Clinical Study to Evaluate Efficacy and Safety of TAK-385 40 mg Compared With Leuprorelin in Patients With Endometriosis
Primary Purpose
Endometriosis
Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
TAK-385
Leuprorelin acetate
Sponsored by
About this trial
This is an interventional treatment trial for Endometriosis
Eligibility Criteria
Inclusion Criteria:
- The participant is a premenopausal Japanese woman aged 20 years or older at the time consent is obtained.
The participant with endometriosis that falls under one of the following. However, in case of recurrence after surgery, it must be diagnosed again by either of the following.
- The participant who has been diagnosed with endometriosis by Laparotomy or Laparoscopy.
- The participant who has been confirmed ovarian chocolate cyst by Magnetic Resonance Imaging (MRI) or ultrasonic examination (vaginal, transabdominal or rectal).
- The participant who has been diagnosed with clinical endometriosis and has the symptom of either induration of Douglas cavum, restriction of uterine mobility or pelvic tenderness confirmed by internal or rectal examination.
- The participant must have dysmenorrhea or pelvic pain associated with endometriosis, of which either 1 or both should be at least "moderate" as determined by the investigator or subinvestigator using the B&B scale.
- The participant must have maximum VAS score > 30 for pelvic pain associated with endometriosis.
- The participant has experienced regular menstrual cycles (25 to 38 days) that should include menstrual bleeding of at least 3 consecutive days (at least 3 regular menstrual cycles to be confirmed).
- The participant agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study.
Exclusion Criteria:
The participant has the following drug usage:
- Use of the following drugs within 24 weeks:bisphosphonate preparation or other investigational agent
- Use of the following drugs within 16 weeks (for 1-, 3- and 6-month sustained-release preparations, within 20, 28 and 40 weeks, respectively): gonadotropin-releasing hormone (GnRH) analogues, danazol, or aromatase inhibitors.
- Use of the following drugs within 8 weeks:dienogest, oral contraceptive or sex hormone preparations (norethindrone, norethisterone, medroxyprogesterone, estrogen, or other progestins, etc.)
- Use of the following drugs (excluding drugs for external use and supplements) within 4 weeks :anti-coagulant drugs, anti-platelet drugs, tranexamic acid, selective estrogen receptor modulators, activated vitamin D preparations, other vitamin D preparations, calcitonin, ipriflavone, steroid hormones, vitamin K preparations, teriparatide, or denosumab
- The participant has received TAK-385 (including placebo) in a previous clinical study.
- The participant has ovarian chocolate cyst of 10 cm or more and over 40 years old at the time imaging test is performed.
- The participant has a history of panhysterectomy or bilateral oophorectomy.
- The participant has had markedly abnormal uterine bleeding or anovulatory bleeding, as determined by the investigator or subinvestigator.
- The participant has nondiagnosable abnormal genital bleeding.
- The participant has a current history of thyroid gland disorder with irregular menstruation, or has a potential for irregular menstruation due to thyroid gland disorder, as determined by the investigator or subinvestigator.
- The participant has uterine fibroid requiring treatment.
- The participant has lower abdominal pain due to irritable bowel syndrome or severe interstitial cystitis.
- The participant has a previous or current history of pelvic inflammatory disease within 8 weeks.
- The participant has a previous or current history of osteoporosis, osteopenia, or other metabolic bone diseases.
- The participant has a positive cervical cytology result [other than Negative for Intraepithelial Lesion or Malignancy (NILM) in accordance with the 2014 Bethesda system]. However, the following participant may participate in this study; Atypical Squamous Cells of Undetermined Significance (ASC-US) and negative by high-risk Human Papillomavirus (HPV) test. And furthermore, regarding the participant with negative cervical cytology result conducted within 1 year, she may participate in this study without additional test.
- The participant has a malignant tumor or a history of a malignant tumor within 5 years.
- The participant has clinically significant cardiovascular disease or uncontrollable hypertension.
- The participant is inappropriate for participation in this study based on 12-lead ECG findings, as determined by the investigator or subinvestigator.
- The participant has active liver disease or jaundice, or has Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) or total bilirubin > 1.5 times the upper limit of normal in the clinical laboratory tests.
