A study to investigate DYSPORT® for the treatment of subjects with loss of bladder control and involuntary urination as a result of spinal cord injury or multiple sclerosis
- Conditions
- rinary incontinence caused by neurogenic detrusor overactivity due to either spinal cord injury or multiple sclerosisMedDRA version: 20.1 Level: PT Classification code 10046543 Term: Urinary incontinence System Organ Class: 10038359 - Renal and urinary disordersTherapeutic area: Not possible to specify
- Registration Number
- EUCTR2015-000507-44-BE
- Lead Sponsor
- Ipsen Innovation
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- Not specified
- Target Recruitment
- 330
The following inclusion criteria will be assessed at the beginning of the Screening process:
1) Written informed consent prior to any study-related procedure.
2) Male or female, aged 18 to 80 years inclusive.
3) UI for at least 3 months prior to Screening as a result of NDO due to SCI or MS.
4) Subjects with SCI must have a stable neurological injury at T1 level or below which occurred at least 6 months prior to Screening.
OR
Subjects with MS must be clinically stable in the investigator’s opinion, with no exacerbation (relapse) of MS for at least 3 months prior to Screening.
5) Subjects in the non-urodynamic subset only, must have NDO (defined as the presence of involuntary detrusor contractions during the storage phase of urodynamic filling cystometry) on a historic urodynamic assessment performed in the 12 months prior to Screening
• If urodynamics are not performed in the 12 months prior to Screening or if results are not available, then a urodynamic filling cystometry assessment must be performed during Screening, per local practice (see inclusion criterion # 16).
6) Subjects must have had an inadequate response after at least 4 weeks of oral medications used in the treatment of NDO (e.g. anticholinergics, beta-3 agonists)and/or have intolerable side-effects.
7) Subjects who are to continue on concomitant oral medications for NDO during the study must be on a stable dose for at least 4 weeks prior to Screening.
8) Subjects who are to continue on concomitant oral medications for NDO during the study must be willing to continue on the same medications and doses during Screening and for at least 12 weeks following the first IMP administration.
9) Routinely performing CIC to ensure adequate bladder emptying (regularly performing CIC at a regimen of every 4–6 hours during waking hours, or more frequently). CIC regimen must be stable for at least 4 weeks prior to Screening (CIC may be performed by the subject or caregiver).
10) Subjects must be willing to continue on the same CIC regimen during Screening and for at least 12 weeks following the first IMP administration.
11) Female subjects of childbearing potential must have a negative pregnancy test result and be willing to use reliable contraceptive measures throughout study participation. Reliable forms of contraception include but are not limited to:
• hormonal contraceptives (e.g. oral, patch, injection)
• double barrier (e.g. male condom plus spermicide, or female diaphragm plus
spermicide)
• intrauterine device
• male partner has had a vasectomy
• total abstinence from intercourse with male partners (periodic abstinence is not
acceptable).
Female subjects meeting any of the following criteria are not considered to be of
childbearing potential:
• postmenopausal (=47 years of age and amenorrhoeic for at least 12 consecutive months)
• have been sterilised s
The following exclusion criteria will be assessed throughout the Screening process:
1) Any current condition (other than NDO) that may impact on bladder function, including but not limited to:
• predominant stress UI (rather than NDO-related incontinence)
• bladder stones
• current symptomatic urinary tract infection
• current active genitourinary infection, e.g. genital warts
• uterine prolapse
• cystocele
• rectocele.
Mild uterine prolapse, cystocele or rectocele that does not impact on bladder function
is not exclusionary.
2) Previous or current, tumour or malignancy affecting the spinal column or spinal cord, or any other nonstable cause of SCI.
3) Surgery less than 6 months prior to Screening for bladder stones.
4) Surgery less than 6 months prior to Screening for uterine prolapse, cystocele or rectocele.
5) Previous open surgery for NDO, e.g. augmentation cystoplasty.
6) Previous urethral stent placement or sphincterotomy.
7) Previous or current diagnosis of, or symptoms/signs/investigations suggestive of, significant urological or pelvic disease, including but not limited to:
• urinary tract malignancy (e.g. bladder, prostate, urethral or kidney cancer)
• hydronephrosis
• interstitial cystitis/bladder pain syndrome
• müllerian duct cysts
• radiation cystitis
• genitourinary tuberculosis.
8) Previous or current uninvestigated haematuria. Subjects with investigated haematuria may enter the study if significant urological/renal pathology has been ruled out to the satisfaction of the investigator.
9) Any condition that will prevent cystoscopic treatment administration or CIC usage e.g. urethral strictures.
10) Current indwelling bladder catheter, or removal of indwelling bladder catheter less than 4 weeks prior to Screening.
11) BTX-A treatment within 9 months prior to Screening for any urological condition
(e.g. detrusor or urethral sphincter treatments).
12) BTX-A treatment within 3 months prior to Screening for any non-urological condition.
13) Bladder instillation with any pharmacologic agent less than 3 months prior to
Screening.
14) Use of capsaicin or resiniferatoxin less than 6 months prior to Screening.
15) Any neuromodulation/electrostimulation usage for urinary symptoms/incontinence
within 4 weeks prior to Screening. Any implanted neuromodulation device must be switched off at least 4 weeks prior to Screening and must remain off throughout study participation.
16) Any concomitant therapy usage that, in the investigator’s opinion, would interfere with the evaluation of safety or efficacy of the IMP, and/or confound the study results.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method