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Fesoterodine

Phase 3

Overactive Bladder | Small molecule | Nephrology |Pfizer, Inc.|Last Updated: Dec 5, 2018

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials6
Total Enrollment4,249

FDA Designations

No designations recorded

Clinical trial landscape

Fesoterodine · 17 trials · 11 indications

Phase 3 5Phase 2 3Phase 1 9
NCT00658684Long Term Study To Evaluate the Safety, Tolerability and Efficacy of Fesoterodine for Overactive Bladder.Overactive Bladder
COMPLETED153 Analytics
NCT00546637Fesoterodine "add-on" Male Overactive Bladder StudyOveractive Bladder Syndrome
COMPLETED947 Analytics
NCT00536484Fesoterodine Flexible Dose StudyOveractive Bladder
COMPLETED896 Analytics
NCT00444925Clinical Trial to Evaluate the Efficacy and Safety of Fesoterodine in Comparison to Tolterodine for Overactive Bladder (OAB)Overactive Bladder
COMPLETED1,712 Analytics
NCT00425100A Clinical Trial To Assess Fesoterodine On Treatment Satisfaction And Symptom Improvement In Overactive Bladder PatientsOveractive Bladder
COMPLETED516 Analytics
PHASE3COMPLETED
Long Term Study To Evaluate the Safety, Tolerability and Efficacy of Fesoterodine for Overactive Bladder.
Overactive BladderUnlock trial analytics
PHASE3COMPLETED
Fesoterodine "add-on" Male Overactive Bladder Study
Overactive Bladder SyndromeUnlock trial analytics
PHASE3COMPLETED
Fesoterodine Flexible Dose Study
Overactive BladderUnlock trial analytics
PHASE3COMPLETED
Clinical Trial to Evaluate the Efficacy and Safety of Fesoterodine in Comparison to Tolterodine for Overactive Bladder (OAB)
Overactive BladderUnlock trial analytics
PHASE3COMPLETED
A Clinical Trial To Assess Fesoterodine On Treatment Satisfaction And Symptom Improvement In Overactive Bladder Patients
Overactive BladderUnlock trial analytics

Study Endpoints

Primary Endpoints

Safety Measurement Based on Adverse Events (AEs), Vital Signs, Clinical Laboratory Test, 12-lead ECG and Residual Urine Volume
52 Weeks

The number of subjects who experienced AEs (all causality and treatment-related ) based on safety assessment during the study were summarized. The severity and seriousness of treatment-emergent AEs as well as discontinuations, dose reductions and temporary discontinuations (DR/TD) due to treatment-emergent AEs were also summarized.

Numerical Change From Baseline in Micturition-Related Urgency Episodes Per 24 Hours at Week 12
Baseline, Week 12

The mean number of micturition-related urgency episodes per 24 hours was calculated as the total number of micturitions with USS Scale \>= 3 divided by the total number of days that diary data was collected at that visit. USS total range 1 to 5: 1. No feeling of urgency, 2. Mild feeling of urgency, 3. Moderate feeling of urgency, 4. Severe feeling of urgency, 5. Unable to hold; leak urine.

Change in Mean Number of Micturition Episodes Per 24 Hours at Week 12 Relative to Baseline.
Baseline and Week 12

The number of micturitions per 24 hours was calculated as the sum of all micturitions divided by the total number of diary days collected at that visit. Change: mean at Week 12 minus mean at Baseline

Change From Baseline in Mean Number of Urgency Urinary Incontinence (UUI) Episodes Per 24 Hours at Week 12 (End of Treatment).
Baseline, Week 12

UUI per 24 hours: total number of micturitions with Urinary Sensation Scale (USS) of 5 divided by total number of diary days collected at visit. USS: 5-item scale to measure urinary urgency; range: 1 (no feeling of urgency) to 5 (unable to hold; leak urine). Change: mean at observation minus mean at baseline.

Mean Number of Micturition Episodes Per 24 Hours
Baseline and Week 12

The mean number of micturitions per 24 hours is calculated as the total number of micturitions divided by the total number of diary days collected at that visit.

Mean Number of Urgency Urinary Incontinence (UUI) Episodes Per 24 Hours
Baseline and Week 12

The mean number of UUI episodes per 24 hours is calculated as the total number of micturitions with Bladder Sensation Scale (BSS) = 5 divided by the total number of diary days collected at that visit. BSS: 5 point scale measuring need to urinate from 1=no urgency to 5=unable to hold; leak urine.

