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An Efficacy Study of Vagitocin in Postmenopausal Women With Symptoms of Vaginal Atrophy

Primary Purpose

Atrophy

Status
Completed
Phase
Phase 2
Locations
Sweden
Study Type
Interventional
Intervention
Oxytocin
Placebo
Sponsored by
PepTonic Medical AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atrophy focused on measuring Atrophy, Pathological Conditions, Anatomical, Oxytocin, Oxytocics

Eligibility Criteria

40 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

To participate in the study, a subject must:

  1. Be a female subject between the ages of 40 and 65 years at the time of randomization, who is willing to participate in the study as indicated by signing the informed consent
  2. Be a postmenopausal woman with at least 24 months of spontaneous amenorrhea or a woman, who has had surgical bilateral oophorectomy with or without hysterectomy at least 6 weeks ago
  3. Have ≤ 5% superficial cells in vaginal smear cytology at screening
  4. Have a vaginal pH > 5.0 at screening
  5. Have a level of estradiol ≤ 30 pg/mL and a level of Follicle Stimulating Hormone (FSH) > 40 milli International Units (mIU)/ml at screening
  6. Have one moderate to severe vaginal atrophy symptom (vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria or presence of vaginal bleeding associated with sexual activity) that has been identified by the subject as being the most bothersome to her
  7. Have a Body Mass Index (BMI) ≤32 kg/m2
  8. Be judged by the Principal Investigator or Sub-investigator as being in otherwise good health based on a pre-study medical evaluation performed within 35 days prior to the initial dose of study medication
  9. Have endometrial thickness of < 4 mm as determined by vaginal ultrasonography, in women with an intact uterus
  10. Be willing to abstain from sexual activity and the use of vaginal douching within 24 hours prior to vaginal pH measurements at screening and at Visits 2 and 3

Exclusion Criteria:

To participate in the study, a subject must not:

  1. Be currently hospitalized
  2. Have a history of ongoing cardiovascular, hepatic, renal, pulmonary, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, psychological, or musculoskeletal disease or disorder that is clinically significant in the opinion of the Principal Investigator or Sub-Investigator
  3. Have had or have any known or suspected tumor disease that is clinically significant in the opinion of the Principal Investigator or Sub-Investigator
  4. Have a history of endometrial hyperplasia or uterine/endometrial, breast or ovarian cancer
  5. Have a history of undiagnosed vaginal bleeding
  6. Have an ongoing urogenital infection at randomization visit
  7. Any contraindication to oxytocin therapy and allergy to the use of oxytocin and any components of the investigational drugs
  8. Have a history of drug and/or alcohol abuse within one year of start of study
  9. Have used any prescription or Over The Counter (OTC) medications including phytoestrogens, herbal medicinal products or hormonal intra-uterine device with known estrogenic effects within 12 weeks prior to screening procedures
  10. Have used any type of vaginal lubricants and moisturizers within 24 hours prior to screening procedures
  11. Have used estrogen alone or estrogen/progestin for any of the time periods specified in the protocol
  12. Have any reason, which in the opinion of the Principal Investigator or Sub-Investigator would prevent the subject from safely participating in the study or complying with protocol requirements
  13. Have participated in another clinical trial within 90 days prior to screening, have received an investigational drug within the three months prior to the initial dose of study medication, or be likely to participate in a clinical trial or receive another investigational medication during the study
  14. Have contraindication to any planned study procedure

Sites / Locations

  • Hoftekliniken
  • Qvinnolivet Specialistläkarna Kungsbacka
  • Kvinnoforskningsenheten, Karolinska Universitetssjukhuset, Huddinge
  • Kvinnokliniken, Norrlands Universitetssjukhus
  • Kvinnokliniken, Akademiska sjukhuset

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Oxytocin 400 IU

Oxytocin 200 IU

Placebo

Arm Description

Oxytocin 400 IU vaginal gel (1 x 1mL/400 IU oxytocin daily for 12 weeks)

Oxytocin 200 IU vaginal gel (1 x 1mL/200 IU oxytocin daily for 12 weeks)

Placebo vaginal gel (1 x 1mL daily for 12 weeks)

Outcomes

Primary Outcome Measures

Change from baseline to Week 12 in severity of vaginal atrophy symptom that has been self-identified by the subject as being the most bothersome to her in the vaginal atrophy questionnaire
Vaginal atrophy symptoms: vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria or presence of vaginal bleeding associated with sexual activity
Change from baseline to Week 12 in % superficial cells (increase is positive)
Change from baseline to Week 12 in Vaginal pH (decrease is positive)

Secondary Outcome Measures

Change from baseline to Week 4 in severity of the vaginal atrophy symptoms that has been self-identified by the subject as being the most bothersome to her in the vaginal atrophy questionnaire
Vaginal atrophy symptoms: vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria and the absence or presence of vaginal bleeding associated with sexual activity
Change from baseline to Week 4 in % superficial cells (increase is positive)
Change from baseline to Week 4 in vaginal pH (decrease is positive)
Change from baseline to week 4 and 12 of % parabasal cells (decrease is positive)
Change from baseline to week 4 and 12 of maturation value (increase is positive)
Change from baseline to Weeks 4 and 12 in severity of vaginal atrophy symptoms self-assessed by the subject in the vaginal atrophy questionnaire
Vaginal atrophy symtoms: vulvar and vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria and the absence or presence of vaginal bleeding associated with sexual activity
Change from baseline to Week 12 in Quality of Life evaluation parameters

