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An Open-Label Study of 50 mg Oral Testosterone Undecanoate (Kyztrex) in Menopausal Women With Low Testosterone and HSDD

Primary Purpose

Hypoactive Sexual Desire Disorder

Status
Not yet recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oral Testosterone Undecanoate
Sponsored by
San Diego Sexual Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypoactive Sexual Desire Disorder

Eligibility Criteria

21 Years - 75 Years (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria: Participant provides written informed consent and HIPAA authorization before any study procedures are conducted; Participant is female; Participant is aged 21 years or greater; Participant is menopausal either naturally (at least 12 months amenorrheic) or after a bilateral salpingo-oophorectomy prior to natural menopause. Subjects with hysterectomy only must meet the following menopause criteria: ≤54 years must be experiencing hot flushes or receiving estrogen therapy for hot flushes (if these subjects are asymptomatic they require a serum FSH > 30 mIU/mL); > 54 years is considered postmenopausal. Participant is in a monogamous relationship ≥ 6 months; Participant has a body mass index (BMI) ≤ 35 kg/m2; Participant has a history of any of the clinical symptoms of low testosterone for at least 6 months prior to the screening visit; At screening, subject has a calculated free testosterone concentration < 0.6 ng/dL; Participant agrees to comply with the study procedures and visits. Exclusion Criteria: Participant has a hypersensitivity to testosterone, gelatin, glycerin, sorbitol, and titanium dioxide (the constituents of Kyzatrex capsule); Participant has received intramuscular testosterone injections, oral or transdermal testosterone within 4 weeks, or subcutaneous testosterone pellet within 6 months prior to the screening visit, or receives any form of testosterone other than study medication during this trial; Participant has documented or suspected breast cancer, history of heart attack or stroke; Participant has a clinically significant history of disease which could alter absorption, distribution, metabolism, or elimination, such as hepatic, renal, hematologic, gastrointestinal, respiratory, endocrine, or neurological disease; Participant has an EKG with an abnormality of clinical significance; Participant has any chronic medical condition or psychologic disorder that the Principal Investigator feels makes her ineligible for the study; Participant requires major surgery within 4 weeks before signing consent or at any time during the study; Participant requires a treatment with any medication listed in Appendix 1 at any time between 30 days before study medication is started or any time until the end of the study; Participant has a history of substance abuse within 12 months prior to signing consent; Participant has received an investigational drug within 30 days prior to signing consent; Participant has any condition or exhibits behavior that indicates to the Principal Investigator that the subject is unlikely to be compliant with study procedures and visits.

Sites / Locations

  • San Diego Sexual Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Active

Arm Description

Participants will receive 50mg oral testosterone undecanoate daily, have pharmacokinetics assessed and complete validated instruments

Outcomes

Primary Outcome Measures

Testosterone
serum concentration of total testosterone to assess pharmacokinetics

Secondary Outcome Measures

Female Sexual Function Index
Female Sexual Function Index to assess changes in each domain and total, total range 2-36, lower the score the more dysfunction therefore worse function

Full Information

First Posted
October 8, 2023
Last Updated
October 12, 2023
Sponsor
San Diego Sexual Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT06082817
Brief Title
An Open-Label Study of 50 mg Oral Testosterone Undecanoate (Kyztrex) in Menopausal Women With Low Testosterone and HSDD
Official Title
An Open-Label Pilot Study of the Pharmacokinetics and Safety of 50 Mg Oral Testosterone Undecanoate (Kyzatrex) in Menopausal Women With Low Testosterone and Hypoactive Sexual Desire Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 1, 2023 (Anticipated)
Primary Completion Date
June 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
San Diego Sexual Medicine