Mean Number of Urgency Episodes Per 24 Hours
Baseline and Week 12

The mean number of urgency episodes per 24 hours is calculated as the total number of micturitions with Bladder Sensation Scale (BSS) \>= 3 divided by the total number of diary days collected at that visit. BSS: 5 point scale measuring need to urinate from 1=no urgency to 5=unable to hold; leak urine.

Number of Participants Reporting Satisfaction With Current Overactive Bladder (OAB) Treatment
Week 12

Number of Participants who responded satisfied = (very satisfied or somewhat satisfied) and dissatisfied = (somewhat dissatisfied or very dissatisfied) to the treatment satisfaction question.

Absorption Rate Constant (Ka)
Day 28 and Day 56
Apparent Volume of Distribution (VC/F)
Day 28 and Day 56

The volume necessary to account for the total amount of drug in the body if it were present throughout the body at the same concentration found in the blood. Estimated using non linear mixed effect modeling.

Area Under the Plasma Drug Concentration Time Curve (AUC)
Day 28 and Day 56

AUC is a measure of the serum concentration of the drug over time. It is used to characterize drug absorption.

Maximum Observed Plasma Concentration (Cmax)
Day 28 and Day 56
Time to Reach Maximum Observed Plasma Concentration (Tmax)
Day 28 and Day 56
Plasma Decay Half-Life (t1/2)
Day 28 and Day 56

Plasma decay half-life is the time measured for the plasma concentration to decrease by one half.

Apparent Oral Clearance (CL/F)
Day 28 and Day 56

Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Clearance was estimated using non linear mixed effect modeling. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.

Change From Baseline in Opening Urethral Pressure (OUP) at Day 7
Baseline, Day 7 of each period

OUP measured by urethral reflectometry calculated as the mean of all of the OUP measurements obtained in triplicate at each time point for each participant. Day 7 mean for each treatment period was calculated as the mean of the three measurements taken post-dose on Day 7 of each treatment period separately.

Change From Baseline in Mean Number of Urgency Urinary Incontinence (UUI) Episodes Per 24 Hours at Week 12.
Baseline to Week 12

Number of urgency urinary incontinence episodes was measured by the 3-day micturition diary completed for 3 consecutive days during the 7 days prior to each visit. Urgency urinary incontinence is the complaint of involuntary leakage accompanied by or immediately preceded by urgency. Urgency is the complaint of a sudden compelling desire to pass urine which is difficult to defer. Change: mean at Week 12 minus mean at Baseline.

Area Under the Curve From Time Zero to Extrapolated Infinite Time [AUC (0 - 8)]
48 hours

AUC is a measure of the serum concentration of the drug over time. It is used to characterize drug absorption.

Area Under the Curve from Time Zero to Extrapolated Infinite Time [AUC(0-inf)]
0, 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 15, 24, 30, 36, and 48 hours post-dose.
Area Under the Curve From Time Zero to Extrapolated Infinite Time [AUC (0 - ∞)] for Fesoterodine Metabolite (5-hydroxymethyltolterodine [5-HMT])
0, 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 15, 24, 30, 36 and 48 hours (hrs) post dose

AUC (0 - ∞) = Area under the plasma concentration versus time curve (AUC) from time zero to extrapolated infinite time (0 - ∞). It is obtained from AUC (0 - t) plus AUC (t - ∞).

Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast) for Fesoterodine Metabolite (5-HMT)
0, 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 15, 24, 30, 36 and 48 hrs post dose

Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast) of 5-HMT.

Maximum Observed Plasma Concentration (Cmax) for Fesoterodine Metabolite (5-HMT)
0, 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 15, 24, 30, 36 and 48 hrs post dose
Computer Based Objective Cognition Testing (CogState) Detection Speed
Baseline

Detection speed: a cognitive test which assessed psychomotor function. A playing card was presented face up in the center of the screen. As soon as this happened, the participant was to press the 'Yes' key. The outcome measure was speed of performance; mean of the log10 transformed reaction time for correct responses \[measured in log10 milliseconds (MS)\]. Lower scores meant a better performance.

Change From Baseline in Computer Based Objective Cognition Testing (CogState) Detection Speed on Day 6
Baseline and Day 6

Detection speed: a cognitive test which assessed psychomotor function. A playing card was presented face up in the center of the screen. As soon as this happened, the participant was to press the 'Yes' key. The outcome measure was speed of performance; mean of the log10 transformed reaction time for correct responses \[measured in log10 milliseconds (MS)\]. Lower scores meant a better performance.

