E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
urinary incontinence caused by neurogenic detrusor overactivity (spinal lesion or multiple sclerosis) |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029279 |
E.1.2 | Term | Neurogenic bladder |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and efficacy of each of 2 dosages of BOTOX (200 U or 300 U) compared to placebo injected into the detrusor for the treatment of urinary incontinence caused by neurogenic detrusor overactivity in patients who have not been adequately managed with anticholinergic therapy |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
- Patient is male or female, aged 18 to 80 years old. - Written informed consent has and written Authorization of Use of sensitive personal data - Patient has urinary incontinence as a result of neurogenic detrusor overactivity for a period of at least 3 months prior to screening as a result of spinal cord injury or multiple sclerosis, determined by documented patient history. In addition: Spinal cord injury patients must have a stable neurological injury level at T1 or below (cervical injuries are excluded) occurring ≥ 6 months prior to screening Multiple sclerosis patients must be clinically stable in the investigators opinion for ≥ 3 months prior to screening day and have an Expanded Disability Status Scale score ≤ 6.5. - Patient has detrusor overactivity (defined as a phasic rise in bladder pressure during the filling phase determined by urodynamics) demonstrated during the screening period or Day 1 (prior to randomization). - Patient has not been adequately managed with one or more anticholinergics for their urinary incontinence, in the opinion of the investigator (inadequate response or intolerable side effects after at least one month of anticholinergic therapy on an optimized dose). - For patients taking anticholinergic medication for their neurogenic overactive bladder, dose is stable - Patient has a negative pregnancy result if female and of childbearing potential. - Patient experiences ≥ 14 episodes of urinary incontinence per week with no more than 2 incontinent-free days determined by completion of patient bladder diary during the screening period. - Patient currently uses or is willing to use clean intermittent catheterization to empty the bladder |
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E.4 | Principal exclusion criteria |
- any pelvic or urological abnormalities - elevated serum creatinine > 2 times the upper limit of normal - history of or currently unexplained hematuria - interstitial cystitis - bladder stones - surgery or other bladder disease - Patient has had previous or current botulinum toxin therapy - Patient has been immunized for any botulinum toxin serotype. - bladder cancer or suspect - prostate cancer. - detrusor compliance below 20 mL/cm H2O 8. Patient has 24 hour total volume voided > 3000 mL of urine - Patient has a post void residual volume above 150 mL - active genital infection - Patient uses any anti-platelet or anticoagulant therapy - hemophilia or other bleeding diatheses. - concurrent treatment or treatment within 6 months of Randomization/Day 1 with capsaicin or resiniferatoxin. - Patient is currently using or plans to use an implanted or non-implantable electrostimulation/neuromodulation device for treatment of overactive bladder. - known allergy or sensitivity to any components of the study medication, or any other products associated with the treatment and general study procedures. - pregnancy, nursing or planning a pregnancy during the study |
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E.5 End points |
E.5.1 | Primary end point(s) |
Number of episodes of urinary incontinence as recorded by patient bladder diary during the 7 days prior to each study visit (telephone and clinic). Primary timepoint is at Week 6 following the first treatment |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
the same IMP at other dose |
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E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 7 |