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An Extension Study Investigating the Efficacy and Safety of a Fast-Dissolving ("Melt") Formulation of Desmopressin for the Treatment of Nocturia in Adults

Phase 3
Completed
Conditions
Nocturia
Interventions
Registration Number
NCT00615836
Lead Sponsor
Ferring Pharmaceuticals
Brief Summary

The purpose of this study was to investigate the long term efficacy and safety of several doses of the Melt formulation of desmopressin in a broad population of adult patients with nocturia.

Detailed Description

FE992026 CS31 was a multicenter open-label extension study for patients who were enrolled in Study FE992026 CS29 (NCT00477490) and had completed at least Visit 3E in Part II of that study.

The CS29 study was structured into 2 double-blind parts (Part I and Part II). In Part I, the initial 28-day treatment period, participants were randomly assigned to 1 of 5 treatment groups: placebo or desmopressin Melt 10 μg, 25 μg, 50 μg, or 100 μg. Immediately upon completion of Part I of the study, all participants on active treatment continued into Part II on the same treatment for approximately 1 to 6 months. Participants assigned to placebo in Part I were randomly assigned to 1 of the 4 active treatments in Part II, based on re-randomization predetermined at the initial randomization (to maintain the blind). Part II began at the final visit for Part I and continued until the database for Part I was locked. Therefore, treatment duration for Part II varied between 1 and 6 months, depending upon when the participant entered.

Upon completion of Part II of CS29, participants were given the option to participate in the open-label extension study (CS31). During CS31, each participant assigned to the 10 μg dose was switched to a higher dose in an open-label manner among the remaining 3 higher doses.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
554
Inclusion Criteria
  • Written informed consent prior to the performance of any study-related activity.
  • Was randomized into Part II of Protocol FE992026 CS29 (NCT00477490), entitled "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" and have completed at least Visit 3E in Part II (Day 15).
Exclusion Criteria
  • Patients using loop diuretics (furosemide, torsemide, ethacrynic acid).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Desmopressin Melt 10 μgDesmopressin MeltParticipants received desmopressin melt 10 μg once a day, placed under the tongue one hour before bedtime until they were re-randomized to one of the other doses of desmopressin Melt (25 μg, 50 μg, or 100 μg).
Desmopressin Melt 25 μgDesmopressin MeltParticipants received desmopressin melt 25 μg once a day, placed under the tongue one hour before bedtime for up to 2 years and 2.5 months.
Desmopressin Melt 50 μgDesmopressin MeltParticipants received desmopressin melt 50 μg once a day, placed under the tongue one hour before bedtime for up to 2 years and 2.5 months.
Desmopressin Melt 100 μgDesmopressin MeltParticipants received desmopressin melt 100 μg once a day, placed under the tongue one hour before bedtime for up to 2 years and 2.5 months.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Mean Number of Nocturnal VoidsBaseline of Study CS29 and Weeks 8, 12, 20, 28, 52-56, 72-76, and 92-96.

Participants completed a voiding diary for 3 consecutive 24-hour periods prior to the study visit in which they recorded each nocturnal urination (void). The mean number of voids per night was the average number of voids from the 3-day diary. Baseline refers to Baseline of Study CS29 and the number of weeks represents the total exposure to study drug.

Participants in the 10μg arm are included only until the time of dose escalation.

Percentage of Participants With a Greater Than 33% Reduction in the Mean Number of Nocturnal VoidsBaseline of Study CS29 and Weeks 8, 12, 20, 28, 52-56, 72-76, and 92-96.

Percentage of participants with \>33% reduction from Baseline in the mean number of nocturnal urinations per night, calculated from the 3-day voiding diary completed prior to each study visit.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in Initial Period of Undisturbed SleepBaseline of Study CS29 and Weeks 8, 12, 20, 28, 52-56, 72-76, and 92-96.

Participants completed a sleep diary on 3 consecutive mornings prior to each study visit, from which the initial period of undisturbed sleep was calculated and averaged for the 3 days. The Initial Period of Undisturbed Sleep is the time elapsed from bedtime to either first void or morning arising minus the minutes it took to fall asleep. Baseline refers to Baseline of Study CS29 and the number of weeks represents the total exposure to study drug.

Participants in the 10μg arm are included only until the time of dose escalation.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Total Sleep TimeBaseline of Study CS29 and Weeks 8, 12, 20, 28, 52-56, 72-76, and 92-96.

