Overactive Bladder (OAB)Phase 4PILLARNCT02216214
Study to Evaluate the Efficacy, Safety, and Tolerability of Mirabegron in Older Adult Subjects With Overactive Bladder (OAB)
A Phase 4 study testing Mirabegron in people with Overactive Bladder (OAB), run by Astellas Pharma Global Development, Inc. at 120 sites in 2 countries.
Trial summary
The purpose of this study was to assess the efficacy, safety and tolerability of mirabegron versus placebo in the treatment of older adult subjects with OAB. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- Overactive Bladder (OAB)
- What is being tested?
- Mirabegron
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 888 participants
- Where
- 120 sitesin 2 countries
- Study dates
- 7 Oct 2014to 2 Jan 2018
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Who may be able to join
- Subject is willing and able to complete the micturition diary and questionnaires correctly.
- Subject has symptoms of wet overactive bladder (OAB) (urinary frequency and urgency with incontinence) for greater than or equal to 3 months prior to Screening.
- Subject agrees not to participate in another interventional study from the time of screening until the final study visit.
- Inclusion Criteria assessed after placebo run-in period at Visit 3 (Baseline):
- Subject continues to meet all inclusion criteria of Visit 1.
- Subjects must experience at least one incontinence episode in the placebo run-in period based on the 3-day micturition diary.
- Subject must experience at least 3 episodes of urgency (grade 3 or 4) based on the 3-day micturition diary.
- Subject must experience an average of greater than or equal to 8 micturitions/day based on the 3-day micturition diary.
Who cannot join
- Subject has ongoing symptoms suggestive of bladder outlet obstruction (BOO) or history of BOO that is currently not well controlled.
- Subject has Post-Void Residual Volume (PVR) greater than 150 mL.
- Subject has neurogenic bladder or neurological dysfunction or injury which could affect the lower urinary tract or nerve supply.
- Subject has significant stress incontinence or mixed stress/urgency incontinence where stress is the predominant factor as determined by the Investigator (for female subjects confirmed by a cough provocation test). Subjects with a history of stress incontinence that is currently treated (e.g. remote history of surgery for stress incontinence) may be included as long as they pass cough provocation test.
- Subject has an indwelling catheter or practices intermittent self-catheterization.
- Subject has evidence of Urinary Tract Infection (UTI). Urine culture and sensitivity will be performed for positive leukocytes, or nitrites, or turbidity, or at the investigator's discretion and will be confirmed with a culture greater than 100,000 cfu/mL. If a subject has a UTI at Screening (Visit 1), the subject can be rescreened after successful treatment of the UTI (confirmed by a laboratory result of negative urine culture).
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- Subject has a chronic inflammatory condition such as interstitial cystitis, bladder stones, previous pelvic radiation therapy, or previous or current malignant disease of the pelvic organs (i.e., within the confines of the pelvis including the bladder and rectum in both sexes and the uterus, ovaries, and fallopian tubes in females; organs of the lower gastrointestinal tract are not necessarily considered pelvic organs as the distal ascending colon, the full transverse colon and proximal portion of the descending colon are in the abdomen).
- Subject resides in a nursing home.
- Subject is likely to enter a hospital or nursing home due to medical instability within the next 6 months in the opinion of the Investigator.
- Subject has received intravesical injection in the past 12 months with botulinum toxin, resiniferatoxin, or capsaicin.
- Subject has received electro-stimulation therapy for OAB (e.g. sacral nerve stimulation or Percutaneous Tibial Nerve Stimulation [PTNS]).
- Subject began or has changed a bladder training program or pelvic floor exercises less than 30 days prior to Screening.
- Subject has moderate or severe hepatic impairment defined as Child-Pugh Class B or C.
- Subject has severe renal impairment defined as estimated creatinine clearance less than 29 mL/min determined by Estimated Glomerular Filtration Rate (eGFR, Cockroft-Gault, or MDRD formulae). A subject with end stage renal disease or undergoing dialysis is also not a candidate for the study.
- Subject has severe uncontrolled hypertension, which is defined as a sitting systolic blood pressure greater than or equal to 180 mmHg and/or diastolic blood pressure greater than or equal to 110 mmHg.
- Subject has evidence of QT prolongation on electrocardiogram (ECG) defined as QTc greater than 450 msec for males, QTc greater than 470 msec for females or a known history of QT prolongation.
