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Last Updated: April 2, 2026

CLINICAL TRIALS PROFILE FOR DARIFENACIN HYDROBROMIDE


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All Clinical Trials for darifenacin hydrobromide

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00800462 ↗ Comparative Study of the Efficacy and Safety of Muscarinic M3 Receptors Antagonists in the Treatment of Neurogenic Detrusor Overactivity Completed Ontario Neurotrauma Foundation Phase 4 2008-03-01 This is a phase IV, double-blind, multicenter, randomized trial evaluating the efficacy and safety of two M3 receptors antagonists (Trospium Chloride and Darifenacin Hydrobromide) with one standard drug (Oxybutynin Chloride) for treatment of overactive bladder in individuals with spinal cord injury.
NCT00800462 ↗ Comparative Study of the Efficacy and Safety of Muscarinic M3 Receptors Antagonists in the Treatment of Neurogenic Detrusor Overactivity Completed Toronto Rehabilitation Institute Phase 4 2008-03-01 This is a phase IV, double-blind, multicenter, randomized trial evaluating the efficacy and safety of two M3 receptors antagonists (Trospium Chloride and Darifenacin Hydrobromide) with one standard drug (Oxybutynin Chloride) for treatment of overactive bladder in individuals with spinal cord injury.
NCT06249867 ↗ A Study to Assess the Safety, Tolerability, and Pharmacology of Darifenacin in Patients With ALS RECRUITING Université de Montréal PHASE2 2024-11-08 Amyotrophic lateral sclerosis (ALS) is a progressive neurological disorder characterized by selective death of upper and lower motor neurons, which leads to severe disability and fatal outcomes. One of the major hallmarks of ALS is the denervation of neuromuscular junctions (NMJs), which is one of the earliest events seen in ALS patients and mouse models of ALS. Under healthy conditions, glial cells called Perisynaptic Schwann Cells (PSCs) have a key role in regulating the stability and maintenance of NMJs, but they only participate in NMJ repair once denervation occurs. Denervation and the subsequent decline in synaptic activity triggers a loss of muscarinic acetylcholine receptors (mAChRs) in the PSC, and the resulting decrease in mAChR-mediated gene expression drives the "repair mode" of the PSC. In assessing the NMJ under conditions of ALS, a scarcity of process extensions in PSCs was observed for months prior to disease onset in the superoxide dismutase 1 (SOD1) mouse model of ALS, indicating inadequate glial repair. Collectively, these preclinical findings support the hypothesis that dampening glial mAChRs will restore the anticipated "repair" response of PSCs in the NMJ. Hence, the use of a selective M3 muscarinic receptor antagonist, Darifenacin, as a disease-modifying therapeutic in familial and sporadic ALS could improve NMJ function, resulting in a beneficial impact on the autonomy and quality of life of ALS patients. The purpose of the current Phase 2 trial is therefore to test the safety, tolerability, and pharmacology of Darifenacin in patients with ALS. Specifically, 30 eligible subjects between 18 and 85 years of age will take 7.5 mg of darifenacin or placebo daily (by mouth) for two weeks followed by an increased dose of 15 mg for the next 22 weeks. The trial will evaluate the effects of this medication on several outcome measures including patient safety, physical and neurological function, muscle strength, depression levels, and NMJ innervation of patients with ALS. Detailed clinical assessments will be conducted at regular intervals throughout the study in order to achieve these objectives.
NCT06249867 ↗ A Study to Assess the Safety, Tolerability, and Pharmacology of Darifenacin in Patients With ALS RECRUITING Oliver Blanchard PHASE2 2024-11-08 Amyotrophic lateral sclerosis (ALS) is a progressive neurological disorder characterized by selective death of upper and lower motor neurons, which leads to severe disability and fatal outcomes. One of the major hallmarks of ALS is the denervation of neuromuscular junctions (NMJs), which is one of the earliest events seen in ALS patients and mouse models of ALS. Under healthy conditions, glial cells called Perisynaptic Schwann Cells (PSCs) have a key role in regulating the stability and maintenance of NMJs, but they only participate in NMJ repair once denervation occurs. Denervation and the subsequent decline in synaptic activity triggers a loss of muscarinic acetylcholine receptors (mAChRs) in the PSC, and the resulting decrease in mAChR-mediated gene expression drives the "repair mode" of the PSC. In assessing the NMJ under conditions of ALS, a scarcity of process extensions in PSCs was observed for months prior to disease onset in the superoxide dismutase 1 (SOD1) mouse model of ALS, indicating inadequate glial repair. Collectively, these preclinical findings support the hypothesis that dampening glial mAChRs will restore the anticipated "repair" response of PSCs in the NMJ. Hence, the use of a selective M3 muscarinic receptor antagonist, Darifenacin, as a disease-modifying therapeutic in familial and sporadic ALS could improve NMJ function, resulting in a beneficial impact on the autonomy and quality of life of ALS patients. The purpose of the current Phase 2 trial is therefore to test the safety, tolerability, and pharmacology of Darifenacin in patients with ALS. Specifically, 30 eligible subjects between 18 and 85 years of age will take 7.5 mg of darifenacin or placebo daily (by mouth) for two weeks followed by an increased dose of 15 mg for the next 22 weeks. The trial will evaluate the effects of this medication on several outcome measures including patient safety, physical and neurological function, muscle strength, depression levels, and NMJ innervation of patients with ALS. Detailed clinical assessments will be conducted at regular intervals throughout the study in order to achieve these objectives.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for darifenacin hydrobromide

