Health-related Quality of Life (HRQoL) Subscale: Sleep Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6: • coping • concern • sleep • social interaction Sleep score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.
Change From Baseline to End of Treatment in Health-related Quality of Life (HRQoL) Subscale: Social Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6: • coping • concern • sleep • social interaction Social score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.
Change From Baseline to End of Treatment in Health-related Quality of Life (HRQoL) Subscale: Total Score Baseline and up to 52 weeks of FDC treatment The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6: • coping • concern • sleep • social interaction Total score is calculated by adding the 4 HRQoL subscale scores and transforming to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.
Number of OAB-q Responders Based on Health-related Quality of Life: Total Score Baseline and up to 52 weeks of FDC treatment A OAB-q responder was defined as a participant with an improvement from baseline in HRQoL subscale total score ≥ 10.
Change From Baseline to End of Treatment in EQ-5D Mobility Score Baseline and up to 52 weeks of FDC treatment The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains: • mobility • self-care • usual activity • pain/discomfort • anxiety/depression Each domain has 3 response levels (1= no problem, 2= some problems, 3 = confined to bed).
Change From Baseline to End of Treatment in EQ-5D Self-care Score Baseline and up to 52 weeks of FDC treatment The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains: • mobility • self-care • usual activity • pain/discomfort • anxiety/depression Each domain has 3 response levels (1= no problem, 2= some problems, 3 = unable to wash/dress).
Change From Baseline to End of Treatment in EQ-5D Usual Activities Score Baseline and up to 52 weeks of FDC treatment The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains: • mobility • self-care • usual activity • pain/discomfort • anxiety/depression Each domain has 3 response levels (1= no problem, 2= some problems, 3 = unable to perform usual activities).
Change From Baseline to End of Treatment in EQ-5D Pain/Discomfort Score Baseline and up to 52 weeks of FDC treatment The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains: • mobility • self-care • usual activity • pain/discomfort • anxiety/depression Each domain has 3 response levels (1= no pain, 2= moderate pain, 3 = extreme pain).
Change From Baseline to End of Treatment in EQ-5D Anxiety/Depression Score Baseline and up to 52 weeks of FDC treatment The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains: • mobility • self-care • usual activity • pain/discomfort • anxiety/depression Each domain has 3 response levels (1= not anxious, 2= moderately anxious, 3 = extremely anxious).
Change From Baseline to End of Treatment in EQ-5D Visual Analogue Scale (VAS) Score Baseline and up to 52 weeks of FDC treatment Visual Analogue Scale (VAS) is part of the EQ-5D questionnaire. The VAS is self-rated by the participant ranging from 0 to 100 (worst imaginable health state to best imaginable health state).