- Subject has a clinically significant ECG abnormality, as determined by the Investigator.
- Subject has aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than 2x upper limit of normal (ULN), or γ-GT greater than 3x ULN and considered clinically significant by the Investigator.
- Subject has a hypersensitivity to any components of mirabegron, other β-AR agonists, or any of the inactive ingredients.
- Subject has any clinically significant condition, which in the opinion of the Investigator makes the subject unsuitable for study participation.
- Subject has been treated with an experimental device within 28 days or received an investigational agent within 28 days or 5 half-lives, whichever is longer, prior to Screening.
- Subject has a concurrent malignancy or history of any malignancy (within the past 5 years), except non-metastatic basal or squamous cell carcinoma of the skin that has been treated successfully.
- Subject with current history of alcohol and/or drug abuse.
- Subject is using prohibited medications which cannot be stopped safely during the period.
- Subject has stopped, started or changed the dose of a restricted medication within the last 30 days prior to Screening.
- Subject is involved in the conduct of the study as an employee of the Astellas group, third party associated with the study, or the study site team.
- Subject has previously received mirabegron.
- Exclusion Criteria assessed after placebo run-in period at Visit 3 (Baseline):
- Subject fulfills any exclusion criteria of Visit 1 (subject does not need to repeat screening assessments [PVR, cough provocation test, chemistry/hematology/urinalysis]).
- Subject was non-compliant during 2-week placebo run-in period, defined as taking less than 80% or greater than 120% of study medication.
- Subject has any systolic blood pressure measurement > 180 mmHg or diastolic blood pressure measurement > 110 in the 3-day diary or during the baseline visit.
Trial locations and contacts
120 sites in 2 countries.
120 sites in 2 countries
United States103 sites
Site US00067
Akron, Ohio, 44313
Site US00140
Albuquerque, New Mexico, 87102
Site US00176
Anaheim, California, 92801
Site US00009
Anchorage, Alaska, 99503
Site US00025
Annapolis, Maryland, 21401
Site US00104
Augusta, Kansas, 67010
Site US00175
Austin, Texas, 78705
Site US00048
Beverly Hills, California, 90211
Site US00142
Beverly Hills, California, 90212
Site US00159
Billings, Montana, 59102
Site US00041
Boise, Idaho, 83642
Site US00032
Bristol, Tennessee, 37620
Site US00091
Brockton, Massachusetts, 02301
Site US00016
Brooklyn, New York, 11215
Site US00064
Brooksville, Florida, 34601
Site US00153
Charlotte, North Carolina, 28209
Site US00154
Chattanooga, Tennessee, 37421
Site US00050
Cincinnati, Ohio, 45249
Site US00095
Cleveland, Ohio, 44109
Site US00026
Colorado Springs, Colorado, 80907
Site US00132
Concord, North Carolina, 28025
Site US00080
Coral Gables, Florida, 33134
Site US00002
DeBary, Florida, 32713
Site US00001
DeLand, Florida, 32720
Site US00017
DeLand, Florida, 32720
Site US00039
Denver, Colorado, 80220
Site US00004
Denver, Colorado, 80239
Site US00113
East Brunswick, New Jersey, 08816
Site US00018
Edgewater, Florida, 32132
Site US00024
Edina, Minnesota, 55435
Site US00085
Fargo, North Dakota, 58103
Site US00027
Fleming Island, Florida, 32003
Site US00053
Franklin, Tennessee, 37064
Site US00056
Grand Rapids, Michigan, 49503
Site US00122
Greensboro, North Carolina, 27403
Site US00060
Greenwood, Indiana, 46143
Site US00150
Hawaiian Gardens, California, 90716
Site US00151
Hialeah, Florida, 33016
Site US00131
Houston, Texas, 77030
Site US00066
Huntsville, Alabama, 35801