Participants completed a sleep diary on 3 consecutive mornings prior to each study visit, from which the total sleep time was calculated and averaged for the 3 days. Baseline refers to Baseline of Study CS29 and the number of weeks represents the total exposure to study drug.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in NQoL Bother/Concern Domain ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The NQoL is a self-administered 13-item 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 12 core items are scored on a 0 to 4 scale with higher numbers indicating a better quality of life. The bother/concern domain summary score is calculated by transforming the raw score into a 0-100 scale with higher numbers indicating a better impact on quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in Nocturia Quality of Life (NQoL) Sleep/Energy Domain ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The NQoL is a self-administered 13-item 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 12 core items are scored on a 0 to 4 scale with higher numbers indicating a better quality of life. The sleep/energy domain summary score is calculated by transforming the raw score into a 0-100 scale with higher numbers indicating a better impact on quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in International Consultation on Incontinence Modular Questionnaire - Nocturia (ICIQ-N) Nighttime Urination Bother ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The ICIQ-N is a self-administered 4-item questionnaire designed to assess the frequency and bother of daytime and nighttime urination. To assess nighttime urination bother, participants were asked to rate the degree of bother of nighttime urination by answering the question "Night time urination: How much does this bother you?" on a scale ranging from 0 (not at all) to 10 (a great deal). Higher numbers indicate greater bother.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in Nocturia Quality of Life (NQoL) Overall ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The NQoL is a self-administered 13-item 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 (which is not included in the overall score). The 12 core items are scored on a 0 to 4 scale, and the overall score is calculated by transforming the raw score into a 0-100 scale with higher numbers indicating better impact on quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in Pittsburgh Sleep Quality Index (PSQI) Global ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The PSQI is a self-administered 19-item questionnaire designed to assess sleep quality and disturbances. The 19 individual items are scored on an evenly weighted 0 to 3 scale and generate 7 component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these 7 components yields 1 global score ranging from 0 to 21. Higher numbers indicate greater sleep disturbance.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in the Short Form-12, Version 2 (SF-12v2) Mental Component Summary ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

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 spanning 8 domains: physical functioning, role function-physical, role function-emotional, bodily pain, general health, vitality, social functioning, and mental health. These scales are combined to create 2 summary measures: the Physical Health Summary and Mental Health Summary. The Mental Health Summary score ranges from 0 to 100, where higher numbers indicate better quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Change From Baseline in the Short Form-12, Version 2 (SF-12v2) Physical Component Summary ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

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 spanning 8 domains: physical functioning, role function-physical, role function-emotional, bodily pain, general health, vitality, social functioning, and mental health. These scales are combined to create 2 summary measures: the Physical Health Summary and Mental Health Summary. The Physical Health Summary score ranges from 0 to 100, where higher numbers indicate better quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Participants With Treatment-Emergent Adverse Events (AEs)From first dose of study drug in Study CS29 until the end of study CS31 (up to 35 months).

An AE was any untoward medical occurrence that did not necessarily have a causal relationship with the study drug. An adverse drug reaction (ADR) was an AE evaluated by the Investigator as being probably or possibly causally related to treatment with the study drug.

A serious AE (SAE) was any event that resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity or congenital anomaly/birth defect or was an important medical event that could have jeopardized the patient's safety or required medical or surgical intervention to prevent 1 of the outcomes listed above. The intensity of an AE was defined as severe if it resulted in the inability to work or perform usual activities.

Change From Baseline in the Nocturia Quality of Life (NQoL) Global Quality of Life ScoreBaseline of Study CS29, Week 16, Visit 12 (approximately 56-78 weeks total study time) and End of Study (up to a maximum of 35 months)

The NQoL is a self-administered 13-item 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 global QoL question is scored on a scale ranging from 0 (not at all) to 10 (a great deal). Higher numbers indicate better impact on quality of life.

Participants in the 10μg arm are included only until the time of dose escalation.

Trial Locations

Locations (68)

Radiant Research, Kansas City

🇺🇸

Overland Park, Kansas, United States

Women's Health Research Group, LLC

🇺🇸

Clearwater, Florida, United States

Urology of Virginia PC

🇺🇸

Virginia Beach, Virginia, United States

Radiant Research, Inc

🇺🇸

Chicago, Illinois, United States

Women's Clinic of Lincoln, P.C.

🇺🇸

Lincoln, Nebraska, United States

Upstate Urology

🇺🇸

NY, New York, United States

Seattle Urology Research Center

🇺🇸

Seattle, Washington, United States

Sheldon J Freedman Ltd

🇺🇸

Las Vegas, Nevada, United States

Investigational site - NationsMed Clinical Research

🇺🇸

Houston, Texas, United States

IMED Research, P.A.

