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A Clinical Study of Intravaginal Prasterone (Intrarosa®) in Postmenopausal Vulvovaginal Atrophy

Primary Purpose

Postmenopausal Vulvovaginal Atrophy

Status
Active
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
intravaginal prasterone
Placebo ovules
Sponsored by
Lee's Pharmaceutical Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postmenopausal Vulvovaginal Atrophy

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject is between 40 and 80 years of age inclusive;
  2. Menopausal women (with or without hysterectomy) must also meet 1 of the following 3 conditions:

    A Non-hysterectomy, menopause ≥ 12 months; B. Menopause > 6 months and < 12 months or premenopausal hysterectomy, follicle stimulating hormone (FSH) > 40 IU/L; C ≥ 6 months since baseline assessment (Day 1) with or without hysterectomy.

  3. At screening and baseline (Day 1), the subject presented with moderate-severe dyspareunia (dyspareunia) as measured by the Vaginal Atrophy Symptom Questionnaire (VASQ) and self-rated as the most bothersome symptom.
  4. ≤ 5% superficial cells by vaginal smear at screening and baseline (Day 1).
  5. Vaginal pH > 5 at Screening and Baseline (Day 1).
  6. Women (with or without a partner) who currently have sex or other sexual activity (masturbation, etc.) at least once a month, or who have sex or other sexual activity at least once a month in the past, with reduced sexual activity due to excessive pain or vaginal dryness.
  7. Normal physical examination of the breast and normal mammographic findings (BI-RADS grade 1 or 2) within 9 months prior to the baseline visit (Day 1).
  8. Normal cervical smear results (including inflammatory changes), regardless of hysterectomy (no abnormal cervical smear in the past 2 years if ASCUS is present, and human papillomavirus (HPV) test negative can be used) within 12 months before the baseline visit (Day 1).
  9. Voluntarily participate in this clinical trial and sign the informed consent form (ICF).

    -

Exclusion Criteria:

  1. Patients with a history of malignant tumor.
  2. Have active or history of thromboembolic disease (excluding thromboembolic events due to accidents, surgery, immobilization).
  3. Clinically significant endocrine metabolic disease (e.g., diabetes mellitus) not controlled with medication.
  4. Use of estrogen injections, estrogen implant sticks, progestogen injections, progestogen implants, androgens, anabolic steroids within 6 months of the screening visit.
  5. Use oral estrogen, oral progesterone, prasterone (DHEA) or intrauterine progesterone treatment, intravaginal hormonal drugs (ring, cream, gel or tablet), estrogen alone or estrogen/pregnancy within 8 weeks before the screening visit, hormone transdermal drug users.
  6. Confirmed depression with poor control under standard treatment or history of diagnosed psychiatric disorder.
  7. Those who have participated in or plan to participate in other drug or device clinical trials during the study period within 1 month prior to the screening visit.
  8. Laboratory findings suggestive of glutamic-pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST) ≥ 2 times the upper limit of normal, or creatinine ≥ 1.5 times the upper limit of normal.
  9. Grade 2 and higher uterine prolapse (cervix reaching labia minora).
  10. Transvaginal ultrasound revealed a uterine fibroid ≥ 3 cm in diameter.
  11. Endometrial thickness ≥ 4 mm by transvaginal ultrasound, or other comprehensive assessment by the investigator with the possibility of endometrial hyperplasia, deterioration.
  12. Current endometrial polyps.
  13. Previous endometrial ablation.
  14. Patients with vulvar lichen sclerosus.
  15. Patients with unexplained vaginal bleeding.
  16. Patients who are known to be allergic to the study drug or its ingredients.
  17. Patients who have participated in other relevant clinical trials of the investigational drug (prasterone vaginal suppositories).
  18. History of past or present drug or alcohol abuse (14 units of alcohol per week: 1 unit = 285 mL of beer, or 25 mL of spirits, or 100 mL of wine).
  19. Subjects who are unable to perform the procedures required by the protocol, or any other subjects who are not suitable for this clinical study judged by the investigator.

    -

Sites / Locations

  • Obstetrics and Gynecology Hospital of Fudan University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Intravaginal prasterone

Placebo ovules

Arm Description

6.5 mg of Intravaginal prasterone once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.

Placebo ovules once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.