Site US00174
Hurst, Texas, 76054
Site US00046
Jeffersonville, Indiana, 47130
Site US00179
Jupiter, Florida, 33458
Site US00003
Kalamazoo, Michigan, 49009
Site US00057
Kissimmee, Florida, 34744
Site US00172
Lake Charles, Louisiana, 70601
Site US00076
Lakeland, Florida, 33805
Site US00014
Las Vegas, Nevada, 89148
Site US00063
Little Rock, Arkansas, 72120
Site US00081
Little Rock, Arkansas, 72205
Site US00112
Los Angeles, California, 90017
Site US00034
Los Angeles, California, 90027
Site US00062
Madison, Wisconsin, 53715
Site US00084
Mentor, Ohio, 44094
Site US00037
Miami, Florida, 33135
Site US00029
Miami, Florida, 33144
Site US00042
Miami, Florida, 33173
Site US00015
Middleburg Heights, Ohio, 44130
Site US00148
Mobile, Alabama, 36608
Site US00082
Moncks Corner, South Carolina, 29461
Site US00162
Mt. Pleasant, South Carolina, 29464
Site US00010
Murrieta, California, 92562
Site US00052
Nashville, Tennessee, 37211
Site US00006
New Bedford, Massachusetts, 02740
Site US00111
New Brunswick, New Jersey, 08901
Site US00040
New London, Connecticut, 06320
Site US00170
Newport News, Virginia, 23606
Site US00105
Newton, Kansas, 67114
Site US00070
Norfolk, Nebraska, 68701
Site US00086
Norfolk, Virginia, 23502
Site US00102
Norman, Oklahoma, 73069
Site US00007
North Miami, Florida, 33161
Site US00045
Overland Park, Kansas, 66202
Site US00180
Pittsburgh, Pennsylvania, 15236
Site US00021
Pompano Beach, Florida, 33060
Site US00035
Port Orange, Florida, 32129
Site US00103
Portland, Oregon, 97239
Site US00161
Raleigh, North Carolina, 27609
Site US00093
Saginaw, Michigan, 48604
Site US00044
Salt Lake City, Utah, 84107
Site US00036
Salt Lake City, Utah, 84124
Site US00068
San Antonio, Texas, 78209
Site US00071
San Antonio, Texas, 78229
Site US00100
San Antonio, Texas, 78229
Site US00135
San Diego, California, 92117
Site US00139
San Diego, California, 92120
Site US00144
Santa Maria, California, 93454
Site US00137
Sartell, Minnesota, 56377
Site US00005
Savannah, Georgia, 31406
Site US00167
Seattle, Washington, 98150
Site US00075
St. Petersburg, Florida, 33709
Site US00083
Stanford, California, 94305
Site US00098
Tacoma, Washington, 98405
Site US00099
Tampa, Florida, 33606
Site US00020
Tucson, Arizona, 85715
Site US00019
Tucson, Arizona, 85745
Site US00090
Washington D.C., District of Columbia, 20010
Site US00145
Watertown, Massachusetts, 02472
Site US00134
West Des Moines, Iowa, 50266
Site US00023
West Jordan, Utah, 84088
Site US00043
Williamsville, New York, 14221
Site US00165
Wilmington, North Carolina, 28401
Site US00166
Winston-Salem, North Carolina, 27103
Canada17 sites
Site CA00155
Brampton, Ontario, L6T 4S5
Site CA00123
Corunna, Ontario, N0N1G0
Site CA00130
Edmonton, Alberta, T5G 0B7
Site CA00169
Greater Sudbury, Ontario, P3E 3Z9
Site CA00126
Hamilton, Ontario, L8N 4A6
Site CA00164
Lévis, Quebec, G6W 0M6
Site CA00118
London, Ontario, N6A 4V2
Site CA00158
Montreal, Quebec, H2Y 1S1
Site CA00073
Point Claire, Quebec, H9R4S3
Site CA00106
Point Claire, Quebec, H9R4S3
Site CA00129
Québec, G1S2L6
Site CA00160
Québec, G1X 0B6
Site CA00116
Sarnia, Ontario, N7T4X3
Site CA00156
Sherbrooke, Quebec, J1H 1Z1
Site CA00061
Sherbrooke, Quebec, J1H5N2
Site CA00168
Toronto, Ontario, M4S 1Y2
Site CA00074
Vancouver, British Columbia, V6J1S3
About this study
Official title: A Phase 4, Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Multi-Center Study to Evaluate the Efficacy, Safety, and Tolerability of Mirabegron in Older Adult Subjects With Overactive Bladder (OAB)
The purpose of this study was to assess the efficacy, safety and tolerability of mirabegron versus placebo in the treatment of older adult subjects with OAB.
