Changes in the Urinary Microbiome and Metabolome During Treatment of the Overactive Bladder in Female Patients

Обзор

This is a non-interventional study that will not pose any burden for the participants. The study subjects will be examined and treated in a standard manner according to current clinical recommendations for the treatment of overactive bladder (OAB). A portion of urine samples, which are routinely collected for biochemical and culture examinations as part of the diagnostic process, will be sent for examination of the characteristics of the urinary microbiome and metabolome (UMM) before and after treatment.

Подробное описание

Participation in the study will be offered to female patients who seek treatment for OAB symptoms themselves or are referred to centers participating in the project if a clinical diagnosis of idiopathic OAB is established in their case as part of the standard examination process.

Patients will be approached by one of the authorized team members with information about the possibility of participating in this study. If the patient is interested in participating in the study, she will give written informed consent to participate in the study. Subsequently, the inclusion and exclusion criteria for participation in the study will be verified and a standardized urine collection will be performed to examine the characteristics of UMM. At the same time, the patient will fill in standard questionnaires used to determine the severity of OAB symptoms.

To research changes in UMM during OAB treatment, patients will be divided into a group with a good treatment response (responders) and a group without a good treatment response (non-responders). The primary indicator of a good treatment effect (definition of responder) is a reduction in the number of episodes of severe urgency with or without urge incontinence over 3 days documented by a voiding diary by more than 50% compared to the state before treatment. Based on the available data, treatment success is anticipated in 60% of patients.

Subsequently, the study participants will be treated with standard drug treatment for five weeks. They will then be invited to evaluate the effect of treatment using standard symptom questionnaires. At the same time, a control standardized urine collection will be performed to examine the characteristics of UMM. The patients will then end their participation in the study and will continue their treatment according to the valid clinical recommendations for treatment.

Вмешательства

• Диагностический тест Urine Microbiological and Metabolomic Analysis
  Microbiological and metabolomic analysis of a urine sample will be performed in the study subjects, before and after the end of the treatment.

Первичные конечные точки

• Proportion of responders to the OAB treatment [Срок оценки: 6 weeks]

Вторичные конечные точки (1)

• Change in UMM characteristics between both groups [Срок оценки: 6 weeks]

Критерии участия

Критерии включения

• Adult women over 18 years of age
• Written consent to participate in the study
• Willingness to undergo OAB evaluation and treatment according to the protocol
• OAB symptoms lasting longer than 3 months
• At least 3 episodes of severe urgency with or without urge incontinence within 3 days documented by voiding diary
• OAB symptom score V8 questionnaire ≥ 8

Критерии исключения

• Known congenital developmental defects of the urinary tract (congenital hydronephrosis, vesicoureteral reflux, renal agenesis and hypoplasia, multicystic and polycystic kidneys)
• Any previous treatment for OAB
• Recurrent urinary tract infections (more than 3 episodes in the last 12 months)
• Presence of a foreign body in the urinary tract - urolithiasis, urinary catheter, ureteral stent
• Acute or chronic diseases with possible influence on the function of the lower urinary tract (LUT)
• Rheumatoid arthritis
• Diabetes mellitus

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Только случаи

Центры проведения

Чехия · 4 центра

• University Hospital Ostrava — Ostrava
• Thomayer University Hospital — Prague
• Institute of Microbiology of the Czech Academy of Sciences — Prague
• University Hospital Bulovka — Prague

Публикации

• Nambiar AK, Arlandis S, Bo K, Cobussen-Boekhorst H, Costantini E, de Heide M, Farag F, Groen J, Karavitakis M, Lapitan MC, Manso M, Arteaga SM, Riogh ANA, O'Connor E, Omar MI, Peyronnet B, Phe V, Sakalis VI, Sihra N, Tzelves L, van Poelgeest-Pomfret ML, van den Bos TWL, van der Vaart H, Harding CK. European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic PMID 35216856
• Peyronnet B, Mironska E, Chapple C, Cardozo L, Oelke M, Dmochowski R, Amarenco G, Game X, Kirby R, Van Der Aa F, Cornu JN. A Comprehensive Review of Overactive Bladder Pathophysiology: On the Way to Tailored Treatment. Eur Urol. 2019 Jun;75(6):988-1000. doi: 10.1016/j.eururo.2019.02.038. Epub 2019 Mar 26. PMID 30922690
• Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001 Jun;87(9):760-6. doi: 10.1046/j.1464-410x.2001.02228.x. PMID 11412210
• Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, Coyne K, Kelleher C, Hampel C, Artibani W, Abrams P. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006 Dec;50(6):1306-14; discussion 1314-5. doi: 10.1016/j.eururo.2006.09.019. Epub 2006 Oct 2. PMID 17049716
• Agarwal A, Eryuzlu LN, Cartwright R, Thorlund K, Tammela TL, Guyatt GH, Auvinen A, Tikkinen KA. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014 Jun;65(6):1211-7. doi: 10.1016/j.eururo.2014.01.019. Epub 2014 Jan 24. PMID 24486308
• Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. doi: 10.1002/nau.10052. No abstract a PMID 11857671
• Zheng H, Wang C, Yu X, Zheng W, An Y, Zhang J, Zhang Y, Wang G, Qi M, Lin H, Wang F. The Role of Metabolomics and Microbiology in Urinary Tract Infection. Int J Mol Sci. 2024 Mar 8;25(6):3134. doi: 10.3390/ijms25063134. PMID 38542107
• Gupta A, Dwivedi M, Mahdi AA, Gowda GA, Khetrapal CL, Bhandari M. 1H-nuclear magnetic resonance spectroscopy for identifying and quantifying common uropathogens: a metabolic approach to the urinary tract infection. BJU Int. 2009 Jul;104(2):236-44. doi: 10.1111/j.1464-410X.2009.08448.x. Epub 2009 Feb 23. PMID 19239442

Идентификаторы

NCT: NCT06921746 · MicrOAB-001

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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