Outcomes

Primary Outcome Measures

The change in the dyspareunia (dyspareunia) severity score at Day 85.
Compared with Day 1, the changes in the dyspareunia (dyspareunia) severity score (by VASQ) at Day 85 (12 weeks) in the two groups of subjects.
The change in the vaginal pH at Day 85.
Compared with Day 1, the changes in the vaginal pH changes at Day 85 (12 weeks) in the two groups of subjects.
The change in the proportion of parabasal cells at Day 85.
Compared with Day 1, the changes in the proportion of parabasal cells at Day 85 (12 weeks) in the two groups of subjects.
The change in the proportion of superficial cells at Day 85.
Compared with Day 1, the changes in the proportion of superficial cells at Day 85 (12 weeks) in the two groups of subjects.

Secondary Outcome Measures

Change in vaginal dryness and vaginal irritation/itching severity score at day 85 (12 weeks).
Compared with the baseline period, at day 85 (12 weeks) in both groups: change in vaginal dryness and vaginal irritation/itching severity score by VASQ.
Change in Female Sexual Function Index at Day 85 (12 weeks).
Compared with the baseline period, the two groups at Day 85 (12 weeks): change in Female Sexual Function Index (FSFI questionnaire).
Effects on DHEA in blood
To test the concentrations of DHEA in blood.
Changes in the gynecological vaginal examination.
The changes of total severity score in the vaginal discharge, vaginal epithelial integrity, vaginal epithelial surface thickness, and vaginal color by gynecological vaginal examination.
Adverse event.
The proportion of adverse events.

Full Information

First Posted
June 23, 2021
Last Updated
October 31, 2022
Sponsor
Lee's Pharmaceutical Limited
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1. Study Identification

Unique Protocol Identification Number
NCT04982692
Brief Title
A Clinical Study of Intravaginal Prasterone (Intrarosa®) in Postmenopausal Vulvovaginal Atrophy
Official Title
A Multi-center, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase Ⅲ, Efficacy and Safety Study of Intravaginal Prasterone (INTRAROSA) on Postmenopausal Vulvovaginal Atrophy (VVA)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 13, 2021 (Actual)
Primary Completion Date
January 30, 2023 (Anticipated)
Study Completion Date
March 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lee's Pharmaceutical Limited

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
This study is a phase III which includes two treatment phases. The phase 1 study is a multi-center, randomized, double-blind, placebo- controlled, parallel group that provide primary efficacy and safety data. The Phase 2 study is a single-arm, open-label conducted in a subset of subjects who completed the phase 1 study to provid additional long-term safety and efficacy.
Detailed Description
The phase 1 study which includes the screening phase (up to 3 weeks) and treatment phase (12 weeks). After signing the informed consent, the inclusion and exclusion criteria will be confirmed preliminarily at screening visit and reconfirmed at Day 1 (baseline). At least 418 eligible subjects will be randomized in a 1:1 ratio to receive 6.5mg of intravaginal prasterone or placebo once-daily for 12 weeks. The phase 2 study which includes the treatment phase (26 weeks). A total of 100 subjects who have completed Phase 1, not occur adverse event(AE) grade ≥3 or serious adverse event (SAE), or recover all AE grades ≤1, and voluntary to participate in Phase 2 study. After signing the ICF, the subject will receive 6.5mg of intravaginal for 26 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postmenopausal Vulvovaginal Atrophy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
418 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intravaginal prasterone
Arm Type
Experimental
Arm Description
6.5 mg of Intravaginal prasterone once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.
Arm Title
Placebo ovules
Arm Type
Placebo Comparator
Arm Description
Placebo ovules once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.
Intervention Type
Drug
Intervention Name(s)
intravaginal prasterone
Other Intervention Name(s)
Intrarosa
Intervention Description
6.5 mg of Intravaginal prasterone once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo ovules
Intervention Description
Placebo ovules once daily at bedtime with a finger to insert the vaginal suppository into the vagina for a treatment cycle of 12 weeks.
Primary Outcome Measure Information:
Title
The change in the dyspareunia (dyspareunia) severity score at Day 85.
Description
Compared with Day 1, the changes in the dyspareunia (dyspareunia) severity score (by VASQ) at Day 85 (12 weeks) in the two groups of subjects.
Time Frame
week 12
Title
The change in the vaginal pH at Day 85.
Description
Compared with Day 1, the changes in the vaginal pH changes at Day 85 (12 weeks) in the two groups of subjects.
Time Frame
week 12
Title
The change in the proportion of parabasal cells at Day 85.
Description
Compared with Day 1, the changes in the proportion of parabasal cells at Day 85 (12 weeks) in the two groups of subjects.
Time Frame
week 12
Title
The change in the proportion of superficial cells at Day 85.
Description
Compared with Day 1, the changes in the proportion of superficial cells at Day 85 (12 weeks) in the two groups of subjects.
Time Frame
week 12
Secondary Outcome Measure Information:
Title
Change in vaginal dryness and vaginal irritation/itching severity score at day 85 (12 weeks).
Description
Compared with the baseline period, at day 85 (12 weeks) in both groups: change in vaginal dryness and vaginal irritation/itching severity score by VASQ.
Time Frame
week 12
Title
Change in Female Sexual Function Index at Day 85 (12 weeks).
Description
Compared with the baseline period, the two groups at Day 85 (12 weeks): change in Female Sexual Function Index (FSFI questionnaire).
Time Frame
week 12
Title
Effects on DHEA in blood
Description
To test the concentrations of DHEA in blood.
Time Frame
week 12
Title
Changes in the gynecological vaginal examination.
Description
The changes of total severity score in the vaginal discharge, vaginal epithelial integrity, vaginal epithelial surface thickness, and vaginal color by gynecological vaginal examination.
Time Frame
week 12
Title
Adverse event.
Description
The proportion of adverse events.
Time Frame
week 6,week 12