- Conditions
- Overactive Bladder (OAB)
- Being tested
- Mirabegron, Placebo
- Keywords
- Urinary Incontinence, Mirabegron, Overactive Bladder
- Medical subject headings
- Urinary Bladder, Overactive, Urinary Incontinence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MirabegronDrug
Also called YM178, Myrbetriq
oral tablet
PlaceboDrug
oral tablet
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Participants received placebo to match mirabegron at an initial dose of 25 mg and may have been increased to 50 mg of matching placebo based on individual participant efficacy, tolerability and investigator discretion. Once a participant had increased dose, they remained on that dose for the remainder of the study unless there were safety reasons that required discontinuation of study drug. Receives: Drug: Placebo |
| Mirabegron | Experimental | Participants received mirabegron at an initial dose of 25 mg and may have been increased to 50 mg mirabegron after 4 weeks or 8 weeks based on individual participant efficacy, tolerability and investigator discretion. Once a participant had increased dose, they remained on that dose for the remainder of the study unless there were safety reasons that required discontinuation of study drug. Receives: Drug: Mirabegron |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline to End of Treatment (EOT) in Mean Number of Micturitions Per 24 Hours
A micturition was defined as any voluntary act of passing urine (excluding incontinence only episodes). The mean number of micturitions per 24 hours was calculated as the average number of times a participant urinated per day during the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Mean Number of Incontinence Episodes Per 24 Hours
An incontinence episode was defined as the complaint of any involuntary leakage of urine. The mean number of incontinence episodes per 24 hours was calculated as the average number of times a participant recorded an incontinence episode per day during the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Secondary outcomes (24)
Change From Baseline to EOT in Mean Volume Voided Per Micturition
The mean volume voided per micturition during 3 days of the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Overactive Bladder Questionnaire (OAB-q): Symptom Bother Score
The OAB-q is a self-reported questionnaire with 33 questions relating to symptom bother and health-related quality of life (HRQoL). The symptom bother portion consists of 8 questions, rated on a 6-point Likert scale (1 through 6). The total symptom bother score was calculated from the 8 answers and then transformed to range from 0 (least severity) to 100 (worst severity). A negative change from baseline indicated an improvement.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in OAB-q: Health Related Quality of Life (HRQL) Total Score
The OAB-q is a self-reported questionnaire with 33 questions relating to symptom bother and health-related quality of life (HRQoL). The HRQoL portion consists of 25 HRQoL items comprising 4 HRQoL subscales (Coping, Concern, Sleep, and Social Interaction), each item was scored 1-6. The total score was calculated by adding the 4 HRQoL subscale scores and transforming to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicated an improvement.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Patient Perception of Bladder Condition (PPBC)
The PPBC is a validated, global assessment tool using a 6-point Likert scale that asks participants to rate their subjective impression of their current bladder condition. Participants assessed their bladder condition using this scale: 1. Does not cause me any problems at all; 2. Causes me some very minor problems; 3. Causes me some minor problems; 4. Causes me (some) moderate problems; 5. Causes me severe problems; 6. Causes me many severe problems. A higher score indicated a worse perception of bladder condition.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Mean Number of Urgency Episodes (Grade 3 and/or 4) Per 24 Hours
Urgency was defined as a complaint of a sudden, compelling desire to pass urine, which is difficult to defer. An urgency episode was defined as any micturition or incontinence episode with a severity of grade 3 or 4, assessed by participants based on the PPIUS, where 0 = No urgency; 1 = Mild urgency; 2 = Moderate urgency, could delay voiding a short while; 3 = Severe urgency, could not delay voiding; 4 = Urge incontinence, leaked before arriving to the toilet. The mean number of urgency episodes (grade 3 and/or 4) per 24 hours was calculated as the average number of times a participant recorded an urgency episode (grade 3 and/or 4) with or without incontinence per day during the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Mean Number of Urgency Incontinence Episodes Per 24 Hours
An urgency incontinence episode was defined as the involuntary leakage of urine accompanied by or immediately preceded by urgency. The mean number of urgency episodes was calculated as the average number of times a participant recorded an urgency incontinence episode per day during the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Change From to EOT in Mean Number of Nocturia Episodes Per 24 Hours