- The participant has previous or current history of diseases considered to be inappropriate for participation in this study, including severe hepatic impairment, jaundice, renal impairment, cardiovascular disease, endocrine system disease, metabolic disorder, pulmonary disease, gastrointestinal disease, neural disease, urological disease, immune disease, or mental disorder (especially depression-like symptoms) or suicide attempt resulting from a mental disorder.
- The participant has a previous or current history of hypersensitivity to GnRH analogues, or has a previous or current history of severe hypersensitivity to other drugs.
- The participant is pregnant, lactating, or intending to become pregnant or to donate ova between the signing date of informed consent and 1 month after the end of the study.
Sites / Locations
- Chubu Rosai Hospital
- Meitetsu Hospital
- Aiiku Ladies Clinic
- Chiba Aoba Municipal Hospital
- Tokyo Bay Urayasu Ichikawa Medical Center
- Tsujinaka Hospital Kashiwanoha
- Fujito Clinic
- Hashimoto Clinic
- Tokeidai Memorial Hospital
- Yoshio Obstetrics Gynecology Hospital
- Shinsuma Hospital
- Kagawa Prefectural Central Hospital
- Takamatsu Red Cross Hospital
- Fujisawa City Hospital
- Rinkan Clinic
- Second Kawasaki Saiwai Clinic
- Tawada Ladies Clinic
- Japanese Red Cross Kumamoto Hospital
- Kurashiki Medical Clinic
- Chayamachi Ladies Clinic
- Hayakawa Clinic
- Minami-Morimachi Ladies Clinic
- Nomura Clinic Nanba
- Rikako Ladies Clinic
- Tanabe Ladies Clinic
- Yoshimura Ladies Clinic
- Dantsuka Clinic
- Kashiwazaki Ladies Clinic
- Maruyama Memorial General Hospital
- Kusatsu General Hospital
- Akasaka-Mitsuke Miyazaki Clinic
- Ginza Yoshida Hospital
- Hamada Hospital
- Ikebukuro Metroporitan Clinic
- NS Clinic
- Sei Women's Clinic
- Seijo Kinoshita Hospital
- Shimamura Memorial Hospital
- Toranomon Women's Clinic
- Yokokura Clinic
- Yukawa Women's Clinic
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
TAK-385
Leuprorelin acetate
Arm Description
TAK-385 40 mg administered orally once daily before breakfast + Leuprorelin placebo administered subcutaneously once every 4 weeks
TAK-385 placebo administered orally once daily before breakfast + Leuprorelin acetate 1.88 mg / 3.75 mg administered subcutaneously once every 4 weeks
Outcomes
Primary Outcome Measures
Change of maximum Visual Analogue Scale (VAS) score for endometriosis associated pelvic pain
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Secondary Outcome Measures
Change of mean VAS score for endometriosis associated pelvic pain
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
VAS score for endometriosis associated pelvic pain
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Change of VAS score for endometriosis associated pelvic pain
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
VAS score for menstrual pain
Menstrual pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Change of VAS score for menstrual pain
Menstrual pain will be assessed using the VAS (0 - 100) as pain evaluation scale
VAS score for endometriosis associated pelvic pain outside the menstruation period
Pelvic pain outside the menstruation period will be assessed using the VAS (0 - 100) as pain evaluation scale
Change of VAS score for endometriosis associated pelvic pain outside the menstruation period
Pelvic pain outside the menstruation period will be assessed using the VAS (0 - 100) as pain evaluation scale
VAS score for dyspareunia
Dyspareunia will be assessed using the VAS (0 - 100) as pain evaluation scale
Change of VAS score for dyspareunia
Dyspareunia will be assessed using the VAS (0 - 100) as pain evaluation scale
Adverse event
Bone mineral density
Serum concentrations of NTx (N-telopeptide)
Serum concentrations of BAP (Bone alkaline phosphatase)
Period from the last dose of study drug to return of menstrual cycles
Full Information
NCT ID
NCT03931915
First Posted
April 24, 2019
Last Updated
December 10, 2020
Sponsor
ASKA Pharmaceutical Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT03931915
Brief Title
Clinical Study to Evaluate Efficacy and Safety of TAK-385 40 mg Compared With Leuprorelin in Patients With Endometriosis
Official Title
Phase III Clinical Study to Evaluate Efficacy and Safety of TAK-385 40 mg Compared With Leuprorelin in Patients With Endometriosis
Study Type
Interventional
2. Study Status
Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
May 8, 2019 (Actual)
Primary Completion Date
June 12, 2020 (Actual)
Study Completion Date
September 28, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ASKA Pharmaceutical Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective is to evaluate the efficacy and safety of TAK-385 40 mg orally administrated once daily for 24 weeks compared with Leuprorelin [once/4 weeks, 3.75 or 1.88 mg subcutaneously (SC)/time] in patients with endometriosis.