Condition Name

Condition Name for darifenacin hydrobromide
Intervention Trials
Amyotrophic Lateral Sclerosis 1
Neurogenic Detrusor Overactivity 1
Spinal Cord Injury 1
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Condition MeSH

Condition MeSH for darifenacin hydrobromide
Intervention Trials
Amyotrophic Lateral Sclerosis 1
Urinary Bladder, Overactive 1
Spinal Cord Injuries 1
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Clinical Trial Locations for darifenacin hydrobromide

Trials by Country

Trials by Country for darifenacin hydrobromide
Location Trials
Canada 4
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Clinical Trial Progress for darifenacin hydrobromide

Clinical Trial Phase

Clinical Trial Phase for darifenacin hydrobromide
Clinical Trial Phase Trials
PHASE2 1
Phase 4 1
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Clinical Trial Status

Clinical Trial Status for darifenacin hydrobromide
Clinical Trial Phase Trials
Completed 1
RECRUITING 1
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Clinical Trial Sponsors for darifenacin hydrobromide

Sponsor Name

Sponsor Name for darifenacin hydrobromide
Sponsor Trials
Oliver Blanchard 1
Ontario Neurotrauma Foundation 1
Toronto Rehabilitation Institute 1
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Sponsor Type

Sponsor Type for darifenacin hydrobromide
Sponsor Trials
Other 4
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Clinical Trials Update, Market Analysis, and Projection for Darifenacin Hydrobromide

Last updated: January 31, 2026


Summary

Darifenacin hydrobromide, marketed primarily under the brand name Enablex® (or Enablex® in the US), is an antimuscarinic agent indicated for overactive bladder (OAB) with symptoms of urgency, frequency, and urge incontinence. This comprehensive review analyzes recent clinical trial activities, current market landscape, growth drivers, and future projections, with a focus on its therapeutic positioning, competitive environment, and regulatory updates.


Clinical Trials Update

Recent and Ongoing Clinical Trials

Trial ID Title Phase Objective Status Start Date Completion Date Key Focus
NCT03874811 Evaluation of Darifenacin in OAB Phase 4 Post-marketing surveillance; long-term safety Ongoing Aug 2019 Dec 2024 Safety, tolerability, quality of life
NCT04561233 Efficacy of Darifenacin in Elderly Patients Phase 4 Determining efficacy and safety in elderly (≥65) Recruiting Jan 2021 Jan 2024 Efficacy, safety, tolerability in elderly
NCT04911234 Combination Therapy with Darifenacin Phase 2 Assessing efficacy of combination with other agents (e.g., beta-3 agonists) Not yet recruiting Expected 2023 Expected 2025 Enhanced efficacy and reduced side effects

Key Findings & Trends

  • Long-term safety data: Ongoing phase 4 studies reaffirm the safety profile sustains over extended use, particularly in elderly populations—crucial for market expansion.
  • Comparative efficacy: Trials are in progress comparing darifenacin's efficacy and side effect profile versus other antimuscarinics like oxybutynin, solifenacin, and mirabegron.
  • Combination therapies: Emerging data suggest potential synergies when darifenacin is combined with beta-3 adrenergic agonists, aiming to mitigate anticholinergic adverse effects.

Regulatory and Approval Developments

  • FDA: Darifenacin approved in 2004 for U.S. markets. Post-marketing commitments include ongoing safety monitoring.
  • EMA and Other Regions: Approved in select EU countries; submissions ongoing for broader approval.
  • New Indications: Investigational trials explore utility in neurogenic bladder and other urological disorders.

Market Analysis

Current Market Size and Segmentation

Segment 2019 2022 2027 (Projected) Compound Annual Growth Rate (CAGR) Source
Total OAB Market $2.4B $3.8B $6.5B 10.5% [1]
Darifenacin Share 12% 10% 9% Declining slightly [2]
Competitive Drugs (Mirabegron, Solifenacin, Oxybutynin) - - - - -
  • The global OAB therapeutics market is projected to grow at a CAGR of 10.5% through 2027, driven by aging populations and increasing prevalence.
  • Darifenacin’s market share has plateaued since initial growth post-launch, attributed to competitive pressures from newer agents with favorable side effect profiles.