A nocturia episode was defined as waking at night one or more time to void (i.e., any voiding associated with sleep disturbance between the date/time the participant goes to bed with the intention to sleep until the date/time the participant gets up in the morning with the intention to stay awake). A night time episode of incontinence only is not considered a nocturia episode. The mean number of nocturia episodes per 24 hours was calculated as the average number of times a participant recorded a nocturia episode per day during the 3-day micturition diary period.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Barthel Index of Daily Living Score
The Barthel Index consists of 10 items that measure a person's daily functioning; specifically the activities of daily living and mobility. The total possible score ranges from 0 to 20, with lower scores indicating increased disability.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Vulnerable Elder Survey-13 (VES-13) Score
The VES-13 is a simple function-based tool for screening community-dwelling populations to identify older persons at risk for health deterioration. The VES-13 considers age, self-related health, limitation in physical function, and functional disabilities. The total possible score ranges from 0 to 10, with higher scores indicating increased disability.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in PPIUS
The PPIUS is a 5-point categorical scale used by participants to rate the degree of associated urgency for each micturition and/or incontinence episode they experienced. categories include: 0 - No urgency, I felt no need to empty my bladder, but did so for other reasons; 1 - Mild urgency, I could postpone voiding as long as necessary, without fear of wetting myself; 2 - Moderate urgency, I could postpone voiding for a short while, without fear of wetting myself; 3 - Severe urgency, I could not postpone voiding, but had to rush to the toilet in order not to wet myself; 4 - Urge incontinence, I leaked before arriving at the toilet. Scores were recorded in the micturition diary.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in OAB-q HRQL Subscale Scores
The OAB-q is a self-reported questionnaire with 33 questions relating to symptom bother and health-related quality of life (HRQoL). The HRQoL portion consists of 25 HRQoL items comprising 4 HRQoL subscales (Coping, Concern, Sleep, and Social Interaction), each item was scored 1-6. The Coping score has 8 items, the Concern score has 7 items, the Sleep and Social score has 5 items each. Each subscale score was calculated by adding each score's items and transforming to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicated an improvement.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Treatment Satisfaction Visual Analog Scale (TS-VAS)
The TS-VAS is a visual analog scale that asks participants to rate their satisfaction with the treatment by placing a vertical mark on a line that runs from 0 (No, not at all) to 100 (Yes, completely).
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in University of Alabama, Birmingham - Life Space Assessment (UAB-LSA)
The UAB-LSA measures mobility in terms of the spatial extent of a person's life. Life space is defined based upon the distance a person routinely travels to perform activities over this time frame. The UAB-LSA includes determining how far and how often the person leaves his or her place of residence and the degree of independence the person has. Each level of life space represents a distance further from the room where one sleeps: 0 - Mobility limited to the room where one sleeps; 1 - Mobility limited to within one's dwelling; 2 - Mobility limited to the space just proximal to one's personal living space (for instance, a porch, patio, or yard just outside the home or hallway outside of an apartment); 3 - Mobility limited to one's neighborhood; 4 - Mobility limited to one's town; 5 - Mobility outside one's town. The total scores ranges from 0-120, where a higher score indicates greater mobility.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline in Number of Incontinence Episodes Reported During 3-Day Diary Prior to Each Visit
An incontinence episode was defined as the complaint of any involuntary leakage of urine. The number of incontinence episodes were calculated as the total number of the incontinence episodes recorded during the 3-day micturition diary period.
Measured: Baseline and Weeks 4, 8 and EOT (up to 12 weeks)
Change From Baseline in Number of Pads During 3-Day Diary Prior to Each Visit
The number of pads were calculated as the number of times a participant records a new pad used during the 3-day micturition diary period. No data were collected for the number of pads used due to a failure in the programming of the diary used for data collection.
Measured: Baseline and EOT (up to 12 weeks)
Percentage of Participants Who Achieved Micturition Frequency Normalization
Participants who achieved micturition frequency normalization were defined as participants who had at least 8 micturitions per 24 hours at baseline and less than 8 micturitions per 24 hours post-baseline.
Measured: End of treatment (up to 12 weeks)
Percentage of Participants With 50% Reduction in Mean Number of Incontinence Episodes Per 24 Hours
An incontinence episode was defined as the complaint of any involuntary leakage of urine. Participants with 50% reduction in mean number of incontinence episodes per 24 hours were defined as participants with at least 50% decrease from baseline in mean number of incontinence episodes per 24 hours during the treatment period at each visit.
