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A Study Comparing Estradiol Vaginal Cream to Estrace® Cream in Females With Atrophic Vaginitis

Primary Purpose

Atrophic Vaginitis

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Estradiol
Placebos
Reference
Sponsored by
Alvogen Pine Brook LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Atrophic Vaginitis

Eligibility Criteria

30 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed Informed Consent that meets all criteria of current FDA regulations
  2. Females age: 30-75 years old inclusive who are postmenopausal.
  3. Postmenopausal defined as at least 12 months of spontaneous amenorrhea or at least 6 months of spontaneous amenorrhea with serum FSH levels > 40 mIU/ml or at least 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy. Hysterectomy without oophorectomy if of age that investigator believes would have naturally reached 12 months of spontaneous amenorrhea.
  4. Baseline evaluation requirements:

    • ≤5% superficial cells on vaginal smear cytology
    • Vaginal pH > 5.0
    • At least one patient self-assessed moderate to severe symptom of vulvar and/or vaginal atrophy (VVA) from the following list that is identified by the subject:
    • Vaginal dryness
    • Vaginal and/or vulvar irritation/itching
    • Dysuria
    • Vaginal pain associated with sexual activity*
    • Vaginal bleeding associated with sexual activity (absence vs. presence)* *provided that patient is currently sexually active and plans to remain so throughout study.
  5. Normal breast exam at screening and mammogram completed within 9 months prior to screening in patients >40 years old.
  6. For women with an intact uterus, an endometrial thickness < 4 mm as determined by vaginal ultrasonography.
  7. Documented PAP smear conducted within previous 12 months with no findings that the Investigator believes would contraindicate the use of topical vaginal estradiol

Exclusion Criteria:

  1. Females younger than 30 years of age or older than 75 years of age
  2. Patients with a serum FSH level of ≤ 40mIU/ml at screening.
  3. Greater than 5% superficial cells on vaginal cytology.
  4. Vaginal pH ≤ 5
  5. Significant history or current evidence of chronic infectious disease, system disorder, organ disorder (including significant liver/kidney impairment) or other medical condition that in the Investigator's opinion would place the study patient at undue risk by participation or could jeopardize the integrity of the study evaluations.
  6. Patients with an intact uterus should have vaginal ultrasonography results to confirm an inactive endometrial lining. Patients with an endometrial thickness equal to or greater than 4mm should be excluded.
  7. Patients with known, suspected or current history of carcinoma of the breast. All patients over the age of 40 must have had a mammogram performed within 9 months of the study start and all patients will have a physical breast exam performed at screening.
  8. Patients with baseline systolic blood pressure of > 150mm Hg and/or diastolic pressure > 90 mm Hg
  9. Any patient with undiagnosed vaginal bleeding or significant risk factors for endometrial cancer.
  10. Any history of estrogen-dependent neoplasia (e.g., endometrial cancer).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Active Comparator

    Placebo Comparator

    Arm Label

    Test

    Reference.

    Placebos

    Arm Description

    Estradiol Vaginal Cream

    Estrace Vaginal Cream

    Placebo with no active pharmaceutical ingredients. Topical vaginal cream

    Outcomes

    Primary Outcome Measures

    Vaginal Cytology
    Number of patients in PP population identified as responders at end of the study.

    Secondary Outcome Measures

    Patient Self-assessment of the Symptoms of Vulvar and Vaginal Atrophy
    Number of participants with the most bothersome vulvar and/or vaginal atrophy symptom treatment success at end of study. A "Treatment Success" was defined as a score of 0 or 1 at Day 8 (maximum Day 10) for the symptom identified at baseline as the most bothersome. This evaluation was based on patient self-assessed symptoms of VVA on a scale of 0 to 3 where 0 = none, 1 = mild, 2 = moderate, and 3 = severe.

    Full Information

    First Posted
    December 14, 2016
    Last Updated
    November 30, 2021
    Sponsor
    Alvogen Pine Brook LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02995694
    Brief Title
    A Study Comparing Estradiol Vaginal Cream to Estrace® Cream in Females With Atrophic Vaginitis
    Official Title
    Clinical Endpoint Therapeutic Equivalence Multi-Site Study Comparing Estradiol Vaginal Cream (0.01%; Alvogen Pine Brook LLC.) to Estrace® Cream (0.01%; Warner Chilcott) in Postmenopausal Females With Atrophic Vaginitis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2021
    Overall Recruitment Status
    Completed
    Study Start Date
    March 2016 (Actual)
    Primary Completion Date
    December 2016 (Actual)
    Study Completion Date
    December 2016 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Alvogen Pine Brook LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to determine the therapeutic equivalence of Alvogen's estradiol vaginal cream to Estrace® cream and superiority of both products to placebo. The protocol describes a randomized, double-blind, multi-dose, placebo-controlled, parallel study of a 7 day treatment.
    Detailed Description
    This randomized, double-blind, placebo-controlled, parallel group, multiple-site study was designed to evaluate the therapeutic efficacy and safety of a generic Estradiol Vaginal Cream USP, 0.01% (Alvogen Pine Brook LLC) compared to the FDA Reference Listed Drug (RLD), Estrace® (estradiol vaginal cream USP, 0.01%, Warner Chilcott) in patients with atrophic vaginitis. Additionally, both the Test and the RLD formulations were tested for superiority against a Placebo. Following the 14-day screening period, patients who continued to meet the inclusion/exclusion criteria were randomized in a 2:2:1 ratio (Test: Reference: Placebo) for 7 days of treatment. Five hundred and thirty-five (535) patients were randomized to one of the three study products as follows: Test: Estradiol Vaginal Cream USP, 0.01% (Alvogen Pine Brook LLC) Reference: Estrace® (estradiol vaginal cream USP, 0.01%) (Warner Chilcott) Placebo: Test product vehicle cream (Alvogen Pine Brook LLC) Patients completed up to three clinic visits as follows: Visit 1 - Screening: Day -14 to Day -1 Visit 2 - Randomization: Day 1 Visit 3 - End of Study: Day 8, maximum Day 10 Study product was self-administered by the patient for 7 days according to the dosing instructions provided. Each patient was required to dose once daily at approximately the me of day for 7 consecutive days.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Atrophic Vaginitis