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is between 40 and 80 years of age inclusive; Menopausal women (with or without hysterectomy) must also meet 1 of the following 3 conditions: A Non-hysterectomy, menopause ≥ 12 months; B. Menopause > 6 months and < 12 months or premenopausal hysterectomy, follicle stimulating hormone (FSH) > 40 IU/L; C ≥ 6 months since baseline assessment (Day 1) with or without hysterectomy. At screening and baseline (Day 1), the subject presented with moderate-severe dyspareunia (dyspareunia) as measured by the Vaginal Atrophy Symptom Questionnaire (VASQ) and self-rated as the most bothersome symptom. ≤ 5% superficial cells by vaginal smear at screening and baseline (Day 1). Vaginal pH > 5 at Screening and Baseline (Day 1). Women (with or without a partner) who currently have sex or other sexual activity (masturbation, etc.) at least once a month, or who have sex or other sexual activity at least once a month in the past, with reduced sexual activity due to excessive pain or vaginal dryness. Normal physical examination of the breast and normal mammographic findings (BI-RADS grade 1 or 2) within 9 months prior to the baseline visit (Day 1). Normal cervical smear results (including inflammatory changes), regardless of hysterectomy (no abnormal cervical smear in the past 2 years if ASCUS is present, and human papillomavirus (HPV) test negative can be used) within 12 months before the baseline visit (Day 1). Voluntarily participate in this clinical trial and sign the informed consent form (ICF). - Exclusion Criteria: Patients with a history of malignant tumor. Have active or history of thromboembolic disease (excluding thromboembolic events due to accidents, surgery, immobilization). Clinically significant endocrine metabolic disease (e.g., diabetes mellitus) not controlled with medication. Use of estrogen injections, estrogen implant sticks, progestogen injections, progestogen implants, androgens, anabolic steroids within 6 months of the screening visit. Use oral estrogen, oral progesterone, prasterone (DHEA) or intrauterine progesterone treatment, intravaginal hormonal drugs (ring, cream, gel or tablet), estrogen alone or estrogen/pregnancy within 8 weeks before the screening visit, hormone transdermal drug users. Confirmed depression with poor control under standard treatment or history of diagnosed psychiatric disorder. Those who have participated in or plan to participate in other drug or device clinical trials during the study period within 1 month prior to the screening visit. Laboratory findings suggestive of glutamic-pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST) ≥ 2 times the upper limit of normal, or creatinine ≥ 1.5 times the upper limit of normal. Grade 2 and higher uterine prolapse (cervix reaching labia minora). Transvaginal ultrasound revealed a uterine fibroid ≥ 3 cm in diameter. Endometrial thickness ≥ 4 mm by transvaginal ultrasound, or other comprehensive assessment by the investigator with the possibility of endometrial hyperplasia, deterioration. Current endometrial polyps. Previous endometrial ablation. Patients with vulvar lichen sclerosus. Patients with unexplained vaginal bleeding. Patients who are known to be allergic to the study drug or its ingredients. Patients who have participated in other relevant clinical trials of the investigational drug (prasterone vaginal suppositories). History of past or present drug or alcohol abuse (14 units of alcohol per week: 1 unit = 285 mL of beer, or 25 mL of spirits, or 100 mL of wine). Subjects who are unable to perform the procedures required by the protocol, or any other subjects who are not suitable for this clinical study judged by the investigator. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
long Sui
Organizational Affiliation
No. 419, Fangxie Road, Huangpu District, Shanghai
Official's Role
Principal Investigator
Facility Information:
Facility Name
Obstetrics and Gynecology Hospital of Fudan University
City
Shanghai
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Clinical Study of Intravaginal Prasterone (Intrarosa®) in Postmenopausal Vulvovaginal Atrophy

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