Measured: End of treatment (up to 12 weeks)
Percentage of Participants With Zero Incontinence Episodes Per 24 Hours
An incontinence episode was defined as the complaint of any involuntary leakage of urine. Participants with zero incontinence episodes per 24 hours were defined as participants who had no incontinence episodes per 24 hours during the treatment period at each visit.
Measured: End of treatment (up to 12 weeks)
Percentage of Participants With ≥ 10-Point Improvement From Baseline in OAB-q HRQL Subscales
The OAB-q is a self-reported questionnaire with 33 questions relating to symptom bother and health-related quality of life (HRQoL). The HRQoL portion consists of 25 HRQoL items comprising 4 HRQoL subscales (Coping, Concern, Sleep, and Social Interaction), each item was scored 1-6. The Coping score has 8 items, the Concern score has 7 items, the Sleep and Social score has 5 items each. Each subscale score was calculated by adding each score's items and transforming to a scale from 0 to 100, with higher scores indicating better quality of life. Participants with ≥ 10-point improvement from baseline in OAB-q HRQL subscales were defined as participants with at least 10-point improvement from baseline in OAB-q Subscales at each visit.
Measured: End of treatment (up to 12 weeks)
Percentage of Participants With ≥ 1-Point Improvement From Baseline in PPBC
The PPBC is a validated, global assessment tool using a 6-point Likert scale that asks participants to rate their subjective impression of their current bladder condition. Participants assessed their bladder condition using this scale: 1. Does not cause me any problems at all; 2. Causes me some very minor problems; 3. Causes me some minor problems; 4. Causes me (some) moderate problems; 5. Causes me severe problems; 6. Causes me many severe problems. A higher score indicated a worse perception of bladder condition. Participants with ≥ 1-point improvement from baseline in PPBC were defined as participants with at least 1-point improvement from baseline in PPBC at each visit.
Measured: End of treatment (up to 12 weeks)
Percentage of Participants Major (≥ 2-Point) Improvement From Baseline in PPBC
The PPBC is a validated, global assessment tool using a 6-point Likert scale that asks participants to rate their subjective impression of their current bladder condition. Participants assessed their bladder condition using this scale: 1. Does not cause me any problems at all; 2. Causes me some very minor problems; 3. Causes me some minor problems; 4. Causes me (some) moderate problems; 5. Causes me severe problems; 6. Causes me many severe problems. A higher score indicated a worse perception of bladder condition. Participants with ≥ 2-point improvement from baseline in PPBC were defined as participants with at least 1-point improvement from baseline in PPBC at each visit.
Measured: End of treatment (up to 12 weeks)
Number of Participants With Adverse Events (AEs)
Safety was assessed by AEs, which included abnormalities identified during a medical test (e.g. laboratory tests, vital signs, electrocardiogram, etc.) if the abnormality induced clinical signs or symptoms, needed active intervention, interruption or discontinuation of study medication or was clinically significant. AEs were considered as serious if resulted in in death, was life-threatening resulted in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, resulted in congenital anomaly or birth defect, required inpatient hospitalization or led to prolongation of hospitalization and other medically important events.
Measured: From first dose of study drug up to 30 days after last dose of study drug (up to 13 weeks)
Change From Baseline to EOT in Montreal Cognitive Assessment (MoCA) Score
The MoCA was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. The total possible score is 30 points, with lower scores indicating worse cognitive function.
Measured: Baseline and EOT (up to 12 weeks)
Change From Baseline in Post-void Residual Volume (PVR)
PVR was assessed by ultrasonography or bladder scan.
Measured: Baseline and EOT (up to 12 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Aug 2014 (estimated)
- Study start7 Oct 2014
- Primary completion29 Nov 2017
- Study completion2 Jan 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Overactive Bladder (OAB)Studies of the same condition, open and under way.
- More trials run by Astellas Pharma Global Development, Inc.The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 888 participants (actual)
Sponsor and investigators
- Lead sponsor
- Astellas Pharma Global Development, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Astellas Pharma Global Development, Inc., Medical Affairs, Americas
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02216214
- Sponsor's protocol ID
- 178-MA-1005
- Acronym
- PILLAR
- Status last verified
- Oct 2024
- First submitted
- 12 Aug 2014
- Last updated
- 22 Nov 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.
