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A Study of the Effect of Testosterone Replacement Therapy on Blood Pressure in Adult Male Participants With Hypogonadism

Primary Purpose

Hypogonadism, Hypogonadism, Male, Hypogonadotropic Hypogonadism

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Aveed Injectable Product
Fortesta
Testim
Sponsored by
Endo Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypogonadism

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Have a diagnosis of primary hypogonadism or hypogonadotropic hypogonadism.
  2. Have a total serum testosterone at screening < 300 ng/dL based on 2 blood samples obtained at 10 am (+/-2 hours) on 2 separate occasions at least 48 hours apart
  3. Be naïve to androgen replacement or washout of 12 weeks following intramuscular androgen injections; 4 weeks following topical or buccal, nasal, or oral androgens.
  4. Have a screening blood pressure at rest of less than 140 millimeters of mercury (mm Hg) for systolic blood pressure and less than 90 mm Hg for diastolic blood pressure.
  5. Be judged to be in good health.
  6. Participants enrolled in the Testim or Fortesta treatment arms: take necessary precautions to avoid skin-to-skin contact and potential transfer and if male use effective contraception.
  7. Be willing and able to cooperate with the requirements of the study.

Exclusion Criteria:

  1. Is from a vulnerable population, as defined by the US Code of Federal Regulations (CFR) Title 45, Part 46, Section 46.111(b) and other local and national regulations, including but not limited to, employees (temporary, part-time, full time, etc) or a family member of the research staff conducting the study, or of the sponsor, or of the contract research organization, or of the Institutional Review Board/Independent Ethics Committee (IRB/IEC).
  2. Has a history of significant sensitivity or allergy to the study drugs, including androgens, or product excipients.
  3. Has a history of or medical examination findings renal, hepatic, neurologic, hematologic, endocrine, oncologic, pulmonary, immunologic, psychiatric conditions, cardiovascular disease/dysrhythmia) or any other condition(s) that restricts study participation.
  4. Has clinically significant changes in any medications (including dosages) or medical conditions in the 28 days prior to screening
  5. Is not on a stable medication regimen for at least 3 months for the treatment of a chronic condition.
  6. Has had a cardiovascular and/or cerebrovascular event within the last 6 months.
  7. Needs blood pressure cuff size larger than 50 centimeters.
  8. Works a night shift or performs heavy manual labor.
  9. Has any known contraindication(s) to active study treatment including, but not limited to: known or suspected carcinoma of the prostate or breast, previous history of cancer (except basal cell carcinoma of the skin) liver disease, active deep vein thrombosis, atrial fibrillation, untreated sleep apnea, or is immune compromised.
  10. Uses known inhibitors (for example, ketoconazole) or inducers of cytochrome P450 3A (for example, dexamethasone, phenytoin, rifampin, carbamazepine) of cytochrome P450 3A (CYP3A) within 30 days prior to study drug administration and through the end of the study.

    1. Uses any of the above listed drugs within 5 half lives of the last dose in the past 6 months prior to study drug administration.
    2. Has received any of the above listed drugs by injection within 30 days or 10 half lives (whichever is longer) prior to study drug administration.
    3. Uses nutraceuticals or homeopathic compounds.
  11. Has a history of drug or alcohol abuse within 6 months prior to study drug administration.
  12. Has untreated moderate to severe depression.
  13. Has any skin lesions/cuts/injury at the application site.
  14. Has suspected reversible hypogonadism.
  15. Donated blood or blood products or experienced significant blood loss within 90 days prior to study drug administration.
  16. Intends to conceive at any time during the study.
  17. Donated bone marrow within 6 months prior to study drug administration.
  18. Has participated in a previous investigational study or received treatment with an investigational product within 30 days of screening.
  19. Has a diagnosis of, is undergoing therapy for, or has received therapy for a hematologic malignancy in the 5 years prior to screening.
  20. Has a history of substance abuse or is taking any substance of abuse (Note: participants on a stable dose of any medications that have been prescribed by a healthcare practitioner for a properly documented medical condition are exempt).
  21. Abnormal electrocardiogram (ECG) (QT prolongation with QTc ≥450 milliseconds).
  22. Has evidence of abnormalities on physical examination, vital signs, ECG, or clinical lab values, unless judged to be clinically insignificant by the investigator
  23. Has any other condition that might indicate the participant to be unsuitable for the study.

