Efficacy and Safety of Desmopressin Melt for the Treatment of Nocturia

NCT ID: NCT00477490

Last Updated: 2015-11-02

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

799 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-05-31

Study Completion Date

2008-02-29

Brief Summary

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The purpose of this study is to investigate the efficacy and safety of several doses of the melt formulation of desmopressin in a broad population of adult patients with nocturia.

Detailed Description

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Conditions

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Nocturia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Placebo

Participants took a placebo 'melt' for 28 days to complete part 1 of the study. In part 2, placebo patients were randomized to one of the other 4 treatment arms based on assignments predetermined at the initial randomization, to receive active desmopressin melt for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Oral placebo placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime.

desmopressin melt 10 μg

Participants took desmopressin melt 10 μg for 28 days to complete part 1 of the study. Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).

Group Type EXPERIMENTAL

desmopressin acetate

Intervention Type DRUG

Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg

desmopressin melt 25 μg

Participants took desmopressin melt 25 μg for 28 days to complete part 1 of the study. Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).

Group Type EXPERIMENTAL

desmopressin acetate

Intervention Type DRUG

Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg

desmopressin melt 50 μg

Participants took desmopressin melt 50 μg for 28 days to complete part 1 of the study. Participants continued on this dose in part 2 of the study for between 1 and 6 months (until the database for part 1 was locked and treatment was unblinded).

Group Type EXPERIMENTAL

desmopressin acetate

Intervention Type DRUG

Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg

desmopressin melt 100 μg

Participants will take desmopressin melt 100 μg for 28 days to complete part 1 of the study. Participants will continue on this dose in part 2 of the study for between 1-6 months (until the database for part 1 is locked and treatment is unblinded).

Group Type EXPERIMENTAL

desmopressin acetate

Intervention Type DRUG

Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg

Interventions

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desmopressin acetate

Oral lyophilisate of desmopressin acetate placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime in the assigned dosage: 10, 25, 50 or 100 μg

Intervention Type DRUG

Placebo

Oral placebo placed under the participant's tongue, without water, once daily approximately 1 hour before bedtime.

Intervention Type DRUG

Other Intervention Names

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Minirin® Melt Nocturin® FE992026

Eligibility Criteria

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Inclusion Criteria

1. Written informed consent prior to the performance of any study-related activity.
2. Patients 18 years and older with an average of ≥ 2 nocturnal voids per night as determined by a 3 day frequency-volume chart during the screening period.

Exclusion Criteria

Males:

1. Clinical suspicion of bladder outlet obstruction and/or urine flow \< 5 ml/s. If medical history and/or physical examination suggest bladder outlet obstruction, uroflowmetry should be performed to confirm the diagnosis
2. Surgical treatment for bladder outlet obstruction/benign prostatic hyperplasia performed within the past 6 months

Females:
3. Pregnancy. Females of reproductive age must have documentation of a reliable method of contraception.
4. Use of pessary for pelvic prolapse.
5. Unexplained pelvic mass.

Males and Females:
6. Clinical suspicion of urinary retention and/or post void residual volume \> 150 ml. If medical history and/or physical examination suggest urinary retention, bladder ultrasound or catheterization should be performed to confirm the diagnosis.
7. Current or past urologic malignancy (e.g., bladder cancer, prostate cancer).
8. Clinical evidence of current genitourinary tract pathology that could interfere with voiding.
9. History of neurogenic detrusor activity (previously known as detrusor hyperreflexia).
10. Suspicion or evidence of cardiac failure.
11. Uncontrolled hypertension.
12. Uncontrolled diabetes mellitus.
13. Renal insufficiency. Serum creatinine must be within normal limits and estimated glomerular filtration rate (eGFR) \>=60 mL/min.
14. Active hepatic and/or biliary disease. Aspartate transaminase (AST) or alanine transaminase (ALT) should not be \>2 times the upper limit of normal. Total bilirubin should not be \> 1.5 mg/dL.
15. Hyponatremia. Serum sodium level must be within normal limits
16. Syndrome of Inappropriate antidiuretic hormone secretion (SIADH).
17. Diabetes insipidus (urine output \> 40 ml/kg over 24 hours) as determined by the 3-day voiding diary.
18. Psychogenic or habitual polydipsia
19. Obstructive sleep apnea

Other
20. Known alcohol or substance abuse
21. Work or lifestyle potentially interfering with regular nighttime sleep (e.g., shift workers)
22. Previous desmopressin treatment for nocturia.
23. Any other medical condition, laboratory abnormality, psychiatric condition, mental incapacity or language barrier that, in the judgment of the investigator, could impair patient participation in the trial.
24. Use of loop diuretics (furosemide, torsemide, ethacrynic acid). Other classes of diuretics (thiazides, triamterene, chlorthalidone, amiloride, indapamide) were permitted, either as monotherapy or combination therapy. Subjects using a diuretic were to be encouraged to take it in the morning, if medically feasible.
25. Use of any other investigational drug within 30 days of screening.

