Intravesical Injection of Botulinum Toxin A Versus Saline for Neurogenic Detrusor Overactivity

NCT01091727 | Completed Phase 3

• 1 other identifier: 0922006
• Study Type: interventional
• Target: 57
• Locations: 1 country
• Sites: 1

Brief Summary

This is a prospective, multicentre (7 sites), randomized, double-blind, study comparing intravesical injection of BOTOX to placebo in 56 subjects with NDO secondary to spinal cord injury or multiple sclerosis. Study subjects will be randomized to one of the following two treatment groups: Group 1 n=28 BOTOX - 300U Group 2 n=28 Placebo BOTOX (saline) All study subjects will receive one injection cycle (BOTOX 300U or Placebo) at Visit 2 (Treatment, Day 0) as per Supplement III. The study duration is approximately 61 weeks and consists of a Pre-Treatment Evaluation, a Treatment/Randomization Visit (Visit 2, Day 0), Telephone Follow-ups at 1, 3 and 4 weeks post-treatment, and Follow-up Visits at 6, 24 and 36 weeks (Visits 3 to 5). At Week 36, subjects will be offered open-label BOTOX 300U and will be followed for an additional 6 months, returning for evaluations at Weeks 48 and 60.

Conditions

Neurogenic Detrusor Overactivity

Keywords

Neurogenic; Detrusor; Overactive; Overactivity; Bladder; Spinal; Cord; Injury

Outcome Measures

Primary Outcomes (1)

• Efficacy

  Frequency of Incontinence Episodes over 3 days (3-Day Voiding Diary)

  36 weeks

Secondary Outcomes (1)

• Efficacy

  36 weeks

Study Arms (2)

Botulinum toxin A

EXPERIMENTAL

Botulinum toxin A 300U diluted with sterile saline (1 ml per injection site) and injected into 30 sites of the bladder, sparing the trigone.

Drug: Botulinum toxin A

Placebo

PLACEBO COMPARATOR

Sterile saline 30 cc injected into 30 sites in the bladder, sparing the trigone.

Drug: Botulinum toxin A

Interventions

Botulinum toxin A DRUG

Comparison of intra-detrusor injection of 300U of Botulinum toxin A versus placebo for effect on neurogenic detrusor overactivity and urinary incontinence.

Also known as: Botox

Botulinum toxin A; Placebo

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Outpatient, male or female subjects, of any race, between 18 and 75 years of age. Female subjects of childbearing potential must have a negative urine pregnancy test result on the day of Treatment (Visit 2) and practice a reliable method of contraception.
• Subjects with a neurogenic bladder and detrusor overactivity secondary to either a spinal cord injury or multiple sclerosis.
• Subjects with urinary incontinence (minimum of one occurrence per day) despite current treatment.
• Subjects with serum creatinine within normal limits and normal renal function.
• Subjects on a stable dose (minimum one month) of concomitant medication for NDO.
• Subjects able to understand the requirements of the study, including completing questionnaires and signing Informed Consent.

You may not qualify if:

• Female subjects who are pregnant (positive urine pregnancy test), are planning to become pregnant during the study period, have an infant they are breast-feeding, or who are of childbearing potential and not practicing a reliable method of birth control.
• Subjects with a history of transurethral sphincterotomy, bladder neck or prostatic resection, previous bladder surgery including myomectomy or augmentation cystoplasty.
• Subjects with chronic indwelling catheters.
• Subjects with any medical condition that may increase their risk of exposure to botulinum toxin including diagnosed Myasthenia Gravis, Eaton-Lambert Syndrome, Amyotrophic Lateral Sclerosis or any other disease that might interfere with neuromuscular function.
• Subjects with an allergy or sensitivity to any component of BOTOX® (Section 5.2).
• Subjects unable to discontinue any agents that might interfere with neuromuscular function (i.e., aminoglycoside antibiotics, curare-like agents, etc.).
• Subjects with, in the opinion of the Investigator, unstable stable multiple sclerosis.
• Subjects with known, uncontrolled systemic disease.
• Subjects with evidence of recent alcohol/drug abuse.
• Subjects who, in the opinion of the Investigator, have a significant condition or situation that may put the subject at significant risk, confound the study results, or interfere significantly with the subject's participation in the study.
• Subjects with a history of poor cooperation, non-compliance, or unreliability.
• Subjects currently participating in an investigational drug study or who have participated in an investigational drug study within 30 days of the Baseline Visit.

Sponsors & Collaborators

• Sunnybrook Health Sciences Centre: lead
• ethica Clinical Research Inc.: collaborator

Study Sites (1)

Sunnybrook Health Sciences Centre

Toronto, Ontario, M4N 3M5, Canada

Location

MeSH Terms

Conditions

Cone-Rod Dystrophies; Wounds and Injuries

Interventions

Botulinum Toxins, Type A

Condition Hierarchy (Ancestors)

Eye Diseases, Hereditary; Eye Diseases; Retinal Dystrophies; Retinal Degeneration; Retinal Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Botulinum Toxins; Metalloendopeptidases; Endopeptidases; Peptide Hydrolases; Hydrolases; Enzymes; Enzymes and Coenzymes; Metalloproteases; Bacterial Proteins; Proteins; Amino Acids, Peptides, and Proteins; Bacterial Toxins; Toxins, Biological; Biological Factors

Study Officials

• Sender Herschorn, MD

  Sunnybrook Health Sciences Centre

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: March 22, 2010
• First Posted: March 24, 2010
• Study Start: October 1, 2006
• Primary Completion: April 1, 2009
• Study Completion: April 1, 2009
• Last Updated: March 24, 2010

Record last verified: 2010-03

Locations

CA (1)