Trial Outcomes & Findings for Bacterial Genomic Sequencing in Overactive Bladder (NCT NCT01642277)

NCT ID: NCT01642277

Last Updated: 2015-12-07

Results Overview

Participants were classified into Low Biomass, Lactobacillus, Gardnerella, Diverse, and Other urotypes based on the bacterial DNA at baseline.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

134 participants

Primary outcome timeframe

12 weeks

Results posted on

2015-12-07

Participant Flow

Recruitment began on July 16th, 2012 and ended on May 22nd, 2014 (i.e., 22.2 months). Participants were recruited during their outpatient appointments to the Urogynecology Clinic at Loyola University Medical Center (Maywood, IL) by a member of the research team.

This was a 12-week open label study with no randomization scheme. Following diagnosis, patients were administered 5 mg daily solifenacin. At the 4-week visit, if a participant's symptoms were adequately controlled (response), she continued at dose for the study duration. If a participant reported no improvement, the dose was increased to 10 mg.

Participant milestones

Participant milestones
Measure
Urinary Urge Incontinence
Seventy-four (n = 74) women received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Non-Urinary Urge Incontinence
Sixty (n = 60) women without UUI were evaluated at baseline only (week 0) in order to serve as a control cohort. These women never received study therapy (i.e., 5-10mg daily solifenacin).
Overall Study
STARTED
74
60
Overall Study
COMPLETED
50
60
Overall Study
NOT COMPLETED
24
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Urinary Urge Incontinence
Seventy-four (n = 74) women received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Non-Urinary Urge Incontinence
Sixty (n = 60) women without UUI were evaluated at baseline only (week 0) in order to serve as a control cohort. These women never received study therapy (i.e., 5-10mg daily solifenacin).
Overall Study
Adverse Event
10
0
Overall Study
Physician Decision
2
0
Overall Study
Protocol Violation
1
0
Overall Study
Withdrawal by Subject
11
0

Baseline Characteristics

Bacterial Genomic Sequencing in Overactive Bladder

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Urinary Urge Incontinence
n=74 Participants
Seventy-four (n = 74) women received 5mg daily solifenacin (with an option to increase to 10mg daily solifenacin at 4 weeks) for the treatment of urinary urge incontinence (UUI).
Non-Urinary Urge Incontinence
n=60 Participants
Sixty (n = 60) women without UUI were evaluated at baseline only (week 0) in order to serve as a control cohort. These women never received study therapy (i.e., 5-10mg daily solifenacin).
Total
n=134 Participants
Total of all reporting groups
Age, Continuous
61.5 years
STANDARD_DEVIATION 11.5 • n=5 Participants
49 years
STANDARD_DEVIATION 14.7 • n=7 Participants
56.04 years
STANDARD_DEVIATION 14.34 • n=5 Participants
Sex: Female, Male
Female
74 Participants
n=5 Participants
60 Participants
n=7 Participants
134 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
White
56 participants
n=5 Participants
43 participants
n=7 Participants
99 participants
n=5 Participants
Race/Ethnicity, Customized
Black
13 participants
n=5 Participants
12 participants
n=7 Participants
25 participants
n=5 Participants
Race/Ethnicity, Customized
Asian
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
5 participants
n=5 Participants
4 participants
n=7 Participants
9 participants
n=5 Participants
Region of Enrollment
United States
74 participants
n=5 Participants
60 participants
n=7 Participants
134 participants
n=5 Participants
Body Mass Index
32.7 kg/m2
STANDARD_DEVIATION 8.4 • n=5 Participants
27.9 kg/m2
STANDARD_DEVIATION 5.5 • n=7 Participants
30.59 kg/m2
STANDARD_DEVIATION 7.61 • n=5 Participants
Vaginal Parity
2.00 Births
n=5 Participants
2.00 Births
n=7 Participants
2.00 Births
n=5 Participants
Estrogen Status
Negative
7 participants
n=5 Participants
32 participants
n=7 Participants
39 participants
n=5 Participants
Estrogen Status
Positive
65 participants
n=5 Participants
26 participants
n=7 Participants
91 participants
n=5 Participants
Estrogen Status
Unknown
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
Diabetes
No
67 participants
n=5 Participants
58 participants
n=7 Participants
125 participants
n=5 Participants
Diabetes
Yes
7 participants
n=5 Participants
2 participants
n=7 Participants
9 participants
n=5 Participants
Hypertension
No
48 participants
n=5 Participants
49 participants
n=7 Participants
97 participants
n=5 Participants
Hypertension
Yes
26 participants
n=5 Participants
11 participants
n=7 Participants
37 participants
n=5 Participants
Coronary Artery Disease
No
65 participants
n=5 Participants
59 participants
n=7 Participants
124 participants
n=5 Participants
Coronary Artery Disease
Yes
9 participants
n=5 Participants
1 participants
n=7 Participants
10 participants
n=5 Participants
Smoking
Non-Smoker
68 participants
n=5 Participants
56 participants
n=7 Participants
124 participants
n=5 Participants
Smoking
Smoker
6 participants
n=5 Participants
4 participants
n=7 Participants
10 participants
n=5 Participants
Marital Status
Married
38 participants
n=5 Participants
37 participants
n=7 Participants
75 participants
n=5 Participants
Marital Status
Separated
3 participants
n=5 Participants
1 participants
n=7 Participants
4 participants
n=5 Participants
Marital Status
Divorced
9 participants
n=5 Participants
6 participants
n=7 Participants
15 participants
n=5 Participants
Marital Status
Widowed
14 participants
n=5 Participants
1 participants
n=7 Participants
15 participants
n=5 Participants
Marital Status
Single
10 participants
n=5 Participants
15 participants
n=7 Participants
25 participants
n=5 Participants
Prior Treatment for OAB
Prior Treatment
37 participants
n=5 Participants
0 participants
n=7 Participants
37 participants
n=5 Participants
Prior Treatment for OAB
No prior treatment
37 participants
n=5 Participants
60 participants
n=7 Participants
97 participants
n=5 Participants
Sequencing Urotypes at Baseline
Low biomass
37 participants
n=5 Participants
34 participants
n=7 Participants
71 participants
n=5 Participants
Sequencing Urotypes at Baseline
Lactobacillus urotype
15 participants
n=5 Participants
16 participants
n=7 Participants
31 participants
n=5 Participants
Sequencing Urotypes at Baseline
Diverse urotype
8 participants
n=5 Participants
4 participants
n=7 Participants
12 participants
n=5 Participants
Sequencing Urotypes at Baseline
Gardnerella urotype
8 participants
n=5 Participants
4 participants
n=7 Participants
12 participants
n=5 Participants
Sequencing Urotypes at Baseline
Other urotypes
6 participants
n=5 Participants
2 participants
n=7 Participants
8 participants
n=5 Participants