Publications
Herschorn S, Staskin D, Schermer CR, Kristy RM, Wagg A. Safety and Tolerability Results from the PILLAR Study: A Phase IV, Double-Blind, Randomized, Placebo-Controlled Study of Mirabegron in Patients >/= 65 years with Overactive Bladder-Wet. Drugs Aging. 2020 Sep;37(9):665-676. doi: 10.1007/s40266-020-00783-w.
PubMed 32725584Griebling TL, Campbell NL, Mangel J, Staskin D, Herschorn S, Elsouda D, Schermer CR. Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4 randomized, placebo-controlled study (PILLAR). BMC Geriatr. 2020 Mar 18;20(1):109. doi: 10.1186/s12877-020-1474-7.
PubMed 32183741
Study at a glance
From the registry record, last updated by the sponsor on 22 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 4, Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Multi-Center Study to Evaluate the Efficacy, Safety, and Tolerability of Mirabegron in Older Adult Subjects With Overactive Bladder (OAB)
- ClinicalTrials.gov ID
- NCT02216214
- Acronym / sponsor ID
- PILLAR / 178-MA-1005
- Conditions
- Overactive Bladder (OAB)
- Keywords
- Urinary Incontinence, Mirabegron, Overactive Bladder
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 888 participants (actual)
- Lead sponsor
- Astellas Pharma Global Development, Inc.Industry (pharma, biotech, devices)
- Study start
- 7 Oct 2014 (actual)
- Primary completion
- 29 Nov 2017 (actual)
- Study completion
- 2 Jan 2018 (actual)
- First posted
- 13 Aug 2014 (estimated)
- Results
- Posted 15 Feb 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study was to assess the efficacy, safety and tolerability of mirabegron versus placebo in the treatment of older adult subjects with OAB.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: PlaceboParticipants received placebo to match mirabegron at an initial dose of 25 mg and may have been increased to 50 mg of matching placebo based on individual participant efficacy, tolerability and investigator discretion. Once a participant had increased dose, they remained on that dose for the remainder of the study unless there were safety reasons that required discontinuation of study drug. |
| Mirabegron | Experimental | Drug: MirabegronParticipants received mirabegron at an initial dose of 25 mg and may have been increased to 50 mg mirabegron after 4 weeks or 8 weeks based on individual participant efficacy, tolerability and investigator discretion. Once a participant had increased dose, they remained on that dose for the remainder of the study unless there were safety reasons that required discontinuation of study drug. |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
Key inclusion criteria (8 listed)
- Subject is willing and able to complete the micturition diary and questionnaires correctly.
- Subject has symptoms of wet overactive bladder (OAB) (urinary frequency and urgency with incontinence) for greater than or equal to 3 months prior to Screening.
- Subject agrees not to participate in another interventional study from the time of screening until the final study visit.
- Subject continues to meet all inclusion criteria of Visit 1.
- Subjects must experience at least one incontinence episode in the placebo run-in period based on the 3-day micturition diary.
Key exclusion criteria (31 listed)
- Subject has ongoing symptoms suggestive of bladder outlet obstruction (BOO) or history of BOO that is currently not well controlled.
- Subject has Post-Void Residual Volume (PVR) greater than 150 mL.
- Subject has neurogenic bladder or neurological dysfunction or injury which could affect the lower urinary tract or nerve supply.
- Subject has significant stress incontinence or mixed stress/urgency incontinence where stress is the predominant factor as determined by the Investigator (for female subjects confirmed by a cough provocation test). Subjects with a history of stress incontinence that is currently treated (e.g. remote history of surgery for stress incontinence) may be included as long as they pass cough provocation test.
- Subject has an indwelling catheter or practices intermittent self-catheterization.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MirabegronAlso: YM178, Myrbetriqoral tablet | Drug | Mirabegron |
| Placebooral tablet | Drug | Placebo |
Primary outcome
Change From Baseline to End of Treatment (EOT) in Mean Number of Micturitions Per 24 Hours
Time frame: Baseline and EOT (up to 12 weeks)
A micturition was defined as any voluntary act of passing urine (excluding incontinence only episodes). The mean number of micturitions per 24 hours was calculated as the average number of times a participant urinated per day during the 3-day micturition diary period.