AUCinf, AUClast, and Cmax of 5-HMT
6 weeks
AUCinf and Cmax of 5-HMT
3 days per period
AUCt and Cmax of 5-HMT after single oral administration of 4 mg fesoterodine SR tablets in formulation D under fasted conditions
Day 1 and 2
AUCt and Cmax of 5-HMT after single oral administration of 4 mg fesoterodine SR tablets in formulation E(1) under fasted conditions
Day 1 and 2
AUCt and Cmax of 5-HMT after single oral administration of 2 tabs of 4 mg fesoterodine SR tablets of formulation F and 1 tab of 8 mg fesoterodine SR tablets of formulation F under fed condition
Day 1 and 2
AUCt and Cmax of 5-HMT after single oral administration of 2 tabs of 4 mg fesoterodine SR tablets of formulation Fand 1 tab of 8 mg fesoterodine SR tablets of formulation F under fasted condition
Day 1 and 2
AUCt and Cmax of 5-HMT under after single oral administration of 1 tab of 8 mg fesoterodine SR tablets of formulation F and 1 tab of 8 mg fesoterodine SR tablet of formulation E(1)
Day 1 and 2

Secondary Endpoints

Change From Baseline in Mean Number of Urgency Urinary Incontinence (UUI) Episodes Per 24 Hours at Week 4, 8, 28 and 52
Week 4, 8, 28 and 52
Change From Baseline in Mean Number of Micturitions at Week 4, 8, 28 and 52
Week 4, 8, 28 and 52
Change From Baseline in Mean Number of Urgency Episodes Per 24 Hours at Week 4, 8, 28 and 52
Week 4, 8, 28 and 52
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Fesoterodine fumarateEXPERIMENTAL -
Fesoterodine 4mg or 8mgEXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
Fesoterodine (Double-Blind)EXPERIMENTAL -
Placebo (Double-Blind)PLACEBO_COMPARATOR -
FesoterodineEXPERIMENTALTablets
TolterodineACTIVE_COMPARATORCapsules
Open Label-fesoterodineEXPERIMENTALSingle treatment study arm.
Fesoterodine once dailyEXPERIMENTAL -
Arm 1EXPERIMENTAL -
Fesoterodine fumarate 4 mg (Double-Blind)EXPERIMENTAL -
Fesoterodine fumarate 8 mg (Double-Blind)EXPERIMENTAL -
Cohort 1EXPERIMENTAL -
Cohort 2EXPERIMENTAL -
Treatment A, Cohort 1EXPERIMENTAL -
Treatment B, Cohort 2EXPERIMENTAL -
Treatment C, Cohort 1EXPERIMENTAL -
Treatment D, Cohort 2EXPERIMENTAL -
Treatment E, Cohort 1 and/or Cohort 2ACTIVE_COMPARATOR -
AEXPERIMENTAL4 mg fesoterodine IR beads in capsule under fasting condition
BEXPERIMENTAL4 mg fesoterodine 10% coated ER beads in capsule under fasting condition
CEXPERIMENTAL4 mg fesoterodine 15% coated ER beads in capsule under fasting condition.
DEXPERIMENTAL4 mg fesoterodine 20% coated ER beads in capsule under fasting condition.
EEXPERIMENTAL4 mg fesoterodine ER tablets under fasting condition.
FEXPERIMENTAL4 mg fesoterodine TBD % coated ER beads in capsule under fed condition.
4mg fesoterodineEXPERIMENTAL -
fesoterodine 8mgEXPERIMENTAL -
1mg alprazolamACTIVE_COMPARATOR -
ReferenceOTHERa single dose of 8 mg fesoterodine (Toviaz™ 8 mg) tablet manufactured at Zwickau
TestOTHERa single dose of 8 mg fesoterodine (Toviaz™ 8 mg) tablet manufactured at Vega Baja (Test)
Fesoterodine AloneEXPERIMENTALReference treatment
fesoterodine plus fluconazoleOTHERTest treatment
A (Cohort I)EXPERIMENTAL -
B (Cohort I)EXPERIMENTAL -
C (Cohort I)EXPERIMENTAL -
B (Cohort II)EXPERIMENTAL -
D (Cohort II)EXPERIMENTAL -
E (Cohort II)EXPERIMENTAL -

