Clinical trial NCT05491525: A Study of Vibegron in Pediatric Participants 2 Years to Less Than (<) 18 Years of Age With NDO and on CIC
Official title: A Phase 2/3, Open-label, Baseline-controlled, Multicenter, Long-term Study to Evaluate the Safety, Efficacy, and Pharmacokinetics of Vibegron in Pediatric Subjects 2 Years to < 18 Years of Age With Neurogenic Detrusor Overactivity (NDO) on Clean Intermittent Catheterization (CIC)
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
PHASE3
Conditions: Neurogenic Detrusor Overactivity
Keywords: Neurogenic Detrusor Overactivity
Vibegron
Clean Intermittent Catheterization
Beta-3 Adrenergic Receptor Agonist
Maximum Cystometric Capacity
Spinal Dysraphism
Spina Bifida
Myelomeningocele
Meningocele
Spinal cord injury
Transverse myelitis
Lead sponsor: Urovant Sciences GmbH
Sponsor class: INDUSTRY
First posted: 2022-08-08
Enrollment: 85
Sex: ALL
Minimum age (years): 2
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the safety, efficacy, and PK of vibegron in pediatric participants with NDO who are regularly using CIC


Eligibility criteria: Inclusion Criteria:

* Male or female participants, age 2 years to \< 18 years at the Screening Visit. Participants age 12 to \< 18 years (Cohort 1) must weigh at least 29.5 kilograms (kg). Participants age 2 to \< 12 years (Cohort 2) must weigh at least 11 kg.
* Participant has been diagnosed with NDO due to one of the following: spinal dysraphism, which includes spina bifida (eg, myelomeningocele, meningocele) and all forms of tethered cord; or acquired NDO from a spinal cord injury or spinal cord surgery, with the injury/surgery having occurred at least 6 months prior to the Screening Visit; or acquired NDO due to transverse myelitis with diagnosis at least 12 months prior to the Screening Visit.
* Participant undergoes CIC at least 3 times per 24 hours (with the last CIC performed prior to going to sleep for the night) for at least 4 weeks prior to the Screening Visit.

Exclusion Criteria:

* Participant has cerebral palsy, uncontrolled epilepsy, diabetes insipidus, or Stage 2 hypertension
* Participant has an active malignancy in the 12 months prior to the Screening Visit.
* Participant has been administered intravesical botulinum toxin within 9 months prior to the Screening Visit and should remain off this therapy during the study.
* Participant is taking digoxin or lithium within 10 days prior to Screening Visit or plans to start taking either during the study.
* Participant currently uses or plans to use a baclofen pump during the study.
* Participant has urethral dilatation or has had urethral surgery in the 3 months prior to the Screening Visit.
* Participant has undergone bladder augmentation surgery.
* Participant has a known genitourinary condition (other than NDO) that may cause overactive contractions or incontinence (bladder exstrophy, urinary tract obstruction, urethral diverticulum or fistula) or bladder stones or another persistent urinary tract pathology that may cause symptoms.
* Participant has an insufficient urethral sphincter, has had implantation of an artificial sphincter, has a surgically-treated underactive urethral sphincter, or, in the 6 months prior to the Screening Visit, has undergone pelvic gender reassignment surgery.
* Participant has one of the following gastrointestinal problems: partial or complete obstruction, decreased motility such as paralytic ileus, risk of gastric retention, or malabsorption syndrome of any form.
* Participant has fecal impaction or a history of fecal impaction requiring hospitalization or ambulatory surgical treatment in the 3 months prior to the Screening Visit.
* Participant has a urinary indwelling catheter in the 4 weeks prior to the Screening Visit.
* Participant has moderate to severe dilating vesicoureteral reflux (Grade III to V) or severe renal failure.
* Participant started electrostimulation/neuromodulation therapy in the 4 weeks before the Screening Visit, or is expected to start this therapy during the study period.
* Participant has participated in another clinical trial and/or has taken an investigational drug within 4 weeks prior to the Screening Visit.
* Participant is unable, or parent/caregiver is not willing, to washout any medication for the management of NDO.
* Participant is a female of childbearing potential who is unwilling or unable to use a highly effective method of contraception for the duration of the study.
* Female participants who are currently breastfeeding or plan to breastfeed any time from the Screening Visit until 28 days after the final study drug administration.

Primary outcomes:
measure: Change from Baseline in maximum cystometric capacity (MCC) based on bladder filling urodynamics
timeFrame: Baseline and at Week 32
Secondary outcomes:
measure: Change from Baseline in MCC
timeFrame: Baseline and at Week 20
measure: Change from Baseline in number of overactive detrusor contractions until the end of bladder filling
timeFrame: Baseline and at Weeks 20 and 32
measure: Change from Baseline in detrusor pressure at the end of bladder filling
timeFrame: Baseline and at Weeks 20 and 32
measure: Change from Baseline in bladder filling volume until first involuntary/hyperactive detrusor contraction
timeFrame: Baseline and at Weeks 20 and 32
measure: Change from Baseline in bladder compliance (mL/cm H2O)
timeFrame: Baseline and at Weeks 20 and 32
measure: Change from Baseline in average first morning catheterized volume
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in average catheterized volume per catheterization
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in average maximum catheterized volume per day
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in average maximum catheterized daytime volume
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in average number of leakage episodes per day
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in estimated number of dry (leakage-free) days/ 7 days
timeFrame: Baseline and at Weeks 1, 4, 8, 20, 32, 48, and 52
measure: Change from Baseline in Pediatric Incontinence Questionnaire (PIN-Q)
timeFrame: Baseline and at Weeks 20, 32 and 52
measure: Change from Baseline in Patient Global Impression of Severity (PGI-S) Scale
timeFrame: Baseline and at Weeks 20, 32 and 52
measure: Change from Baseline in Clinical Global Impression of Change (CGI-C) Scale
timeFrame: Baseline and at Weeks 20, 32 and 52
Other outcomes:
Locations:
city: Orange
country: United States
facility: Children's Hospital of Orange County
state: California
city: Jacksonville
country: United States
facility: Nemours Childrens Health, Jacksonville
state: Florida
city: Wichita
country: United States
facility: Wichita Urology Group
state: Kansas
city: New Orleans
country: United States
facility: Childrens Hospital New Orleans
state: Louisiana
city: Albany
country: United States
facility: Albany Medical College
state: New York
city: Durham
country: United States
facility: Duke University Medical Center
state: North Carolina
Study officials:
References: