Beta-Agonist Versus OnabotulinumtoxinA Trial for Urgency Urinary Incontinence
NCT ID: NCT05806164
Last Updated: 2025-09-25
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
432 participants
INTERVENTIONAL
2023-06-06
2030-08-01
Brief Summary
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Participants will be randomly selected to receive one of the two treatments. The primary outcome measure will be at 3 months, and women will be followed for a total of 12 months.
Based on patient expert input, there are 2 primary outcomes: Treatment satisfaction and urinary symptom severity.
The study will also have a long-term follow-up component (prospective cohort) including 346 participants from the parent trial to describe treatment continuation, treatment efficacy, patient direct costs and other secondary outcomes up to 5 years after treatment.
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Detailed Description
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The study will also compare secondary outcomes identified as important by patients. At the end of the study, the investigators will have patient and stakeholder-derived comparative outcomes between these 2 commonly available treatment categories. A stakeholder and community engagement (CE) plan will be developed and implemented. The investigators will also develop a model to help guide patients and providers through this decision process.
SPECIFIC AIMS Specific Aim 1: Compare the efficacy of beta agonist versus onabotulinumtoxinA on patient-important treatment outcomes at 3 months in women with UUI.
This multi-center, randomized clinical trial (RCT) includes 5 sites across the U.S. Two co-primary outcomes will be measured using validated patient-reported outcomes (PROs), selected by patients: Co-primary outcome 1: Symptom severity, measured by change in Overactive Bladder Questionnaire-Symptom Bother Scale (OAB-q-SS) score.
Co-primary outcome 2: Treatment satisfaction, measured by the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-General (FACIT-TS-G), powered based on a single item.
Specific Aim 2: Compare secondary patient-important outcomes. Direct comparisons between intervention effects on secondary outcomes chosen by patients and stakeholders, including adverse events, UUI quality of life, global improvement, and sexual function.
Specific Aim 3: Use predictive modeling to help stakeholders better determine expected outcomes after treatment with beta agonist versus onabotulinumtoxinA.
Comparators: Beta agonist oral medication (mirabegron or vibegron) versus intradetrusor onabotulinumtoxinA.
Both beta-agonists and onabotulinumtoxinA are US Food and Drug Administration (FDA) approved for the treatment of UUI, and widely available options with established efficacy.
432 women will be randomly assigned to each treatment option: 216 to beta agonist oral medication and 216 to intradetrusor onabotulintoxinA. Women will be undergo outcomes assessments at 3, 6, 9, and 12 months. The primary outcome measure will be at 3 months.
For the long-term follow up study, a prospective cohort of 346 study participants of the parent trial who agree will be followed with additional outcome assessments for 3-5 years. Outcomes for the long-term follow up study will include: continuation/discontinuation of treatment, treatment satisfaction and symptom control, treatment crossover, additional treatments, patient-important complications, costs, and understanding barriers to continued long-term UUI care and possible solutions. Qualitative methods will be expanded to further explore barriers to continuing long-term UUI care.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Beta-3 receptor agonist oral medication
Selective beta-3 receptor agonist oral medication approved for the treatment of urgency urinary incontinence including mirabegron or vibegron. Usual clinical care standards will be used for prescribing and dosing changes. For mirabegron, dosages are 25 mg and 50 mg as clinically indicated. For vibegron, dosage is 75 mg daily by mouth as clinically indicated.
Beta3-Agonists, Adrenergic [Mirabegron/Vibegron]
The beta-agonist oral medication will be prescribed and dose adjusted per usual care.
Intradetrusor onabotulinumtoxinA
OnabotulinumtoxinA at a dose of 100 units will be injected into the bladder per usual care pathways.
OnabotulinumtoxinA 100 UNT [Botox]
OnabotulinumtoxinA will be prepared by dissolving 100 units into 10 ml of injectable saline. The injection will be an office based procedure, performed per usual care.
Interventions
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Beta3-Agonists, Adrenergic [Mirabegron/Vibegron]
The beta-agonist oral medication will be prescribed and dose adjusted per usual care.
OnabotulinumtoxinA 100 UNT [Botox]
OnabotulinumtoxinA will be prepared by dissolving 100 units into 10 ml of injectable saline. The injection will be an office based procedure, performed per usual care.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. report at least "quite a bit bothered" or worse by their UUI defined by response to OAB-q-SS item #8 "How bothered are you by urine loss associated with a strong desire to urinate?"
3. are not and do not plan to become pregnant
4. have persistent UUI defined as previous unsuccessful results after conservative and anticholinergic treatment, or are unable to tolerate or have contraindications to anticholinergics
5. are currently not taking anticholinergics or are willing to stop medication for 3 weeks prior to enrollment.
6. for participants reporting mixed urinary incontinence symptoms, participant must (a) have less bother from SUI than from UUI, defined as a response of "Not at all bothered" or only "a little bit bothered" by SUI on the Urogenital Distress Inventory item "Do you experience urine leakage related to physical activity? (walking, running, laughing, sneezing, coughing), and (b) SUI symptoms be stable (\> 3 months), and (c)participant does not desire additional treatment for SUI in the upcoming 3 months.
7. Participants after unsuccessful neuromodulation trial can be eligible after a 4-week washout period.
Exclusion Criteria
2. prior therapeutic trial of either study treatment
3. unevaluated hematuria, current or prior bladder malignancy
4. surgically altered detrusor muscle
5. prior pelvic radiation
6. post-void residual \>150 mL in past 3 months
7. neurogenic bladder
8. pelvic floor surgery within the past 3 months
9. anticipating pelvic surgery within primary outcome follow up period (3 months)
18 Years
FEMALE
Yes
Sponsors
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University of New Mexico
OTHER
University of Alabama at Birmingham
OTHER
University of California, San Diego
OTHER
Howard University
OTHER
Brown University
OTHER
Patient-Centered Outcomes Research Institute
OTHER
Women and Infants Hospital of Rhode Island
OTHER
Responsible Party
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Vivian Sung
MD, MPH, Professor of Obstetrics & Gynecology, The Warren Alpert Medical School of Brown University; Director of Research, Division of Urogynecology, Women & Infants Hospital of Rhode Island
Principal Investigators
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Vivian Sung, MD, MPH
Role: PRINCIPAL_INVESTIGATOR
Women and Infants Hospital of Rhode Island
Peter Jeppson, MD
Role: PRINCIPAL_INVESTIGATOR
University of New Mexico
Locations
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University of Alabama at Birmingham
Birmingham, Alabama, United States
University of California, San Diego
San Diego, California, United States
Howard University
Washington D.C., District of Columbia, United States
University of New Mexico
Albuquerque, New Mexico, United States
Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States
Countries
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Central Contacts
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Facility Contacts
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Gabriella Halder, MD
Role: backup
Other Identifiers
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1895985
Identifier Type: -
Identifier Source: org_study_id
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