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    535 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Test
    Arm Type
    Experimental
    Arm Description
    Estradiol Vaginal Cream
    Arm Title
    Reference.
    Arm Type
    Active Comparator
    Arm Description
    Estrace Vaginal Cream
    Arm Title
    Placebos
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo with no active pharmaceutical ingredients. Topical vaginal cream
    Intervention Type
    Drug
    Intervention Name(s)
    Estradiol
    Other Intervention Name(s)
    Estadiol Vaginal Cream
    Intervention Description
    Estradiol Vaginal Cream
    Intervention Type
    Drug
    Intervention Name(s)
    Placebos
    Other Intervention Name(s)
    Topical Vaginal Cream
    Intervention Description
    Placebo with no active pharmaceutical ingredients. Topical vaginal cream
    Intervention Type
    Drug
    Intervention Name(s)
    Reference
    Other Intervention Name(s)
    Topical Vaginal Cream
    Intervention Description
    Estrace Vaginal Cream
    Primary Outcome Measure Information:
    Title
    Vaginal Cytology
    Description
    Number of patients in PP population identified as responders at end of the study.
    Time Frame
    Day 8
    Secondary Outcome Measure Information:
    Title
    Patient Self-assessment of the Symptoms of Vulvar and Vaginal Atrophy
    Description
    Number of participants with the most bothersome vulvar and/or vaginal atrophy symptom treatment success at end of study. A "Treatment Success" was defined as a score of 0 or 1 at Day 8 (maximum Day 10) for the symptom identified at baseline as the most bothersome. This evaluation was based on patient self-assessed symptoms of VVA on a scale of 0 to 3 where 0 = none, 1 = mild, 2 = moderate, and 3 = severe.
    Time Frame
    Day 8

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    30 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Signed Informed Consent that meets all criteria of current FDA regulations Females age: 30-75 years old inclusive who are postmenopausal. Postmenopausal defined as at least 12 months of spontaneous amenorrhea or at least 6 months of spontaneous amenorrhea with serum FSH levels > 40 mIU/ml or at least 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy. Hysterectomy without oophorectomy if of age that investigator believes would have naturally reached 12 months of spontaneous amenorrhea. Baseline evaluation requirements: ≤5% superficial cells on vaginal smear cytology Vaginal pH > 5.0 At least one patient self-assessed moderate to severe symptom of vulvar and/or vaginal atrophy (VVA) from the following list that is identified by the subject: Vaginal dryness Vaginal and/or vulvar irritation/itching Dysuria Vaginal pain associated with sexual activity* Vaginal bleeding associated with sexual activity (absence vs. presence)* *provided that patient is currently sexually active and plans to remain so throughout study. Normal breast exam at screening and mammogram completed within 9 months prior to screening in patients >40 years old. For women with an intact uterus, an endometrial thickness < 4 mm as determined by vaginal ultrasonography. Documented PAP smear conducted within previous 12 months with no findings that the Investigator believes would contraindicate the use of topical vaginal estradiol Exclusion Criteria: Females younger than 30 years of age or older than 75 years of age Patients with a serum FSH level of ≤ 40mIU/ml at screening. Greater than 5% superficial cells on vaginal cytology. Vaginal pH ≤ 5 Significant history or current evidence of chronic infectious disease, system disorder, organ disorder (including significant liver/kidney impairment) or other medical condition that in the Investigator's opinion would place the study patient at undue risk by participation or could jeopardize the integrity of the study evaluations. Patients with an intact uterus should have vaginal ultrasonography results to confirm an inactive endometrial lining. Patients with an endometrial thickness equal to or greater than 4mm should be excluded. Patients with known, suspected or current history of carcinoma of the breast. All patients over the age of 40 must have had a mammogram performed within 9 months of the study start and all patients will have a physical breast exam performed at screening. Patients with baseline systolic blood pressure of > 150mm Hg and/or diastolic pressure > 90 mm Hg Any patient with undiagnosed vaginal bleeding or significant risk factors for endometrial cancer. Any history of estrogen-dependent neoplasia (e.g., endometrial cancer).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Meena Venugopal, Ph.D.
    Organizational Affiliation
    Alvogen Pine Brook LLC
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    A Study Comparing Estradiol Vaginal Cream to Estrace® Cream in Females With Atrophic Vaginitis

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