Sites / Locations

  • Endo Clinical Trial Site #8
  • Endo Clinical Trial Site #22
  • Endo Clinical Trial Site #15
  • Endo Clinical Trial Site #32
  • Endo Clinical Trial Site #33
  • Endo Clinical Trial Site #30
  • Endo Clinical Trial Site #12
  • Endo Clinical Trial Site #34
  • Endo Clinical Trial Site #29
  • Endo Clinical Trial Site #10
  • Endo Clinical Trial Site #18
  • Endo Clinical Trial Site #26
  • Endo Clinical Trial Site #2
  • Endo Clinical Trial Site #28
  • Endo Clinical Trial Site #3
  • Endo Clinical Trial Site #4
  • Endo Clinical Trial Site #11
  • Endo Clinical Trial Site #23
  • Endo Clinical Trial Site #16
  • Endo Clinical Trial Site #27
  • Endo Clinical Trial Site #17
  • Endo Clinical Trial Site #35
  • Endo Clinical Trial Site #9
  • Endo Clinical Trial Site #7
  • Endo Clinical Trial Site #25
  • Endo Clinical Trial Site #5
  • Endo Clinical Trial Site #13
  • Endo Clinical Trial Site #19
  • Endo Clinical Trial Site #31
  • Endo Clinical Trial Site #20
  • Endo Clinical Trial Site #21
  • Endo Clinical Trial Site #1
  • Endo Clinical Trial Site #14
  • Endo Clinical Trial Site #6
  • Endo Clinical Trial Site #24

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

AVEED (Testosterone Undecanoate Injection)

FORTESTA (Testosterone Gel)

TESTIM (Testosterone Gel)

Arm Description

Fixed dosage level of 750 milligrams (mg)/3 milliliters (mL) administered by intramuscular injections.

40 mg once daily topical gel administration.

50 mg once daily topical gel administration.

Outcomes

Primary Outcome Measures

Change from Baseline in 24-Hour Average Systolic Ambulatory Blood Pressure

Secondary Outcome Measures

Change from Baseline in 24-Hour Average Arterial Pressure
Change from Baseline in 24-Hour Average Systolic Blood Pressure
Change from Baseline in 24-Hour Average Diastolic Blood Pressure
Change from Baseline in 24-Hour Average Heart Rate
Change from Baseline in 24-Hour Average Pulse Pressure
Percent of Participants Taking New Antihypertensive Medications
Percent of Participants with Dose Increases From Baseline in Antihypertensive Medications

Full Information

First Posted
June 30, 2020
Last Updated
July 27, 2023
Sponsor
Endo Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04456296
Brief Title
A Study of the Effect of Testosterone Replacement Therapy on Blood Pressure in Adult Male Participants With Hypogonadism
Official Title
An Open-Label, Randomized, Parallel-Group, Three Treatment Arm, Multicenter Study on Hypogonadal Males to Evaluate the Effect on 24-Hour Ambulatory Blood Pressure After 16-Week Continuous Administration With Marketed Testosterone Products
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
June 30, 2020 (Actual)
Primary Completion Date
July 12, 2023 (Actual)
Study Completion Date
July 12, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endo Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Testosterone is the principal androgen produced by the male testes. Hypogonadism is the result of inadequate production of testosterone by the Leydig cells of the testes and is reflected by total serum concentrations of testosterone of < 300 nanograms (ng)/deciliters (dL), with discernible diurnal pattern. The etiology of hypogonadism may be primary or secondary. The treatment of males with primary, and in some cases, secondary hypogonadism includes administration of testosterone. Testim® and Fortesta® are topical gels that when applied daily help to increase the total testosterone levels in the blood through skin absorption. Aveed® is an injectable form of testosterone treatment and participants randomized to this treatment arm will receive 3 injections over the course of 16 weeks. This study is designed to evaluate the effect on blood pressure of approved testosterone products (Testim®, Fortesta®, and Aveed®) after 16 weeks of therapy using 24-hour ambulatory blood pressure to reveal shifts in blood pressure levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypogonadism, Hypogonadism, Male, Hypogonadotropic Hypogonadism