Detailed Description
This study is a phase III, multicenter, randomized, double-blind, parallel-group study to investigate the efficacy and safety of TAK-385 40 mg once daily compared with leuprorelin (once/4 weeks, 3.75 or 1.88 mg SC/time) in premenopausal subjects ≥ 20 years of age with endometriosis. 320 women with endometriosis will be enrolled in the study. This study consists of screening of approximately 1 to 6 weeks, run-in of approximately 3 to 6 weeks, treatment of 24 weeks, and follow-up of 4 weeks. After signing the informed consent form, subjects should record their symptoms in the electronic patient diary every day. During run-in period, daily data will be collected in the electronic patient diary for calculation of the baseline values for the efficacy evaluation.Following run-in period, subjects will receive investigational products (TAK-385 + leuprorelin placebo or TAK-385 placebo + leuprorelin) under double blind. During this study, subjects will visit the study center to undergo the designated examinations and evaluations at each visit. Safety will be assessed throughout the study by monitoring adverse events, vital signs, physical examinations, clinical laboratory tests, 12-lead electrocardiograms (ECG), and assessments of bone mineral density.Subjects will visit the study center to undergo the designated examinations and evaluations at 28 days after final administration.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Endometriosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
335 (Actual)
8. Arms, Groups, and Interventions
Arm Title
TAK-385
Arm Type
Experimental
Arm Description
TAK-385 40 mg administered orally once daily before breakfast + Leuprorelin placebo administered subcutaneously once every 4 weeks
Arm Title
Leuprorelin acetate
Arm Type
Active Comparator
Arm Description
TAK-385 placebo administered orally once daily before breakfast + Leuprorelin acetate 1.88 mg / 3.75 mg administered subcutaneously once every 4 weeks
Intervention Type
Drug
Intervention Name(s)
TAK-385
Other Intervention Name(s)
relugolix
Intervention Description
TAK-385 40 mg tablets + Leuprorelin acetate placebo injection
Intervention Type
Drug
Intervention Name(s)
Leuprorelin acetate
Intervention Description
TAK-385 placebo tablets + Leuprorelin acetate 1.88 mg / 3.75 mg injection
Primary Outcome Measure Information:
Title
Change of maximum Visual Analogue Scale (VAS) score for endometriosis associated pelvic pain
Description
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and the last 28 days of treatment period
Secondary Outcome Measure Information:
Title
Change of mean VAS score for endometriosis associated pelvic pain
Description
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and the last 28 days of treatment period
Title
VAS score for endometriosis associated pelvic pain
Description
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Up to Week 24
Title
Change of VAS score for endometriosis associated pelvic pain
Description
Pelvic pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and up to Week 24
Title
VAS score for menstrual pain
Description
Menstrual pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Up to Week 24
Title
Change of VAS score for menstrual pain
Description
Menstrual pain will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and up to Week 24
Title
VAS score for endometriosis associated pelvic pain outside the menstruation period
Description
Pelvic pain outside the menstruation period will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Up to Week 24
Title
Change of VAS score for endometriosis associated pelvic pain outside the menstruation period
Description
Pelvic pain outside the menstruation period will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and up to Week 24
Title
VAS score for dyspareunia
Description
Dyspareunia will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Up to Week 24
Title
Change of VAS score for dyspareunia
Description
Dyspareunia will be assessed using the VAS (0 - 100) as pain evaluation scale
Time Frame
Baseline and up to Week 24
Title
Adverse event
Time Frame
Up to Week 28
Title
Bone mineral density
Time Frame
Up to Week 24
Title
Serum concentrations of NTx (N-telopeptide)
Time Frame
Up to Week 24
Title
Serum concentrations of BAP (Bone alkaline phosphatase)
Time Frame
Up to Week 24
Title
Period from the last dose of study drug to return of menstrual cycles
Time Frame
From Week 24 to Week 28
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The participant is a premenopausal Japanese woman aged 20 years or older at the time consent is obtained.