PRIMARY outcome

Timeframe: 12 weeks

Population: This was a completer analysis comprising participants who completed 12 weeks of treatment (n = 50).

Participants were classified into Low Biomass, Lactobacillus, Gardnerella, Diverse, and Other urotypes based on the bacterial DNA at baseline.

Outcome measures

Outcome measures
Measure
Urinary Urge Incontinence
n=50 Participants
Women who received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Solifenacin Non-Responder
Individuals with urinary urge incontinence who did not respond to solifenacin at 12 weeks
Bacterial Genomic Sequencing
Low biomass
25 participants
Bacterial Genomic Sequencing
Lactobacillus urotype
11 participants
Bacterial Genomic Sequencing
Diverse urotype
3 participants
Bacterial Genomic Sequencing
Gardnerella urotype
6 participants
Bacterial Genomic Sequencing
Other urotypes
3 participants

SECONDARY outcome

Timeframe: End of study (Week 12)

Population: Participants who received solifenacin were asked to complete the OABQ at 12 weeks in order to assess overactive bladder symptoms.

The Overactive Bladder Questionnaire (OAB-q) was developed to assess symptom bother and the impact of overactive bladder (OAB) on health-related quality of life (HRQL). The instrument comprises 33 items. Response options for the symptom frequency and HRQL items are presented as 6-point Likert scales ranging from 'none of the time' to 'all of the time' for symptom frequency (and 'not at all' to 'a very great deal' for symptom bother). From these 33 items, six sub-scales are assessed separately: (1) OAB symptom severity, (2) Coping with OAB symptoms, (3) Concern for OAB symptoms, (4) Sleep as a function of OAB symptoms, (5) Social functioning as a consequence of OAB symptoms, and (6) Health related quality of life (HRQL) as a function of OAB symptoms. Each sub-scale score ranges from 0 to 100 (where higher scores indicate more severe OAB symptoms and lower scores indicate minimal symptom severity).

Outcome measures

Outcome measures
Measure
Urinary Urge Incontinence
n=37 Participants
Women who received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Solifenacin Non-Responder
n=13 Participants
Individuals with urinary urge incontinence who did not respond to solifenacin at 12 weeks
Assessment of Overactive Bladder Questionnaire (OABQ)
Symptom Severity Score
17.50 units on a scale
Interval 7.5 to 32.5
37.50 units on a scale
Interval 15.0 to 61.25
Assessment of Overactive Bladder Questionnaire (OABQ)
Coping Score
92.50 units on a scale
Interval 85.0 to 100.0
80.00 units on a scale
Interval 46.25 to 95.0
Assessment of Overactive Bladder Questionnaire (OABQ)
Concern Score
97.14 units on a scale
Interval 85.71 to 100.0
82.86 units on a scale
Interval 41.43 to 95.71
Assessment of Overactive Bladder Questionnaire (OABQ)
Sleep Score
92.00 units on a scale
Interval 76.0 to 100.0
84.00 units on a scale
Interval 50.0 to 96.0
Assessment of Overactive Bladder Questionnaire (OABQ)
Social Score
100.00 units on a scale
Interval 98.0 to 100.0
96.00 units on a scale
Interval 80.0 to 100.0
Assessment of Overactive Bladder Questionnaire (OABQ)
Health Related Quality of Life (HRQL)
92.80 units on a scale
Interval 86.0 to 99.2
76.00 units on a scale
Interval 63.2 to 95.2

SECONDARY outcome

Timeframe: 12 weeks

Population: Participants who received solifenacin were asked to complete the PFDI questionnaire at 12 weeks in order to assess certain bowel, bladder, and pelvic symptoms.