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
676 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AVEED (Testosterone Undecanoate Injection)
Arm Type
Active Comparator
Arm Description
Fixed dosage level of 750 milligrams (mg)/3 milliliters (mL) administered by intramuscular injections.
Arm Title
FORTESTA (Testosterone Gel)
Arm Type
Active Comparator
Arm Description
40 mg once daily topical gel administration.
Arm Title
TESTIM (Testosterone Gel)
Arm Type
Active Comparator
Arm Description
50 mg once daily topical gel administration.
Intervention Type
Drug
Intervention Name(s)
Aveed Injectable Product
Other Intervention Name(s)
Testosterone undecanoate
Intervention Description
Testosterone undecanoate administered by intramuscular injections.
Intervention Type
Drug
Intervention Name(s)
Fortesta
Other Intervention Name(s)
Testosterone gel
Intervention Description
Testosterone gel administered topically. The daily dose of the study drug will be titrated for each participant, according to approved dosage and administration instructions, until the circulating testosterone concentrations of the participant reaches normal concentrations (300-1000 ng/dL).
Intervention Type
Drug
Intervention Name(s)
Testim
Other Intervention Name(s)
Testosterone gel
Intervention Description
Testosterone gel administered topically. The daily dose of the study drug will be titrated for each participant, according to approved dosage and administration instructions, until the circulating testosterone concentrations of the participant reaches normal concentrations (300-1000 ng/dL).
Primary Outcome Measure Information:
Title
Change from Baseline in 24-Hour Average Systolic Ambulatory Blood Pressure
Time Frame
Baseline (Day 1), Week 16
Secondary Outcome Measure Information:
Title
Change from Baseline in 24-Hour Average Arterial Pressure
Time Frame
Baseline (Day 1), Week 16
Title
Change from Baseline in 24-Hour Average Systolic Blood Pressure
Time Frame
Baseline (Day 1), Week 16
Title
Change from Baseline in 24-Hour Average Diastolic Blood Pressure
Time Frame
Baseline (Day 1), Week 16
Title
Change from Baseline in 24-Hour Average Heart Rate
Time Frame
Baseline (Day 1), Week 16
Title
Change from Baseline in 24-Hour Average Pulse Pressure
Time Frame
Baseline (Day 1), Week 16
Title
Percent of Participants Taking New Antihypertensive Medications
Time Frame
Week 16
Title
Percent of Participants with Dose Increases From Baseline in Antihypertensive Medications
Time Frame
Week 16

