A Study to Find Out if Fezolinetant Helps Reduce Moderate to Severe Hot Flashes in Women Going Through Menopause - 2 (Skylight 2)
Hot Flashes
About this trial
This is an interventional treatment trial for Hot Flashes focused on measuring ESN364, menopause, fezolinetant, vasomotor symptoms
Eligibility Criteria
Inclusion Criteria:
- Subject has a body mass index ≥ 18 kg/m^2 and ≤ 38 kg/m^2.
Subject must be seeking treatment or relief for vasomotor symptoms (VMS) associated with menopause and confirmed as menopausal per 1 of the following criteria at the screening visit:
- Spontaneous amenorrhea for ≥ 12 consecutive months
- Spontaneous amenorrhea for ≥ 6 months with biochemical criteria of menopause (follicle-stimulating hormone [FSH] > 40 IU/L); or
- Having had bilateral oophorectomy ≥ 6 weeks prior to the screening visit.
- Within the 10 days prior to randomization, subject must have a minimum average of 7 to 8 moderate to severe hot flashes (HFs) vasomotor symptoms (VMS) per day, or 50 to 60 per week.
- Subject is in good general health as determined on the basis of medical history and general physical examination, including a bimanual clinical pelvic examination and clinical breast examination devoid of relevant clinical findings, performed at the screening visit; hematology and biochemistry parameters, pulse rate and/or blood pressure and electrocardiogram (ECG) within the reference range for the population studied, or showing no clinically relevant deviations.
- Subject has documentation of a normal/negative or no clinically significant findings mammogram (obtained at screening or within the prior 12 months of study enrollment). Appropriate documentation includes a written report or an electronic report indicating normal/negative or no clinically significant mammographic findings.
- Subject is willing to undergo a transvaginal ultrasound (TVU) to evaluate the uterus and ovaries at screening and at week 52 end of treatment (EOT), and for subjects who are withdrawn from the study prior to completion, a TVU at the early discontinuation (ED) visit.
- Subject is willing to undergo an endometrial biopsy at screening and at week 52 (EOT), for subjects with uterine bleeding, and for subjects who are withdrawn from the study prior to completion. The endometrial biopsy obtained at screening must be considered evaluable.
- Subject has documentation of a normal or not clinically significant Papanicolaou (Pap) test (or equivalent cervical cytology) within the previous 12 months or at screening.
- Subject has a negative urine pregnancy test at screening.
- Subject has a negative serology panel (i.e. negative hepatitis B surface antigen, negative hepatitis C virus antibody and negative human immunodeficiency virus antibody screens) at screening.
- Subject agrees not to participate in another interventional study while participating in the present study.
Exclusion Criteria:
- Subject uses a prohibited therapy (strong or moderate cytochrome P450 1A2 [CYP1A2] inhibitors, hormone replacement therapy [HRT], hormonal contraceptive or any treatment for VMS [prescription, over the counter or herbal]) or is not willing to wash out and discontinue use of such drugs for the full duration of study conduct.
- Subject has known substance abuse or alcohol addiction within 6 months of screening.
- Subject has previous or current history of a malignant tumor, except for basal cell carcinoma.
Subject's systolic blood pressure is ≥ 130 mmHg or diastolic blood pressure is ≥ 80 mmHg based on the average of 2 to 3 readings, on at least 2 different occasions within the screening period.
- Subjects who do not meet these criteria may be re-assessed after initiation or review of antihypertensive measures.
- Subjects with a medical history of hypertension can be enrolled once they are medically clear (stable and compliant).
- Subject has history of severe allergy, hypersensitivity or intolerance to drugs in general, including the study drug and any of its excipients.
- Subject has an unacceptable result from the TVU assessment at screening (i.e., full length of endometrial cavity cannot be visualized or presence of a clinically significant finding).
- Subject has an endometrial biopsy confirming presence of disordered proliferative endometrium, endometrial hyperplasia, endometrial cancer or other clinically significant findings at screening.
- Subject has a history within the last 6 months of undiagnosed uterine bleeding.
- Subject has a history of seizures or other convulsive disorders.
- Subject has a medical condition or chronic disease (including history of neurological [including cognitive], hepatic, renal, cardiovascular, gastrointestinal, pulmonary [e.g., moderate asthma], endocrine or gynecological disease) or malignancy that could confound interpretation of the study outcome.
- Subject has active liver disease, jaundice or elevated liver aminotransferases (alanine aminotransferase [ALT] or aspartate aminotransferase [AST]), elevated total or direct bilirubin, elevated international normalized ratio (INR), or elevated alkaline phosphatase (ALP). Patients with mildly elevated ALT or AST up to 1.5 times the upper limit of normal (ULN) can be enrolled if total and direct bilirubin are normal. Patients with mildly elevated ALP (up to 1.5 x ULN) can be enrolled if cholestatic liver disease is excluded and no cause other than fatty liver is diagnosed. Patients with Gilbert's syndrome with elevated total bilirubin may be enrolled as long as direct bilirubin, hemoglobin and reticulocytes are normal.
- Subject has creatinine > 1.5 × ULN; or estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula ≤ 59 mL/min per 1.73 m^2 at screening.