🇺🇸

San Antonio, Texas, United States

Urology Associates PC

🇺🇸

Denver, Colorado, United States

Downtown Women's Health Care

🇺🇸

Denver, Colorado, United States

Genitourinary Surgical Consultants

🇺🇸

Denver, Colorado, United States

Advanced Urology Medical Center

🇺🇸

Anaheim, California, United States

Impact Clinical Trials

🇺🇸

Beverly Hills, California, United States

Arkansas Primary Care Clinic, PA

🇺🇸

Little Rock, Arkansas, United States

California Professional Research

🇺🇸

Newport Beach, California, United States

West Coast Clinical Research

🇺🇸

Tarzana, California, United States

Western Clinical Research

🇺🇸

Torrance, California, United States

Connecticut Clinical Research Center, LLC

🇺🇸

Middlebury, Connecticut, United States

Tampa Bay Urology

🇺🇸

Tampa, Florida, United States

South Florida Medical Research

🇺🇸

Aventura, Florida, United States

Radiant Research - St. Petersburg

🇺🇸

Pinellas Park, Florida, United States

Investigational site

🇨🇦

North Bay, Ontario, Canada

Sunrise Medical Research

🇺🇸

Plantation, Florida, United States

Southeastern Medical Research Institute

🇺🇸

Columbus, Georgia, United States

Benchmark Research

🇺🇸

Metairie, Louisiana, United States

Regional Urology, LLC

🇺🇸

Shreveport, Louisiana, United States

Accelovance

🇺🇸

Houston, Texas, United States

FutureCare Studies, Inc.

🇺🇸

Springfield, Massachusetts, United States

Radiant Research, Minneapolis

🇺🇸

Edina, Minnesota, United States

Central Jersey Medical Research Center

🇺🇸

Elizabeth, New Jersey, United States

Urology Group of New Mexico, PC

🇺🇸

Albuquerque, New Mexico, United States

AccuMed Research Associates

🇺🇸

Garden City, New York, United States

University Urology Associates

🇺🇸

New York, New York, United States

Hudson Valley Urology, PC

🇺🇸

Poughkeepsie, New York, United States

New Hanover Medical Research

🇺🇸

Wilmington, North Carolina, United States

Radiant Research Inc.

🇺🇸

Cincinnati, Ohio, United States

Radiant Research - Akron

🇺🇸

Mogadore, Ohio, United States

Philadelphia Clinical Research, LLC

🇺🇸

Philadelphia, Pennsylvania, United States

Urologic Consultants of SE PA

🇺🇸

Bala Cynwyd, Pennsylvania, United States

Piedmont Medical Research Associates

🇺🇸

Winston-Salem, North Carolina, United States

Advanced Clinical Concepts

🇺🇸

West Readings, Pennsylvania, United States

Palmetto Medical Research

🇺🇸

Mt. Pleasant, South Carolina, United States

Radiant Research, Greer

🇺🇸

Greer, South Carolina, United States

Holston Medical Group

🇺🇸

Kingsport, Tennessee, United States

Advanced Research Associates

🇺🇸

Corpus Christi, Texas, United States

Virginia Urology

🇺🇸

Richmond, Virginia, United States

Can-Med Clinical Research Inc.

🇨🇦

Victoria, British Columbia, Canada

Women's Clinical Research Center

🇺🇸

Seattle, Washington, United States

Southern Interior Medical Research Inc.

🇨🇦

Kelowna, British Columbia, Canada

Investigational site - Clinical Research

🇨🇦

Victoria, British Columbia, Canada

Brantford Urology Research

🇨🇦

Brantford, Ontario, Canada

Investigational site - Professional Corporation

🇨🇦

Fredericton, New Brunswick, Canada

Guelph Urology Associates

🇨🇦

Guelph, Ontario, Canada

Lawrenceville Urology, P.A. DBA

🇺🇸

Lawrenceville, New Jersey, United States

Carolina Urologic Research Center

🇺🇸

Myrtle Beach, South Carolina, United States

Radiant Research San Antonio

🇺🇸

San Antonio, Texas, United States

Radiant Research, Inc.

🇺🇸

St. Louis, Missouri, United States

Investigational site - Adult & Pediatric Urology

🇺🇸

Carmel, New York, United States

San Diego Uro-Reseach

🇺🇸

San Diego, California, United States

PharmQuest

🇺🇸

Greensboro, North Carolina, United States

Innovative Clinical Trials

🇺🇸

San Antonio, Texas, United States

The Male/Female Health and Research

🇨🇦

Barrie, Ontario, Canada

The Fe/Male Health Centres

🇨🇦

Oakville, Ontario, Canada

Regional Medical Center and Diagnostic

🇺🇸

Humble, Texas, United States

NationsMed

🇺🇸

Stafford, Texas, United States

Radiant Research

🇺🇸

West Palm Beach, Florida, United States

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