10. Eligibility

Sex
Male
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have a diagnosis of primary hypogonadism or hypogonadotropic hypogonadism. Have a total serum testosterone at screening < 300 ng/dL based on 2 blood samples obtained at 10 am (+/-2 hours) on 2 separate occasions at least 48 hours apart Be naïve to androgen replacement or washout of 12 weeks following intramuscular androgen injections; 4 weeks following topical or buccal, nasal, or oral androgens. Have a screening blood pressure at rest of less than 140 millimeters of mercury (mm Hg) for systolic blood pressure and less than 90 mm Hg for diastolic blood pressure. Be judged to be in good health. Participants enrolled in the Testim or Fortesta treatment arms: take necessary precautions to avoid skin-to-skin contact and potential transfer and if male use effective contraception. Be willing and able to cooperate with the requirements of the study. Exclusion Criteria: Is from a vulnerable population, as defined by the US Code of Federal Regulations (CFR) Title 45, Part 46, Section 46.111(b) and other local and national regulations, including but not limited to, employees (temporary, part-time, full time, etc) or a family member of the research staff conducting the study, or of the sponsor, or of the contract research organization, or of the Institutional Review Board/Independent Ethics Committee (IRB/IEC). Has a history of significant sensitivity or allergy to the study drugs, including androgens, or product excipients. Has a history of or medical examination findings renal, hepatic, neurologic, hematologic, endocrine, oncologic, pulmonary, immunologic, psychiatric conditions, cardiovascular disease/dysrhythmia) or any other condition(s) that restricts study participation. Has clinically significant changes in any medications (including dosages) or medical conditions in the 28 days prior to screening Is not on a stable medication regimen for at least 3 months for the treatment of a chronic condition. Has had a cardiovascular and/or cerebrovascular event within the last 6 months. Needs blood pressure cuff size larger than 50 centimeters. Works a night shift or performs heavy manual labor. Has any known contraindication(s) to active study treatment including, but not limited to: known or suspected carcinoma of the prostate or breast, previous history of cancer (except basal cell carcinoma of the skin) liver disease, active deep vein thrombosis, atrial fibrillation, untreated sleep apnea, or is immune compromised. Uses known inhibitors (for example, ketoconazole) or inducers of cytochrome P450 3A (for example, dexamethasone, phenytoin, rifampin, carbamazepine) of cytochrome P450 3A (CYP3A) within 30 days prior to study drug administration and through the end of the study. Uses any of the above listed drugs within 5 half lives of the last dose in the past 6 months prior to study drug administration. Has received any of the above listed drugs by injection within 30 days or 10 half lives (whichever is longer) prior to study drug administration. Uses nutraceuticals or homeopathic compounds. Has a history of drug or alcohol abuse within 6 months prior to study drug administration. Has untreated moderate to severe depression. Has any skin lesions/cuts/injury at the application site. Has suspected reversible hypogonadism. Donated blood or blood products or experienced significant blood loss within 90 days prior to study drug administration. Intends to conceive at any time during the study. Donated bone marrow within 6 months prior to study drug administration. Has participated in a previous investigational study or received treatment with an investigational product within 30 days of screening. Has a diagnosis of, is undergoing therapy for, or has received therapy for a hematologic malignancy in the 5 years prior to screening. Has a history of substance abuse or is taking any substance of abuse (Note: participants on a stable dose of any medications that have been prescribed by a healthcare practitioner for a properly documented medical condition are exempt). Abnormal electrocardiogram (ECG) (QT prolongation with QTc ≥450 milliseconds). Has evidence of abnormalities on physical examination, vital signs, ECG, or clinical lab values, unless judged to be clinically insignificant by the investigator Has any other condition that might indicate the participant to be unsuitable for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Karen Kang
Organizational Affiliation
Endo Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Endo Clinical Trial Site #8
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35235
Country
United States
Facility Name
Endo Clinical Trial Site #22
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
Endo Clinical Trial Site #15
City
North Little Rock
State/Province
Arkansas
ZIP/Postal Code
72116
Country
United States
Facility Name
Endo Clinical Trial Site #32
City
Bell Gardens
State/Province
California
ZIP/Postal Code
90201
Country
United States
Facility Name
Endo Clinical Trial Site #33
City
Canoga Park
State/Province
California
ZIP/Postal Code
91304
Country
United States
Facility Name
Endo Clinical Trial Site #30
City
Beverly Hills
State/Province
Florida
ZIP/Postal Code
90211
Country
United States
Facility Name
Endo Clinical Trial Site #12
City
Boynton Beach
State/Province
Florida
ZIP/Postal Code
33435
Country
United States
Facility Name
Endo Clinical Trial Site #34
City
Boynton Beach
State/Province
Florida
ZIP/Postal Code
33435
Country
United States
Facility Name
Endo Clinical Trial Site #29
City
Fleming Island
State/Province
Florida
ZIP/Postal Code
32003
Country
United States
Facility Name
Endo Clinical Trial Site #10
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
Endo Clinical Trial Site #18
City
Miami Gardens
State/Province
Florida
ZIP/Postal Code
33023
Country
United States
Facility Name
Endo Clinical Trial Site #26
City
Miami
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Endo Clinical Trial Site #2
City
Miami
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Endo Clinical Trial Site #28
City
Miami
State/Province
Florida
ZIP/Postal Code
33183
Country
United States
Facility Name
Endo Clinical Trial Site #3
City
Oviedo
State/Province
Florida
ZIP/Postal Code
32765
Country
United States
Facility Name
Endo Clinical Trial Site #4
City
Pembroke Pines
State/Province
Florida
ZIP/Postal Code
33027
Country
United States
Facility Name
Endo Clinical Trial Site #11
City
Pompano Beach
State/Province
Florida
ZIP/Postal Code
33060
Country
United States
Facility Name
Endo Clinical Trial Site #23
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33401
Country
United States
Facility Name
Endo Clinical Trial Site #16
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Endo Clinical Trial Site #27
City
Glen Burnie
State/Province
Maryland
ZIP/Postal Code
21061
Country
United States
Facility Name
Endo Clinical Trial Site #17
City
Towson
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
Endo Clinical Trial Site #35
City
East Orange
State/Province
New Jersey
ZIP/Postal Code
07018
Country
United States
Facility Name
Endo Clinical Trial Site #9
City
Garden City
State/Province
New York
ZIP/Postal Code
11530
Country
United States
Facility Name
Endo Clinical Trial Site #7
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Endo Clinical Trial Site #25
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Endo Clinical Trial Site #5
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45417
Country
United States
Facility Name
Endo Clinical Trial Site #13
City
Bala-Cynwyd
State/Province
Pennsylvania
ZIP/Postal Code
19004
Country
United States
Facility Name
Endo Clinical Trial Site #19
City
Houston
State/Province
Texas
ZIP/Postal Code
77036
Country
United States
Facility Name
Endo Clinical Trial Site #31
City
Houston
State/Province
Texas
ZIP/Postal Code
77084
Country
United States
Facility Name
Endo Clinical Trial Site #20
City
Houston
State/Province
Texas
ZIP/Postal Code
77087
Country
United States
Facility Name
Endo Clinical Trial Site #21
City
Missouri City
State/Province
Texas
ZIP/Postal Code
77459
Country
United States
Facility Name
Endo Clinical Trial Site #1
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Endo Clinical Trial Site #14
City
Rutland
State/Province
Vermont
ZIP/Postal Code
05701
Country
United States
Facility Name
Endo Clinical Trial Site #6
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22911
Country
United States
Facility Name
Endo Clinical Trial Site #24
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23462
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes

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A Study of the Effect of Testosterone Replacement Therapy on Blood Pressure in Adult Male Participants With Hypogonadism

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