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an unblinded study to be conducted at a single research center, San Diego Sexual Medicine. Eligible subjects will receive 50 mg capsules of Kyzatrax® to be taken orally daily over a 3-month period. Multiple blood samples will be taken at baseline and on days 7, 28 and 56 to assess safety and pharmacokinetics of the testosterone. After the informed consent is signed and for up to 84 days after baseline, subjects will have serial blood samples collected in addition to other routine study procedures (e.g. vital signs measured, adverse events assessed, validated outcome scales completed).
Detailed Description
This study is being conducted in an unblinded fashion because the primary endpoint is pharmacokinetic information, and all subjects will receive the same active drug at the same dosage. The primary objectives of this study are to assess the short-term safety and to investigate the pharmacokinetics of serum concentration of total testosterone with daily administration of one (1) 50 mg capsule of testosterone undecanoate (Kyzatrax®) in thirty menopausal women with hypoactive sexual desire disorder (HSDD) and low testosterone. The secondary objective of this study is to assess the efficacy of daily oral administration of one (1) 50 mg capsule of testosterone undecanoate (Kyzatrax®) in thirty menopausal women with HSDD and low testosterone. The eligibility criterion for testosterone concentration (< 25 ng/mL [< 0.87 nmol/L]) is based on the lower limit of the normal testosterone reference range for adult females. The dose of 50 mg was chosen because this is the lowest oral testosterone currently being manufactured and it represents 12.5% of the starting dose of Kyzatrex FDA approved for men (see Attachment 1). Based on the guidelines of the International Society for the Study of Women's Sexual Health, the starting dose of testosterone for peri- and post-menopausal women is approximately 10% of a testosterone product FDA approved for men. In clinical practice, women are typically prescribed testosterone therapy at 10-20% of the dose given to men, depending on individual adsorption and metabolism characteristics.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypoactive Sexual Desire Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Open label 50mg daily dosing with pharmacokinetics assessed by multiple blood draws
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active
Arm Type
Experimental
Arm Description
Participants will receive 50mg oral testosterone undecanoate daily, have pharmacokinetics assessed and complete validated instruments
Intervention Type
Drug
Intervention Name(s)
Oral Testosterone Undecanoate
Other Intervention Name(s)
Kyzatrex
Intervention Description
50mg oral testosterone undecanoate daily
Primary Outcome Measure Information:
Title
Testosterone
Description
serum concentration of total testosterone to assess pharmacokinetics
Time Frame
days 0, 7, 28, 56
Secondary Outcome Measure Information:
Title
Female Sexual Function Index
Description
Female Sexual Function Index to assess changes in each domain and total, total range 2-36, lower the score the more dysfunction therefore worse function
Time Frame
Days 0, 28, 56, 84