The participant with endometriosis that falls under one of the following. However, in case of recurrence after surgery, it must be diagnosed again by either of the following.
The participant who has been diagnosed with endometriosis by Laparotomy or Laparoscopy.
The participant who has been confirmed ovarian chocolate cyst by Magnetic Resonance Imaging (MRI) or ultrasonic examination (vaginal, transabdominal or rectal).
The participant who has been diagnosed with clinical endometriosis and has the symptom of either induration of Douglas cavum, restriction of uterine mobility or pelvic tenderness confirmed by internal or rectal examination.
The participant must have dysmenorrhea or pelvic pain associated with endometriosis, of which either 1 or both should be at least "moderate" as determined by the investigator or subinvestigator using the B&B scale.
The participant must have maximum VAS score > 30 for pelvic pain associated with endometriosis.
The participant has experienced regular menstrual cycles (25 to 38 days) that should include menstrual bleeding of at least 3 consecutive days (at least 3 regular menstrual cycles to be confirmed).
The participant agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study.
Exclusion Criteria:
The participant has the following drug usage:
Use of the following drugs within 24 weeks:bisphosphonate preparation or other investigational agent
Use of the following drugs within 16 weeks (for 1-, 3- and 6-month sustained-release preparations, within 20, 28 and 40 weeks, respectively): gonadotropin-releasing hormone (GnRH) analogues, danazol, or aromatase inhibitors.
Use of the following drugs within 8 weeks:dienogest, oral contraceptive or sex hormone preparations (norethindrone, norethisterone, medroxyprogesterone, estrogen, or other progestins, etc.)
Use of the following drugs (excluding drugs for external use and supplements) within 4 weeks :anti-coagulant drugs, anti-platelet drugs, tranexamic acid, selective estrogen receptor modulators, activated vitamin D preparations, other vitamin D preparations, calcitonin, ipriflavone, steroid hormones, vitamin K preparations, teriparatide, or denosumab
The participant has received TAK-385 (including placebo) in a previous clinical study.
The participant has ovarian chocolate cyst of 10 cm or more and over 40 years old at the time imaging test is performed.
The participant has a history of panhysterectomy or bilateral oophorectomy.
The participant has had markedly abnormal uterine bleeding or anovulatory bleeding, as determined by the investigator or subinvestigator.
The participant has nondiagnosable abnormal genital bleeding.
The participant has a current history of thyroid gland disorder with irregular menstruation, or has a potential for irregular menstruation due to thyroid gland disorder, as determined by the investigator or subinvestigator.
The participant has uterine fibroid requiring treatment.
The participant has lower abdominal pain due to irritable bowel syndrome or severe interstitial cystitis.
The participant has a previous or current history of pelvic inflammatory disease within 8 weeks.
The participant has a previous or current history of osteoporosis, osteopenia, or other metabolic bone diseases.
The participant has a positive cervical cytology result [other than Negative for Intraepithelial Lesion or Malignancy (NILM) in accordance with the 2014 Bethesda system]. However, the following participant may participate in this study; Atypical Squamous Cells of Undetermined Significance (ASC-US) and negative by high-risk Human Papillomavirus (HPV) test. And furthermore, regarding the participant with negative cervical cytology result conducted within 1 year, she may participate in this study without additional test.
The participant has a malignant tumor or a history of a malignant tumor within 5 years.
The participant has clinically significant cardiovascular disease or uncontrollable hypertension.
The participant is inappropriate for participation in this study based on 12-lead ECG findings, as determined by the investigator or subinvestigator.
The participant has active liver disease or jaundice, or has Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) or total bilirubin > 1.5 times the upper limit of normal in the clinical laboratory tests.
The participant has previous or current history of diseases considered to be inappropriate for participation in this study, including severe hepatic impairment, jaundice, renal impairment, cardiovascular disease, endocrine system disease, metabolic disorder, pulmonary disease, gastrointestinal disease, neural disease, urological disease, immune disease, or mental disorder (especially depression-like symptoms) or suicide attempt resulting from a mental disorder.
The participant has a previous or current history of hypersensitivity to GnRH analogues, or has a previous or current history of severe hypersensitivity to other drugs.
The participant is pregnant, lactating, or intending to become pregnant or to donate ova between the signing date of informed consent and 1 month after the end of the study.