Change From Baseline to EOT in Mean Number of Incontinence Episodes Per 24 Hours
Time frame: Baseline and EOT (up to 12 weeks)
An incontinence episode was defined as the complaint of any involuntary leakage of urine. The mean number of incontinence episodes per 24 hours was calculated as the average number of times a participant recorded an incontinence episode per day during the 3-day micturition diary period.
24 secondary outcomes
Change From Baseline to EOT in Mean Volume Voided Per Micturition
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Overactive Bladder Questionnaire (OAB-q): Symptom Bother Score
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in OAB-q: Health Related Quality of Life (HRQL) Total Score
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Patient Perception of Bladder Condition (PPBC)
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Mean Number of Urgency Episodes (Grade 3 and/or 4) Per 24 Hours
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Mean Number of Urgency Incontinence Episodes Per 24 Hours
Time frame: Baseline and EOT (up to 12 weeks)
Change From to EOT in Mean Number of Nocturia Episodes Per 24 Hours
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Barthel Index of Daily Living Score
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Vulnerable Elder Survey-13 (VES-13) Score
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in PPIUS
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in OAB-q HRQL Subscale Scores
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in Treatment Satisfaction Visual Analog Scale (TS-VAS)
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline to EOT in University of Alabama, Birmingham - Life Space Assessment (UAB-LSA)
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline in Number of Incontinence Episodes Reported During 3-Day Diary Prior to Each Visit
Time frame: Baseline and Weeks 4, 8 and EOT (up to 12 weeks)
Change From Baseline in Number of Pads During 3-Day Diary Prior to Each Visit
Time frame: Baseline and EOT (up to 12 weeks)
Percentage of Participants Who Achieved Micturition Frequency Normalization
Time frame: End of treatment (up to 12 weeks)
Percentage of Participants With 50% Reduction in Mean Number of Incontinence Episodes Per 24 Hours
Time frame: End of treatment (up to 12 weeks)
Percentage of Participants With Zero Incontinence Episodes Per 24 Hours
Time frame: End of treatment (up to 12 weeks)
Percentage of Participants With ≥ 10-Point Improvement From Baseline in OAB-q HRQL Subscales
Time frame: End of treatment (up to 12 weeks)
Percentage of Participants With ≥ 1-Point Improvement From Baseline in PPBC
Time frame: End of treatment (up to 12 weeks)
Percentage of Participants Major (≥ 2-Point) Improvement From Baseline in PPBC
Time frame: End of treatment (up to 12 weeks)
Number of Participants With Adverse Events (AEs)
Time frame: From first dose of study drug up to 30 days after last dose of study drug (up to 13 weeks)
Change From Baseline to EOT in Montreal Cognitive Assessment (MoCA) Score
Time frame: Baseline and EOT (up to 12 weeks)
Change From Baseline in Post-void Residual Volume (PVR)
Time frame: Baseline and EOT (up to 12 weeks)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Nov 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 32725584Herschorn S, Staskin D, Schermer CR, Kristy RM, Wagg A. Safety and Tolerability Results from the PILLAR Study: A Phase IV, Double-Blind, Randomized, Placebo-Controlled Study of Mirabegron in Patients >/= 65 years with Overactive Bladder-Wet. Drugs Aging. 2020 Sep;37(9):665-676. doi: 10.1007/s40266-020-00783-w.
- Derived from this study: PubMed 32183741Griebling TL, Campbell NL, Mangel J, Staskin D, Herschorn S, Elsouda D, Schermer CR. Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4 randomized, placebo-controlled study (PILLAR). BMC Geriatr. 2020 Mar 18;20(1):109. doi: 10.1186/s12877-020-1474-7.
- Individual participant dataSharing planned: Yes. Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Astellas Pharma Global Development, Inc., Medical Affairs, Americas
120 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Mirabegron in people with Overactive Bladder (OAB), run by Astellas Pharma Global Development, Inc. at 120 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 120 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 15 Feb 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline to End of Treatment (EOT) in Mean Number of Micturitions Per 24 Hours (time frame: Baseline and EOT (up to 12 weeks)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02216214, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Nov 2024.