The PFDI comprises 46 items on a 4-point symptom severity scale ranging from 1 = "Not at all" to 4 = "Quite a bit". From these items, 13 separate sub-scales are reported: (1) Obstructive discomfort, (2) Irritation, (3) Stress resulting from urinal distress, (4) A general sub-scale for pelvic organ prolapse distress, (5) An anterior sub-scale for pelvic organ prolapse distress, (6) A posterior sub-scale for pelvic organ prolapse distress, (7) An obstructive sub-scale for colorectal anal distress, (8) Incontinence, (9) Pain, and (10) A rectal prolapse sub-scale for colorectal anal distress. For each of these sub-scales, scores from from 0 to 100 (where higher scores indicate greater symptom severity). There are three additional sub-scales: (11) The urinary distress inventory, (12) The pelvic organ distress inventory, and (13) The colorectal distress inventory. Each of these ranges from 0 to 400 (with higher scores indicating greater symptom severity).

Outcome measures

Outcome measures
Measure
Urinary Urge Incontinence
n=37 Participants
Women who received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Solifenacin Non-Responder
n=13 Participants
Individuals with urinary urge incontinence who did not respond to solifenacin at 12 weeks
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Obstructive Discomfort Score
5.77 units on a scale
Interval 0.0 to 17.31
7.69 units on a scale
Interval 1.92 to 26.92
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Irritative Score
12.50 units on a scale
Interval 5.0 to 30.0
32.50 units on a scale
Interval 7.5 to 52.5
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Stress Score
8.33 units on a scale
Interval 0.0 to 27.08
16.67 units on a scale
Interval 6.25 to 50.0
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Urinary Distress Inventory Score
40.19 units on a scale
Interval 12.86 to 63.37
60.26 units on a scale
Interval 23.37 to 110.87
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
General Score
7.14 units on a scale
Interval 0.0 to 16.07
14.29 units on a scale
Interval 8.93 to 25.0
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Anterior Score
8.33 units on a scale
Interval 0.0 to 18.75
8.33 units on a scale
Interval 0.0 to 31.25
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Posterior Score
0 units on a scale
Interval 0.0 to 33.33
16.67 units on a scale
Interval 8.33 to 33.33
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Pelvic Organ Prolapse Distress Inventory Score
20.83 units on a scale
Interval 12.2 to 58.33
47.62 units on a scale
Interval 31.85 to 85.12
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Obstructive Score
0 units on a scale
Interval 0.0 to 33.33
16.67 units on a scale
Interval 8.33 to 33.33
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Pain Irritation Score
10.71 units on a scale
Interval 0.0 to 26.79
10.71 units on a scale
Interval 0.0 to 26.79
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Rectal Prolapse
0 units on a scale
Interval 0.0 to 0.0
0 units on a scale
Interval 0.0 to 0.0
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Colo-Rectal-Anal Distress Inventory Score
17.86 units on a scale
Interval 7.14 to 75.48
42.86 units on a scale
Interval 29.52 to 66.25
Assessment of Pelvic Floor Disease Inventory (PFDI) Questionnaire
Incontinence Score
0 units on a scale
Interval 0.0 to 20.0
10.00 units on a scale
Interval 0.0 to 22.5

Adverse Events

Urinary Urge Incontinence

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Non-Urinary Urge Incontinence

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Urinary Urge Incontinence
n=74 participants at risk
Seventy-four (n = 74) women received 5-10mg daily solifenacin for the treatment of urinary urge incontinence (UUI).
Non-Urinary Urge Incontinence
Sixty (n = 60) women without UUI were evaluated at baseline only (week 0) in order to serve as a control cohort. These women never received study therapy (i.e., 5-10mg daily solifenacin).
General disorders
Dry Mouth
4.1%
3/74 • Number of events 3 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
0/0 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
Gastrointestinal disorders
Constipation
5.4%
4/74 • Number of events 4 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
0/0 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
General disorders
Elevated Blood Pressure
1.4%
1/74 • Number of events 1 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
0/0 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
Immune system disorders
Hives
1.4%
1/74 • Number of events 1 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
0/0 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
General disorders
Dizziness
1.4%
1/74 • Number of events 1 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).
0/0 • Participants who received solifenacin were assessed for adverse events over 12 weeks. Control participants who did not receive solifenacin, however, were only seen at baseline (0 weeks).

Additional Information

Dr. Alan J. Wolfe

Loyola University Chicago, Microbiology and Immunology

Phone: 224-392-4002

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place