TReating Incontinence for Underlying Mental and Physical Health
NCT ID: NCT05362292
Last Updated: 2025-12-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
PHASE4
270 participants
INTERVENTIONAL
2022-10-04
2027-08-02
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
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Anticholinergic bladder medication plus behavioral self-management education
Tolterodine tartrate is a muscarinic receptor antagonist designed to treat urgency incontinence, urgency, and frequency associated with overactive bladder. Behavioral self-management education includes written education about timed urination, lifestyle changes, pelvic floor muscle exercises, and urge suppression.
Tolterodine Tartrate ER
Anticholinergic
Beta-3-adrenergic agonist medication plus behavioral self-management education
Mirabegron, currently sold under the brand name Mybetriq by Astellas Pharma, is a selective beta-3-adrenergic receptor agonist approved for treatment of urgency urinary incontinence, urgency, and frequency associated with overactive bladder. Behavioral self-management education includes written education about timed urination, lifestyle changes, pelvic floor muscle exercises, and urge suppression.
Mirabegron
Beta-3-adrenergic agonist
Placebo medication plus behavioral self-management education
Microcrystalline cellulose placebo encapsulated to appear identical to tolterodine and mirabegron medication will be prepared by a compounding pharmacy. Behavioral self-management education includes written education about timed urination, lifestyle changes, pelvic floor muscle exercises, and urge suppression.
Placebo
matching placebo pill
Interventions
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Tolterodine Tartrate ER
Anticholinergic
Mirabegron
Beta-3-adrenergic agonist
Placebo
matching placebo pill
Eligibility Criteria
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Inclusion Criteria
* Female sex at birth, without surgical or hormonal gender re-assignment therapy
* Able to walk to the bathroom and use the toilet without assistance
* Report urinary incontinence starting at least 3 months prior to screening
* Report that at least half of incontinence episodes occur with a sudden or strong sensation of urgency
* Report 2 or more urgency incontinence episodes over a 7-day period
* Willing to provide informed consent and adhere to study procedures throughout the length of the study
Exclusion Criteria
* Current use of anticholinergic, beta-3-adrenergic agonist, or other medication designed to improve urgency incontinence symptoms, or use in the past 1 month
* Initiation, discontinuation, or dose change of dementia medications (such as donepezil, galantamine, memantine, rivastigmine) in the past 1 month (but candidates on stable doses are eligible)
* Initiation, discontinuation, or dose change of other drugs with strong anticholinergic effects (based on the Beers List) in the past 1 month (but candidates on stable doses are eligible)
* Initiation, discontinuation, or dose change of other drugs that can affect urinary frequency, including diuretics, in the past 1 month (but candidates on stable doses are eligible)
* Current urinary tract infection (UTI) based on screening urinalysis and culture (but candidates can re-present for re-screening after undergoing treatment for UTI)
* History of allergy or sensitivity to either of the study medications or an ingredient in the placebo or study medication capsule
* Severe hepatic impairment (Child-Pugh score B or greater) or renal impairment (creatinine clearance \<30 mL/min) as a contraindication to both study medications
* Current bladder obstruction or urinary retention (defined by symptoms suggesting difficulty emptying the bladder in addition to postvoid residual urine volume greater than 150 cc by portable bladder ultrasound)
* Uncontrolled hypertension (based on measured systolic blood pressure greater than 180 or diastolic blood pressure greater than 110 mmHg) as a contraindication to beta-3-adrenergic therapy
* Self-reported history of gastric retention, uncontrolled narrow angle glaucoma, myasthenia gravis, severe ulcerative colitis, or toxic megacolon as contraindications for anticholinergic bladder therapy
* Use of drugs with adverse interactions with one of the study medications in the past 1 month, including potent CYP3A4 inhibitors, hepatic enzyme metabolism inducers, narrow therapeutic index drugs metabolized by CYP2D6, or intention to start taking one of these medications during the study treatment period
* History of bladder surgery, invasive intra-vesical therapy, or bulk bladder injections in the past 3 months (more remote surgery will not be exclusionary), or intention to undergo one of these procedures in the study treatment period
* Use of other specialized incontinence therapy (electrostimulation, pelvic physiotherapy, formal behavioral therapy overseen by certified practitioners) in the past 3 months (more remote therapy will not be exclusionary), or intention to undergo one of these procedures in the study treatment period
* Inability to sign informed consent or complete questionnaires, interviews, or study testing in English
* Other condition that would prevent the participant from completing study procedures, in the opinion of the investigators (e.g., uncontrolled psychosis)
60 Years
FEMALE
Yes
Sponsors
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National Institute on Aging (NIA)
NIH
University of California, San Francisco
OTHER
Responsible Party
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Principal Investigators
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Alison Huang, MD, MAS, MPhil
Role: PRINCIPAL_INVESTIGATOR
University of California, San Francisco
Locations
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Stanford University
Palo Alto, California, United States
University of California San Francisco
San Francisco, California, United States
Countries
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Central Contacts
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Facility Contacts
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References
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Huang AJ, Walter LC, Yaffe K, Vittinghoff E, Kornblith E, Schembri M, Chang A, Subak LL. TReating Incontinence for Underlying Mental and Physical Health (TRIUMPH): a study protocol for a multicenter, double-blinded, randomized, 3-arm trial to evaluate the multisystem effects of pharmacologic treatment strategies for urgency-predominant urinary incontinence in ambulatory older women. Trials. 2023 Apr 21;24(1):287. doi: 10.1186/s13063-023-07279-z.
Other Identifiers
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21-35858
Identifier Type: -
Identifier Source: org_study_id