Int Neurourol J.  2022 Jun;26(2):119-128. 10.5213/inj.2142382.191.

Efficacy and Safety of DA-8010, a Novel M3 Antagonist, in Patients With Overactive Bladder: A Randomized, Double-Blind Phase 2 Study

Affiliations
  • 1Department of Urology and Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
  • 3Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 4Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  • 5Department of Urology, Bucheon St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Korea
  • 6Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 7Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
  • 8Department of Urology, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
  • 9Department of Urology, Seoul National University Bundang Hospital, Seoul National University School of Medicine, Seongnam, Korea
  • 10JTS Urology Center; Department of Urology, Cheil General Hospital and Women’s Healthcare Center, Dankook University College of Medicine, Seoul, Korea
  • 11Department of Urology, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, Korea
  • 12Department of Urology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea

Abstract

Purpose
DA-8010 is a novel muscarinic M3 receptor antagonist with significant selectivity for bladder over salivary gland in preclinical studies. We evaluated the clinical efficacy and safety of DA-8010 in overactive bladder (OAB) patients.
Methods
This phase 2, randomized, double-blind, parallel-group, active reference- and placebo-controlled trial was conducted at 12 centers in South Korea (NCT03566134). Patients aged ≥19 years with OAB symptoms for ≥3 months were enrolled. Three hundred six patients (30.07% male) were randomized to 12 weeks of treatment among 4 groups; 2 experimental groups (DA-8010 2.5 or 5 mg), an active reference group (solifenacin 5 mg), and a placebo group. The change from the baseline of (=∆) 24-hour frequency at 12 weeks (primary endpoint), episodes of urgency, overall/urgency urinary incontinence, average/ maximum voided volume, nocturia, and patients’ subjective responses were analyzed.
Results
In the full analysis set, the mean (standard deviation) [median] values for ∆ 24-hour frequency at 12 weeks were -1.01 (2.44) [-1.33] for placebo, -1.22 (2.05) [-1.33] for DA-8010 2.5 mg, and -1.67 (2.25) [-1.67] for DA-8010 5 mg; DA-8010 5 mg showed a significant decrease compared with placebo (P=0.0413). At 4 and 8 weeks, both DA-8010 2.5 mg (P=0.0391 at 4 weeks, P=0.0335 at 8 weeks) and DA-8010 5 mg (P=0.0001 at 4 weeks, P=0.0210 at 8 weeks) showed significant decrease in ∆ 24-hour frequency compared with placebo. DA-8010 5 mg achieved a significant decrease in ∆ number of urgency episodes, compared with placebo at 4 (P=0.0278) and 8 (P=0.0092) weeks. Adverse drug reactions (ADRs) were observed in 3.95% of placebo, 6.67% of DA-8010 2.5 mg, 18.42% of DA-8010 5 mg, and 17.33% of solifenacin 5 mg groups. No serious ADRs were observed in any patient.
Conclusions
Both DA-8010 2.5 mg and 5 mg showed therapeutic efficacy for OAB without serious ADRs. Therefore, both dosages of DA-8010 can advance to a subsequent large-scale phase 3 trial.

Keyword

DA-8010; Muscarinic antagonists; Receptor, Muscarinic M3; Urinary bladder; Overactive
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