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
Cis-gender female identifying as a female
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participant provides written informed consent and HIPAA authorization before any study procedures are conducted; Participant is female; Participant is aged 21 years or greater; Participant is menopausal either naturally (at least 12 months amenorrheic) or after a bilateral salpingo-oophorectomy prior to natural menopause. Subjects with hysterectomy only must meet the following menopause criteria: ≤54 years must be experiencing hot flushes or receiving estrogen therapy for hot flushes (if these subjects are asymptomatic they require a serum FSH > 30 mIU/mL); > 54 years is considered postmenopausal. Participant is in a monogamous relationship ≥ 6 months; Participant has a body mass index (BMI) ≤ 35 kg/m2; Participant has a history of any of the clinical symptoms of low testosterone for at least 6 months prior to the screening visit; At screening, subject has a calculated free testosterone concentration < 0.6 ng/dL; Participant agrees to comply with the study procedures and visits. Exclusion Criteria: Participant has a hypersensitivity to testosterone, gelatin, glycerin, sorbitol, and titanium dioxide (the constituents of Kyzatrex capsule); Participant has received intramuscular testosterone injections, oral or transdermal testosterone within 4 weeks, or subcutaneous testosterone pellet within 6 months prior to the screening visit, or receives any form of testosterone other than study medication during this trial; Participant has documented or suspected breast cancer, history of heart attack or stroke; Participant has a clinically significant history of disease which could alter absorption, distribution, metabolism, or elimination, such as hepatic, renal, hematologic, gastrointestinal, respiratory, endocrine, or neurological disease; Participant has an EKG with an abnormality of clinical significance; Participant has any chronic medical condition or psychologic disorder that the Principal Investigator feels makes her ineligible for the study; Participant requires major surgery within 4 weeks before signing consent or at any time during the study; Participant requires a treatment with any medication listed in Appendix 1 at any time between 30 days before study medication is started or any time until the end of the study; Participant has a history of substance abuse within 12 months prior to signing consent; Participant has received an investigational drug within 30 days prior to signing consent; Participant has any condition or exhibits behavior that indicates to the Principal Investigator that the subject is unlikely to be compliant with study procedures and visits.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sue W Goldstein, BA
Phone
619-265-8865
Email
suewgoldstein@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Claudia Gardner, BA
Phone
619-265-8865
Email
cgardner@sdsm.info
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Irwin Goldstein, MD
Organizational Affiliation
San Diego Sexual Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
San Diego Sexual Medicine
City
San Diego
State/Province
California
ZIP/Postal Code
92120
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29545008
Citation
Clayton AH, Goldstein I, Kim NN, Althof SE, Faubion SS, Faught BM, Parish SJ, Simon JA, Vignozzi L, Christiansen K, Davis SR, Freedman MA, Kingsberg SA, Kirana PS, Larkin L, McCabe M, Sadovsky R. The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clin Proc. 2018 Apr;93(4):467-487. doi: 10.1016/j.mayocp.2017.11.002. Epub 2018 Mar 12.
Results Reference
background
PubMed Identifier
33814355
Citation
Parish SJ, Simon JA, Davis SR, Giraldi A, Goldstein I, Goldstein SW, Kim NN, Kingsberg SA, Morgentaler A, Nappi RE, Park K, Stuenkel CA, Traish AM, Vignozzi L. International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. J Sex Med. 2021 May;18(5):849-867. doi: 10.1016/j.jsxm.2020.10.009. Epub 2021 Apr 1.
Results Reference
background
PubMed Identifier
11937111
Citation
Bachmann G, Bancroft J, Braunstein G, Burger H, Davis S, Dennerstein L, Goldstein I, Guay A, Leiblum S, Lobo R, Notelovitz M, Rosen R, Sarrel P, Sherwin B, Simon J, Simpson E, Shifren J, Spark R, Traish A; Princeton. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment. Fertil Steril. 2002 Apr;77(4):660-5. doi: 10.1016/s0015-0282(02)02969-2.
Results Reference
background
PubMed Identifier
26358173
Citation
Davis SR, Wahlin-Jacobsen S. Testosterone in women--the clinical significance. Lancet Diabetes Endocrinol. 2015 Dec;3(12):980-92. doi: 10.1016/S2213-8587(15)00284-3. Epub 2015 Sep 7.
Results Reference
background
PubMed Identifier
34114726
Citation
White WB, Bernstein JS, Rittmaster R, Dhingra O. Effects of the oral testosterone undecanoate Kyzatrex on ambulatory blood pressure in hypogonadal men. J Clin Hypertens (Greenwich). 2021 Jul;23(7):1420-1430. doi: 10.1111/jch.14297. Epub 2021 Jun 11.
Results Reference
result
PubMed Identifier
36268410
Citation
Asghar AA, Hashmi MR, Ahmed R, Khabir Y. Kyzatrex - Oral testosterone replacement therapy. Ann Med Surg (Lond). 2022 Sep 11;82:104625. doi: 10.1016/j.amsu.2022.104625. eCollection 2022 Oct. No abstract available.
Results Reference
result

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An Open-Label Study of 50 mg Oral Testosterone Undecanoate (Kyztrex) in Menopausal Women With Low Testosterone and HSDD

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