- Subject has a history of suicide attempt or suicidal behavior within the last 12 months or has suicidal ideation within the last 12 months (a response of "yes" to question 4 or 5 on the suicidal ideation portion of the Columbia Suicide Severity Rating Scale [C-SSRS]), or who is at significant risk to commit suicide at screening and at randomization.
- Subject has previously been enrolled in a clinical trial with fezolinetant.
- Subject is participating concurrently in another interventional study or participated in an interventional study within 28 days prior to screening, or received any investigational drug within 28 days or within 5 half-lives prior to screening, whichever is longer.
- Subject is unable or unwilling to complete the study procedures.
- Subject has any condition which makes the subject unsuitable for study participation.
- Subject has had partial or full hysterectomy.
Sites / Locations
- Mesa Obstetricians and Gynecologists
- Precision Trials
- Visions Clinical Research - Tuscon
- Excell Research
- Dream Team Clinical Research, LLC
- Clinical Trials Research
- Wake Research Associates, LLC
- Women's Healthcare Affiliates
- Bayview Research Group
- Downtown Women's Health Care
- Horizons Clincial Research Center LLC
- Physicians' Research Options/Red Rocks OB/GYN
- Helix Biomedics
- Renaissance Research and Medical Group, Inc.
- Nature Coast Clinical Research
- Bioclinica Research, Melbourne
- LCC Medical Research Institute, LLC
- Suncoast Clinical Research, Inc.
- Suncoast Research
- Medical Health Center & Research
- Healthcare Clinical Data Inc
- Sensible Healthcare LLC
- Bioclinica Research
- Ormond Medical Arts Pharmaceutical Research Center
- Progressive Medical Research
- Meridien Research
- Physician Care Clinical Research, LLC
- GCP Clinical Research, LLC
- Comprehensive Clinical Development
- Clinical Research of Central Florida
- Georgia Research for Women
- Agile Clinical Research Trials, LLC
- iResearch Atlanta LLC
- WR-Mount Vernon Clinical Research
- Georgia Clinical Research
- Elite Clinical Trials
- ASR, LLC-Advanced Specialty Research
- Affinity Clinical Research Institute
- Cypress Medical Research Center
- Praetorian Pharmaceutical Research
- Southern Clinical Research Associates
- Women Under Study, LLC
- Pharmasite Research Inc
- Clinical Research Center of Nevada (CRCN)
- Dr.R. Garn Mabey, MD,Office Of
- Hassman Research Institute, LLC
- Albuquerque Clinical Trials, Inc.
- Bosque Women's Care
- Circuit Clinical
- Premier Gynecology & Wellness
- Medication Management, LLC
- Hwc Women's Research Center
- OB/GYN Associates of Erie
- Dr. Marvin Kalafer MD, Office Of
- Research Protocol Management Specialists
- Clinical Neuroscience Solutions, Inc
- The Clinical Research Center, LLC
- Advances in Health
- Centex Studies, Inc.
- FMC Science
- ClinRx Research
- Granger Medical Clinic
- Wasatch Clinical Research, LLC
- Seattle Women's: Health, Research, Gynecology
- North Spokane Women's Health
- Site CA15006
- Site CA15009
- Site CA15007
- Site CA15002
- Site CA15001
- Site CA15008
- Site CZ42007
- Site CZ42006
- Site CZ42004
- Site CZ42005
- Site CZ42003
- Site LV37101
- Site LV37103
- Site PL48001
- Site PL48013
- Site PL48009
- Site PL48011
- Site PL48002
- Site PL48012
- Site PL48004
- Site PL48006
- Site PL48005
- Site PL48010
- Site PL48003
- Site ES34003
- Site ES34002
- Site ES34001
- Site GB44001
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Placebo Comparator
Experimental
Experimental
Double-blind Period: Fezolinetant 30 mg/Extension Period: Fezolinetant 30 mg
Double-blind Period: Fezolinetant 45 mg/Extension Period: Fezolinetant 45 mg
Double-blind Period: Placebo
Double-blind Period: Placebo/Extension Period: Fezolinetant 30 mg
Double-blind Period: Placebo/Extension Period: Fezolinetant 45 mg
Participants received fezolinetant 30 mg (one 30 mg fezolinetant tablet and one placebo tablet) orally, QD up to week 12 during double-blind treatment period followed by fezolinetant 30 mg orally, QD from week 13 up to Week 52 during extension treatment period.
Participants received fezolinetant 45 mg (one 30 mg tablet and one 15 mg tablet) orally, QD up to week 12 during double-blind treatment period followed by fezolinetant 45 mg orally, QD from week 13 up to Week 52 during extension treatment period.
Participants received fezolinetant matching placebo (two fezolinetant matching placebo tablets) orally, once daily (QD) up to week 12 during double-blind treatment period.
Participants who received placebo during double-blind treatment period were re-randomized to receive fezolinetant 30 mg orally, QD from week 13 up to week 52 during extension treatment period.
Participants who received placebo during double-blind treatment period were re-randomized to receive fezolinetant 45 mg orally, QD from week 13 up to week 52 during extension treatment period.