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Efficacy of Combined Pharmacotherapy Versus Solifenacin With Vaginal Estrogen Cream for Women With Detrusor Overactivity

Phase 4
Recruiting
Conditions
Urinary Bladder, Overactive
Effect of Drug
Interventions
Drug: Combination pharmacotherapy
Registration Number
NCT06197295
Lead Sponsor
Mackay Memorial Hospital
Brief Summary

To investigates the effects of combined pharmacotherapy with solifenacin and mirabegron versus solifenacin with vaginal estrogen cream in women with detrusor overactivity.

Detailed Description

Women with detrusor overactivity who were refractory to anti-muscarinics were enrolled for prospective study. Patients were divided into two groups: one receive combined pharmacotherapy with solifenacin and mirabegron, and the other received solifenacin and vaginal estrogen cream. Incontinence-related symptoms distress and impact on quality of life were evaluated by short form of Urinary Distress Inventory, (UDI-6), Incontinence Impact Questionnaire (IIQ-7) and Overactive Bladder Symptom Score (OABSS). Objective outcomes include changes from baseline in episodes of daily micturition, urgency, urinary incontinence and nocturia.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
200
Inclusion Criteria
  • Patients with detrusor overactivity which defined as a urodynamic observation characterized by involuntary detrusor contractions during the filling phase. Those who were refractory to monotherapy with anti-muscarinics were enrolled for prospective study.
Exclusion Criteria
  • Postvoid urine retention before treatment
  • Women who had medical illness and contraindication for using solifenacin and mirabegron, such as narrow-angle glaucoma and hypertension
  • Concerns for using estrogen include: Women with history of cerebrovascular disease; thromboembolic disorders; gallbladder disease; known or suspected breast carcinoma; estrogen-dependent neoplasm or undiagnosed abnormal genital bleeding.
  • Women who were on hormone replacement therapy within 3 months were also excluded from the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Solifenacin with vaginal estrogen creamSolifenacin with vaginal estrogen creamSolifenacin 5mg once per day with vaginal conjugated equine estrogen (CEE) 0.625 mg twice a week.
Combination pharmacotherapyCombination pharmacotherapyCombined solifenacin 5mg and mirabegron 25mg once per day.
Primary Outcome Measures
NameTimeMethod
Short form of Urinary Distress Inventory (UDI-6)Assess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

UDI-6 is a valid questionnaire, used particularly to investigate symptoms associated with lower urinary tract dysfunction and inquire on irritative, stress, and obstructive or discomfort complaints. UDI-6 consists of six items: frequent urination; leakage related to feeling of urgency; leakage related to activity, coughing, or sneezing; small amounts of leakage (drops); difficulty emptying the bladder; and pain or discomfort in the lower abdominal or genital area. The total score ranges from 0 to 18 , with a higher score indicating more severe of incontinence.

Short form of Incontinence Impact Questionnaire (IIQ-7)Assess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

The IIQ-7 assess the impact of urinary incontinence on QoL. 7 items assess influence of urinary incontinence on physical activity, travel, social/relationships \& emotional health. Each item is scored between 0 (activities not affected at all) to 3 (activities greatly affected). The total score ranges from 0 to 21, with a higher score indicating more severe of incontinence.

Overactive Bladder Symptom Score (OABSS)Assess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

The total OABSS is the sum of four symptom scores: daytime frequency (score 0-2), nighttime frequency (score 0-3), urgency (score 0-5), and urgency incontinence (score 0-5). The total score ranges from 0 to 15, with a higher score indicating more severe of OAB symptoms.

Secondary Outcome Measures
NameTimeMethod
Episodes of daily micturitionAssess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

Patients report daily lower urinary tract symptoms episodes

Episodes of daily nocturiaAssess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

Patients report daily lower urinary tract symptoms episodes

Episodes of daily urgencyAssess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

Patients report daily lower urinary tract symptoms episodes

Episodes of daily incontinenceAssess before treatment and 1 month, 3 months, 6 months and 1 year after treatment

Patients report daily lower urinary tract symptoms episodes

Trial Locations

Locations (1)

Mackay Memorial Hospital

🇨🇳

Taipei, Taiwan

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