Facility Information:
Facility Name
Chubu Rosai Hospital
City
Aichi
Country
Japan
Facility Name
Meitetsu Hospital
City
Aichi
Country
Japan
Facility Name
Aiiku Ladies Clinic
City
Chiba
Country
Japan
Facility Name
Chiba Aoba Municipal Hospital
City
Chiba
Country
Japan
Facility Name
Tokyo Bay Urayasu Ichikawa Medical Center
City
Chiba
Country
Japan
Facility Name
Tsujinaka Hospital Kashiwanoha
City
Chiba
Country
Japan
Facility Name
Fujito Clinic
City
Hiroshima
Country
Japan
Facility Name
Hashimoto Clinic
City
Hokkaido
Country
Japan
Facility Name
Tokeidai Memorial Hospital
City
Hokkaido
Country
Japan
Facility Name
Yoshio Obstetrics Gynecology Hospital
City
Hokkaido
Country
Japan
Facility Name
Shinsuma Hospital
City
Hyogo
Country
Japan
Facility Name
Kagawa Prefectural Central Hospital
City
Kagawa
Country
Japan
Facility Name
Takamatsu Red Cross Hospital
City
Kagawa
Country
Japan
Facility Name
Fujisawa City Hospital
City
Kanagawa
Country
Japan
Facility Name
Rinkan Clinic
City
Kanagawa
Country
Japan
Facility Name
Second Kawasaki Saiwai Clinic
City
Kanagawa
Country
Japan
Facility Name
Tawada Ladies Clinic
City
Kanagawa
Country
Japan
Facility Name
Japanese Red Cross Kumamoto Hospital
City
Kumamoto
Country
Japan
Facility Name
Kurashiki Medical Clinic
City
Okayama
Country
Japan
Facility Name
Chayamachi Ladies Clinic
City
Osaka
Country
Japan
Facility Name
Hayakawa Clinic
City
Osaka
Country
Japan
Facility Name
Minami-Morimachi Ladies Clinic
City
Osaka
Country
Japan
Facility Name
Nomura Clinic Nanba
City
Osaka
Country
Japan
Facility Name
Rikako Ladies Clinic
City
Osaka
Country
Japan
Facility Name
Tanabe Ladies Clinic
City
Osaka
Country
Japan
Facility Name
Yoshimura Ladies Clinic
City
Osaka
Country
Japan
Facility Name
Dantsuka Clinic
City
Saitama
Country
Japan
Facility Name
Kashiwazaki Ladies Clinic
City
Saitama
Country
Japan
Facility Name
Maruyama Memorial General Hospital
City
Saitama
Country
Japan
Facility Name
Kusatsu General Hospital
City
Shiga
Country
Japan
Facility Name
Akasaka-Mitsuke Miyazaki Clinic
City
Tokyo
Country
Japan
Facility Name
Ginza Yoshida Hospital
City
Tokyo
Country
Japan
Facility Name
Hamada Hospital
City
Tokyo
Country
Japan
Facility Name
Ikebukuro Metroporitan Clinic
City
Tokyo
Country
Japan
Facility Name
NS Clinic
City
Tokyo
Country
Japan
Facility Name
Sei Women's Clinic
City
Tokyo
Country
Japan
Facility Name
Seijo Kinoshita Hospital
City
Tokyo
Country
Japan
Facility Name
Shimamura Memorial Hospital
City
Tokyo
Country
Japan
Facility Name
Toranomon Women's Clinic
City
Tokyo
Country
Japan
Facility Name
Yokokura Clinic
City
Tokyo
Country
Japan
Facility Name
Yukawa Women's Clinic
City
Tokyo
Country
Japan
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
34895700
Citation
Harada T, Osuga Y, Suzuki Y, Fujisawa M, Fukui M, Kitawaki J. Relugolix, an oral gonadotropin-releasing hormone receptor antagonist, reduces endometriosis-associated pain compared with leuprorelin in Japanese women: a phase 3, randomized, double-blind, noninferiority study. Fertil Steril. 2022 Mar;117(3):583-592. doi: 10.1016/j.fertnstert.2021.11.013. Epub 2021 Dec 8.
Results Reference
derived
Learn more about this trial
Clinical Study to Evaluate Efficacy and Safety of TAK-385 40 mg Compared With Leuprorelin in Patients With Endometriosis
We'll reach out to this number within 24 hrs