Randomised trial of detrusor botulinum toxin injection compared to placebo in idiopathic detrusor overactivity

ISRCTN ISRCTN26091555
DOI https://doi.org/10.1186/ISRCTN26091555
Secondary identifying numbers UHL 9735 and 2004-002981-39
Submission date
11/04/2005
Registration date
26/05/2005
Last edited
14/02/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Douglas Tincello
Scientific

Robert Kilpatrick Clinical Sciences Building
PO Box 65
Leicester Royal Infirmary
Leicester
LE2 7LX
United Kingdom

Phone +44 (0)116 252 3165
Email dgt4@le.ac.uk

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific title
Study acronymRELAX
Study objectivesThe principal research objectives for this trial are:
1. To determine the efficacy of detrusor muscle botulinum toxin A (BOTOX®) injection at relieving symptoms of detrusor overactivity
2. To examine the side effects and complications of detrusor muscle BOTOX® injection
3. To collect basic cost effectiveness data including EuroQol 5D data to allow simple cost effectiveness calculations to be done
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedDetrusor overactivity
InterventionPrior to 16/03/10:
Women will be randomised to receive either a single treatment with 200 IU of botulinum toxin A (BOTOX®) into the detrusor muscle (10 units in 1 ml in 20 separate sites, sparing the trigone), or a single treatment of injection of normal saline (placebo) (20 separate injections of 1 ml) into the detrusor muscle.

Modified 16/03/10:
Women will be randomised to receive either a single treatment with 200 IU of botulinum toxin A (BOTOX®) into the detrusor muscle (10 units in 1 ml in 20 separate sites, sparing the trigone), or a single treatment of injection of placebo (injection vehicle) into the detrusor muscle.
Intervention typeOther
Primary outcome measureDiary recorded urinary voiding frequency per 24 hours measured at 6 months. A minimum of two complete diary days will be accepted as valid data. A window of –2 to +8 weeks around the 6 month follow up visit will be allowed.
Secondary outcome measuresa. Diary measures
1. Urgency episode frequency/24 hours at 3 and 6 months
2. Incontinence episode frequency at 3 and 6 months
3. Urgency severity assessed by IUSS26 at 3 and 6 months

b. Questionnaire measures
1. International Consultation on Incontinence Questionnaire short form score (ICIQ-SF)
2. Incontinence Quality of Life (IQOL) questionnaire score

c. Physical measures
1. Incidence of complications (including voiding dysfunction, urinary tract infection, haematuria, dysuria, reported muscle weakness)
2. Need for additional treatment during follow up, defined as a new prescription for drugs, or a new referral for other therapies
3. Interval between treatment and patient reported return of troublesome symptoms

d. Health economics
1. EuroQol 5D data compared between baseline, 6 weeks and 6 months follow up
2. Estimated costs of each treatment, using reported health care contacts at 6 weeks and 6 months
Overall study start date01/02/2006
Completion date31/10/2010

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participants240
Key inclusion criteria1. 8 weeks of continued treatment with oral anticholinergic medication, with a screening Patient Global Impression of Improvement (PGI-I) scale score of 'a little better' or 'worse'. This point of the scale represents a reduction of incontinence episode frequency of around 50% (Slack, unpublished data).
2. 8 weeks of continued treatment, with a verbal response that the treatment has not provided acceptable improvement
3. Treatment stopped because of side effects within 8 weeks
4. Previous treatments stopped because of lack of efficacy, and currently receiving no treatment

Additionally, patients will report at least 8 voids per 24 hours, with at least 2 urgency episodes per 24 hours. Urgency episodes will be defined as those rated as 'moderate' or higher on the Urgency severity scale, and urge incontinence episodes will be defined as recorded leakage in association with an urgency episode.
Key exclusion criteria1. Patients with known multiple sclerosis, stroke, spinal injury, or other neurological disease
2. Patients with pre-existing voiding dysfunction (flow rate less than 5th centile, or post void residual volume greater than 100 ml)
3. Patients fulfilling the exclusion criteria for the licensed indications of botulinum toxin (myasethenia gravis and Eaton Lambert syndrome, or allergy to constituents of BOTOX® injection)
4. Patients with co-existing urodynamic stress incontinence
Date of first enrolment01/02/2006
Date of final enrolment31/10/2010

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Robert Kilpatrick Clinical Sciences Building
Leicester
LE2 7LX
United Kingdom

Sponsor information

University Hospitals of Leicester NHS Trust (UK)
Hospital/treatment centre

Research and Development Office
Leicester General Hospital
Gwendolen Road
Leicester
LE5 4PW
England
United Kingdom

Phone +44 (0)116 249 0490
Email Carolyn.maloney@uhl-tr.nhs.uk
ROR logo "ROR" https://ror.org/02fha3693

Funders

Funder type

Charity

Moulton Charitable Trust (UK)

No information available

Added 16./03/10: Wellbeing of Women (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/09/2012 Yes No
Results article results 01/01/2013 Yes No