Concomitant Medications

The following medications are permitted provided that the subject has been on a stable dose for the 3 months prior to the screening date (i.e. treatment has not been initiated or discontinued and there has been no change in dose):

* Alpha-blockers: Cardura (doxazosin); Flomax (tamsulosin); Hytrin (terazosin); Uroxatral (alfuzosin)
* 5 alpha-reductase inhibitors: Avodart (dutasteride); Proscar (finasteride)
* Antispasmodic, anticholinergic, antimuscarinic therapy for overactive bladder: Detrol, Detrol LA (tolterodine); Ditropan, Ditropan XL (oxybutynin); Enablex (darifenacin); Levsin(hyoscyamine); Oxytrol transdermal (oxybutynin); Sanctura (trospium); Vesicare (solifenacin)
* Sedative/hypnotic medications for sleep disorders
* Selective serotonin and mixed norepinephrine/serotonin reuptake inhibitors: Celexa (citalopram); Cymbalta (duloxetine); Effexor (venlafaxine); Lexapro (escitalopram); Paxil(paroxetine); Prozac (fluoxetine); Zoloft (sertraline)
* Chronic use of nonsteroidal anti-inflammatory agents
* Diabinese (chlorpropamide)
* Carbamazepine (carbatrol/tegretol)
* Amiodarone
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ferring Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Development Support

Role: STUDY_DIRECTOR

Ferring Pharmaceuticals

Locations

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Radiant Research

Birmingham, Alabama, United States

Site Status

Radiant Research

Scottsdale, Arizona, United States

Site Status

Arkansas Primary Care Clinic

Little Rock, Arkansas, United States

Site Status

Advanced Urology Medical Center

Anaheim, California, United States

Site Status

Impact Clinical Trials

Beverly Hills, California, United States

Site Status

Atlantic Urology Medical Group

Long Beach, California, United States

Site Status

California Professional Research

Newport Beach, California, United States

Site Status

San Diego Uro-Research

San Diego, California, United States

Site Status

Radiant Research

Santa Rosa, California, United States

Site Status

West Coast Clinical Research

Tarzana, California, United States

Site Status

Western Clinical Research

Torrance, California, United States

Site Status

Urology Associates PC

Denver, Colorado, United States

Site Status

Downtown Women's Health Care

Denver, Colorado, United States

Site Status

Genitourinary Surgical Consultants

Denver, Colorado, United States

Site Status

Connecticut Clinical Research Center, LLC

Middlebury, Connecticut, United States

Site Status

South Florida Medical Research

Aventura, Florida, United States

Site Status

Women's Medical Research Group, LLC

Clearwater, Florida, United States

Site Status

Medsearch Professional Group

Miami, Florida, United States

Site Status

Sunrise Medical Research

Plantation, Florida, United States

Site Status

Radiant Research

Stuart, Florida, United States

Site Status

Southeastern Research Group, Inc.

Tallahassee, Florida, United States

Site Status

Tampa Bay Urology

Tampa, Florida, United States

Site Status

Radiant Research

West Palm Beach, Florida, United States

Site Status

Southeastern Medical Research Institute

Columbus, Georgia, United States

Site Status

Investigational site - PC

Dunwoody, Georgia, United States

Site Status

Accelovance

Peoria, Illinois, United States

Site Status

Radiant Research, Kansas City

Overland Park, Kansas, United States

Site Status

Benchmark Research

Metairie, Louisiana, United States

Site Status

Regional Urology, LLC

Shreveport, Louisiana, United States

Site Status

Pierremont Women's Clinic

Shreveport, Louisiana, United States

Site Status

FutureCare Studies, Inc.

Springfield, Massachusetts, United States

Site Status

Radiant Research Inc.

St Louis, Missouri, United States

Site Status

Women's Clinic of Lincoln, P.C

Lincoln, Nebraska, United States

Site Status

Investigational site

Las Vegas, Nevada, United States

Site Status

AdvanceMed Research

Lawrenceville, New Jersey, United States

Site Status

Lawrenceville Urology

Lawrenceville, New Jersey, United States

Site Status

Morristown Urology

Morristown, New Jersey, United States

Site Status

Urology Group of New Mexico, PC

Albuquerque, New Mexico, United States

Site Status

Upstate Urology

Albany, New York, United States

Site Status

Investigational site - Adult & Pediatric Urology

Carmel, New York, United States

Site Status

AccuMed Research Associates

Garden City, New York, United States

Site Status

University Urology Associates

New York, New York, United States

Site Status

Ferring Pharmaceutical Inc

Suffern, New York, United States

Site Status

Northeast Urology Research

Concord, North Carolina, United States

Site Status

PharmQuest

Greensboro, North Carolina, United States

Site Status

New Hanover Medical Research

Wilmington, North Carolina, United States

Site Status

Piedmont Medical Research Associates

Winston-Salem, North Carolina, United States

Site Status

Radiant Research

Cincinnati, Ohio, United States

Site Status

Radiant Research - Akron

Mogadore, Ohio, United States

Site Status

Urologic Consultants of SE PA

Bala-Cynwyd, Pennsylvania, United States

Site Status

Philadelphia Clinical Research, LLC

Philadelphia, Pennsylvania, United States

Site Status

Radiant Research

Philadelphia, Pennsylvania, United States

Site Status

Advanced Clinical Concepts

Reading, Pennsylvania, United States

Site Status

University Medical Group

Greenville, South Carolina, United States

Site Status

Radiant Research, Greer

Greer, South Carolina, United States

Site Status

Palmetto Medical Research

Mt. Pleasant, South Carolina, United States

Site Status

Carolina Urologic Research Center

Myrtle Beach, South Carolina, United States

Site Status

Holston Medical Group

Kingsport, Tennessee, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Advanced Research Associates

Corpus Christi, Texas, United States

Site Status

Health Central Women's Care

Dallas, Texas, United States

Site Status

Accelovance

Houston, Texas, United States

Site Status

Regional Medical Center and Diagnostic

Humble, Texas, United States

Site Status

Radiant Research San Antonio

San Antonio, Texas, United States

Site Status

Urology San Antonio Research, PA

San Antonio, Texas, United States

Site Status

Virginia Urology Center

Richmond, Virginia, United States

Site Status

Urology of Virginia PC

Virginia Beach, Virginia, United States

Site Status

Women's Clinical Research Center

Seattle, Washington, United States

Site Status

Investigational site - Medical Professional

Seattle, Washington, United States

Site Status

Seattle Urology Research Center

Seattle, Washington, United States

Site Status

Southern Interior Medical Center

Kelowna, British Columbia, Canada

Site Status

Can-Med Clinical Research Inc.

Victoria, British Columbia, Canada

Site Status

Investigational site - Clinical Research

Victoria, British Columbia, Canada

Site Status

Investigational site - Professional Corporation

Fredericton, New Brunswick, Canada

Site Status

The Male/Female Health and Reserach

Barrie, Ontario, Canada

Site Status

Brantford Urology Research

Brantford, Ontario, Canada

Site Status

Guelph Urology Associates

Guelph, Ontario, Canada

Site Status

Investigational site

North Bay, Ontario, Canada

Site Status

The Fe/Male Health Centres

Oakville, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Juul KV, Klein BM, Norgaard JP. Long-term durability of the response to desmopressin in female and male nocturia patients. Neurourol Urodyn. 2013 Apr;32(4):363-70. doi: 10.1002/nau.22306. Epub 2012 Sep 12.

Reference Type BACKGROUND
PMID: 22972524 (View on PubMed)

Weiss JP, Zinner NR, Klein BM, Norgaard JP. Desmopressin orally disintegrating tablet effectively reduces nocturia: results of a randomized, double-blind, placebo-controlled trial. Neurourol Urodyn. 2012 Apr;31(4):441-7. doi: 10.1002/nau.22243. Epub 2012 Mar 22.

Reference Type RESULT
PMID: 22447415 (View on PubMed)

Juul KV, Malmberg A, van der Meulen E, Walle JV, Norgaard JP. Low-dose desmopressin combined with serum sodium monitoring can prevent clinically significant hyponatraemia in patients treated for nocturia. BJU Int. 2017 May;119(5):776-784. doi: 10.1111/bju.13718. Epub 2016 Dec 10.

Reference Type DERIVED
PMID: 27862898 (View on PubMed)

Bliwise DL, Holm-Larsen T, Goble S. Increases in duration of first uninterrupted sleep period are associated with improvements in PSQI-measured sleep quality. Sleep Med. 2014 Oct;15(10):1276-8. doi: 10.1016/j.sleep.2014.05.013. Epub 2014 Jun 13.

Reference Type DERIVED
PMID: 25172115 (View on PubMed)

Juul KV, Klein BM, Sandstrom R, Erichsen L, Norgaard JP. Gender difference in antidiuretic response to desmopressin. Am J Physiol Renal Physiol. 2011 May;300(5):F1116-22. doi: 10.1152/ajprenal.00741.2010. Epub 2011 Mar 2.

Reference Type DERIVED
PMID: 21367921 (View on PubMed)

Other Identifiers

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FE992026 CS29

Identifier Type: -

Identifier Source: org_study_id

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