Interventions

NameTypeDescription
fesoterodine fumarateDRUG4 mg tablets OD for 4 weeks, then either 4 mg or 8 mg tablets OD for 48 weeks
FesoterodineDRUGFesoterodine 4mg or 8mg
PlaceboDRUGPlacebo
tolterodine tartrateDRUG4 mg once daily (OD) for 12 weeks
Fesoterodine ER (fasted)DRUGCommercial Fesoterodine ER 4 mg (single dose)
Fesoterodine SR3 (fasted)DRUGFesoterodine SR3 4 mg (single dose)
Fesoterodine SR3 (fed)DRUGFesoterodine SR3 4 mg (single dose) with high-fat meal
Fesoterodine ER (fed)DRUGCommercial Fesoterodine ER 4 mg (single dose) with high-fat meal
Fesoterodine SR3 (sprinkle)DRUGFesoterodine SR3 4 mg (single dose) beads sprinkled on applesauce
Fesoterodine SR4 (fasted)DRUGFesoterodine SR4 4 mg (single dose)
Fesoterodine SR4 (fed)DRUGFesoterodine SR4 4 mg (single dose) with high-fat/high calorie meal
Fesoterodine SR4 (sprinkle)DRUGFesoterodine SR4 4 mg (single dose) beads sprinkled on applesauce
4mg fesoterodineDRUG4mg tablet once daily for 6 days
8mg fesoterodineDRUG4mg tablet once daily for 3 days followed by 8mg tablet once daily for 3 days
alprazolam 1mgDRUG1mg tablet once on last day of treatment period at clinic
fesoterodine plus fluconazoleDRUGOn Day 1, fluconazole (200 mg oral dose) will be given 1 hour before and approximately 11 hour following a single 8 mg oral dose of fesoterodine (fesoterodine SD). Fluconazole will also be administered 200 mg BID on the Day 2 (ie, at approximately 24 and 36 hours following the fesoterodine SD treatment given on Day 1)
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Eligibility Criteria

Age Range20 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites12

Inclusion Criteria: * Adult OAB patients who present with OAB symptoms, including micturitions \>= 8 per day and urinary urgency episodes \>=1 per day. Exclusion Criteria: * Patient has known hypersensitivity to the active substance (fesoterodine fumarate) or to peanut or soya or any of the excip...

Countries:JapanUnited StatesBelgiumBrazilCanadaColombiaGermanyGreeceIndiaMalaysiaNetherlandsNorwayPhilippinesPolandSingaporeSlovakiaSouth KoreaSpainSwedenThailandChileCosta RicaCzechiaDenmarkHong KongHungaryItalyPeruRomaniaRussiaSouth AfricaSwitzerlandTaiwanUkraine
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Frequently asked questions about Fesoterodine

What is Fesoterodine used for?

Fesoterodine is used for the treatment of overactive bladder with symptoms of frequency, urgency, and urge urinary incontinence. It is also studied for overactive bladder syndrome and therapeutic equivalency. The drug is being developed as a small molecule therapy for these urological conditions.

Who makes Fesoterodine?

Fesoterodine is being developed by Pfizer, Inc., a biopharmaceutical company listed on the New York Stock Exchange under the ticker symbol PFE. Pfizer is conducting clinical trials to evaluate the drug's efficacy and safety for overactive bladder indications.

What phase is Fesoterodine in?

Fesoterodine is in Phase 3 clinical development for overactive bladder. It has completed multiple Phase 3 trials, including studies assessing treatment satisfaction and symptom improvement, as well as long-term safety and efficacy. The drug remains investigational and is not yet approved.

What clinical trials is Fesoterodine in?

Fesoterodine has been studied in several completed clinical trials. NCT00425100 is a Phase 3 trial in overactive bladder patients with 516 participants. NCT00561951 is a Phase 2 dose-finding study with 951 participants. NCT00658684 is a long-term Phase 3 safety study with 153 participants. NCT00857896 is a Phase 2 pediatric trial with 21 participants.

How does Fesoterodine work?

Fesoterodine is an antimuscarinic agent that works by blocking muscarinic receptors in the bladder, which helps reduce bladder muscle contractions. This mechanism is intended to alleviate symptoms of overactive bladder, including urinary frequency, urgency, and urge incontinence.

Is Fesoterodine the same as other overactive bladder medications?

Fesoterodine is a distinct medication from other overactive bladder treatments. It is a small molecule developed by Pfizer, and its clinical trials are separate from those of other drugs. No alternative names for Fesoterodine have been established in the clinical trial data.