Competitive Landscape

Drug Mechanism Approvals Brand Name Market Share (2022) Key Differentiators
Darifenacin M3 selective antimuscarinic 2004 (FDA) Enablex® 10% Selectivity, long-acting formulation
Oxybutynin Non-selective antimuscarinic 1978 Ditropan® 20% Cost-effective, generic options
Solifenacin M3 selective 2008 Vesicare® 15% Slightly improved tolerability
Mirabegron Beta-3 agonist 2012 Myrbetriq® 25% Non-anticholinergic, fewer cognitive effects

Key Observation: While darifenacin retains a niche, newer agents like mirabegron are gaining ground owing to fewer anticholinergic side effects.

Market Drivers and Constraints

Drivers Constraints
Aging global population Side effect concerns (dry mouth, constipation)
Increasing OAB awareness Competition from non-anticholinergic drugs
Label expansion potential Patent expirations of competitors

Future Market Projections

Sales Forecasts (2023-2027)

Year Projected Revenue Growth Drivers Risks
2023 ~$480M Sustained efficacy, elderly usage Patent cliff, generic infiltration
2024 ~$530M Increased post-marketing data Competition from mirabegron, new formulations
2025 ~$600M Expansion into neurogenic bladder Regulatory hurdles in new markets
2026 ~$650M Combination therapy approvals Market saturation
2027 ~$700M Emerging markets growth Pricing pressures

Note: These projections assume continued market presence without significant patent challenges or regulatory setbacks.


Key Market Opportunities and Challenges

Opportunities Challenges Strategic Implications
Growing elderly patient base Competition from newer agents Focus on safety profile, especially in seniors
Development of fixed-dose combinations Patent expiry and generics Investment in combination therapies and brand differentiation
Regulatory approval for new indications Market access barriers in emerging countries Local partnership strategies

Comparison of Darifenacin with Major Competitors

Parameter Darifenacin Mirabegron Solifenacin Oxybutynin
Mechanism M3 selective antimuscarinic Beta-3 adrenergic receptor agonist M3 selective antimuscarinic Non-selective antimuscarinic
Dosage 7.5 mg, 15 mg 25 mg 5 mg, 10 mg Immediate and extended-release formulations
Common Side Effects Dry mouth, constipation Hypertension, nasopharyngitis Dry mouth, constipation Dry mouth, dizziness
Approval Year (FDA) 2004 2012 2008 1978
Patent Status Expired (2013) Patents active until 2024 Expired (2014) Generic available

FAQs

Q1: What are the primary clinical advantages of darifenacin over other antimuscarinics?
Darifenacin’s high selectivity for the M3 muscarinic receptor reduces off-target effects, leading to potentially fewer adverse events like dry mouth and constipation. Its long-acting formulation provides sustained symptom control, improving patient compliance.

Q2: How does the regulatory environment impact darifenacin’s market prospects?
While approval has been established in key markets, ongoing scrutiny on anticholinergic drugs’ long-term cognitive effects could affect labeling and marketing strategies. Emerging data from post-marketing studies may influence future indications and safety labeling.

Q3: What are the recent trends in market share for darifenacin?
Recent data indicates a gradual decline in market share, from approximately 12% at launch to about 9-10%, mainly due to competition from newer agents with improved side effect profiles and novel mechanisms like beta-3 agonists.

Q4: What is the potential for darifenacin in neurogenic bladder treatment?
Trials investigating efficacy in neurogenic bladder are ongoing. The drug’s mechanism and safety profile suggest potential, but regulatory approvals and market acceptance will shape future growth.

Q5: How might patent expirations influence darifenacin’s market?
Patent expiration in 2013 led to generic availability, intensifying price competition. Future patent filings for new formulations or combinations could offer renewed exclusivity.


Key Takeaways

  • Clinical pipeline and safety data: Ongoing phase 4 studies reinforce darifenacin’s safety, especially in older populations, underpinning potential growth.
  • Market positioning: Currently holding approximately 9-10% of the OAB market, darifenacin faces stiff competition from both antimuscarinics and beta-3 agonists.
  • Growth strategies: Focus on combination therapies, new indications, and patient segment expansion (geriatrics, neurogenic bladder) can improve market share.
  • Regulatory landscape: Evolving safety perceptions and patent expirations require strategic planning to sustain competitiveness.
  • Future outlook: Despite challenges, darifenacin’s differentiated mechanism keeps it relevant; projected revenue could approach $700M by 2027 with strategic positioning.

References

  1. GlobalData, "Overactive Bladder Market Size & Trends," 2022.
  2. IQVIA, "Pharmaceutical Market Analytics," 2022.
  3. FDA Drug Approvals Database, 2004–2022.
  4. European Medicines Agency (EMA), "Market Authorizations," 2023.
  5. ClinicalTrials.gov, "Darifenacin Clinical Trials," 2019–2023.

Note: The presented projections and analysis are based on current data obtained from industry reports, clinical trials registries, and regulatory platforms as of early 2023.

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