Full Information

First Posted
July 6, 2015
Last Updated
October 20, 2015
Sponsor
PepTonic Medical AB
Collaborators
A+ Science AB
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1. Study Identification

Unique Protocol Identification Number
NCT02497547
Brief Title
An Efficacy Study of Vagitocin in Postmenopausal Women With Symptoms of Vaginal Atrophy
Official Title
A Phase 2b, Double-blind, Randomized, Parallel, Placebo-Controlled, Multiple-Dose Study to Evaluate the 12-week Efficacy of Vagitocin in Postmenopausal Women With Symptoms of Vaginal Atrophy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PepTonic Medical AB
Collaborators
A+ Science AB

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Up to 50% of postmenopausal women frequently suffer from atrophic vaginitis or vaginal atrophy with symptoms including vaginal dryness, irritation, burning, itching or discomfort. Vaginal atrophy is a consequence of the lining tissue of the vagina becoming thinner, drier, and less elastic due to lack of estrogen. In addition, vaginal atrophy is associated with an increased pH, which creates an environment more susceptible to infections. Menopausal hormone therapy is a common treatment for vaginal atrophy. However, menopausal hormone therapy has been shown to coincide with an increased incidence of breast cancer, heart attack and stroke. Some women experience adverse reactions such as uterine bleeding, perineal pain, and breast pain with menopausal hormone therapy. Many women are also reluctant to initiate estrogen treatment, due to a general negative view of menopausal hormone therapy in the society. There are also many contraindicated conditions like undiagnosed vaginal bleeding, thromboembolic disease, breast cancer, other estrogen-sensitive cancers, or liver disease. Women suffering from vaginal atrophy and presenting with these conditions have extremely limited options for effective therapy. Oxytocin is a peptide hormone, normally released into the circulation via the pituitary. Oxytocin has been shown in vitro to exert positive effects on the proliferation of human vaginal mucosal cells from postmenopausal women. Local application of oxytocin, in the form of a vaginal gel, Vagitocin, has been investigated in previous studies on postmenopausal women, as a new effective and safe option for the treatment of vaginal atrophy. Vagitocin appeared to reverse the manifestation of vaginal atrophy by stimulating vaginal mucosal growth, reducing symptoms of vaginal atrophy and increasing the patients' wellbeing and quality of life. Overall, treatment with Vagitocin was safe and well tolerated by the subjects in the studies. In this study, the clinical efficacy of Vagitocin as a potential treatment for postmenopausal women suffering from moderate to severe symptoms of vaginal atrophy, vaginal irritation/itching and vaginal discomfort and/or pain associated with sexual activity will be explored. In addition, the dose relationship and lowest effective dose of Vagitocin will be investigated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrophy
Keywords
Atrophy, Pathological Conditions, Anatomical, Oxytocin, Oxytocics

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
227 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Oxytocin 400 IU
Arm Type
Experimental
Arm Description
Oxytocin 400 IU vaginal gel (1 x 1mL/400 IU oxytocin daily for 12 weeks)
Arm Title
Oxytocin 200 IU
Arm Type
Experimental
Arm Description
Oxytocin 200 IU vaginal gel (1 x 1mL/200 IU oxytocin daily for 12 weeks)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo vaginal gel (1 x 1mL daily for 12 weeks)
Intervention Type
Drug
Intervention Name(s)
Oxytocin
Other Intervention Name(s)
Vagitocin
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Change from baseline to Week 12 in severity of vaginal atrophy symptom that has been self-identified by the subject as being the most bothersome to her in the vaginal atrophy questionnaire
Description
Vaginal atrophy symptoms: vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria or presence of vaginal bleeding associated with sexual activity
Time Frame
After 12 weeks of treatment
Title
Change from baseline to Week 12 in % superficial cells (increase is positive)
Time Frame
After 12 weeks of treatment
Title
Change from baseline to Week 12 in Vaginal pH (decrease is positive)
Time Frame
After 12 weeks of treatment
Secondary Outcome Measure Information:
Title
Change from baseline to Week 4 in severity of the vaginal atrophy symptoms that has been self-identified by the subject as being the most bothersome to her in the vaginal atrophy questionnaire
Description
Vaginal atrophy symptoms: vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria and the absence or presence of vaginal bleeding associated with sexual activity
Time Frame
After 4 weeks of treatment
Title
Change from baseline to Week 4 in % superficial cells (increase is positive)
Time Frame
After 4 weeks of treatment
Title
Change from baseline to Week 4 in vaginal pH (decrease is positive)
Time Frame
After 4 weeks of treatment
Title
Change from baseline to week 4 and 12 of % parabasal cells (decrease is positive)
Time Frame
After 4 and 12 weeks of treatment
Title
Change from baseline to week 4 and 12 of maturation value (increase is positive)
Time Frame
After 4 and 12 weeks of treatment
Title
Change from baseline to Weeks 4 and 12 in severity of vaginal atrophy symptoms self-assessed by the subject in the vaginal atrophy questionnaire
Description
Vaginal atrophy symtoms: vulvar and vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria and the absence or presence of vaginal bleeding associated with sexual activity
Time Frame
After 4 and 12 weeks of treatment
Title
Change from baseline to Week 12 in Quality of Life evaluation parameters
Time Frame
After 12 weeks of treatment

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To participate in the study, a subject must: Be a female subject between the ages of 40 and 65 years at the time of randomization, who is willing to participate in the study as indicated by signing the informed consent Be a postmenopausal woman with at least 24 months of spontaneous amenorrhea or a woman, who has had surgical bilateral oophorectomy with or without hysterectomy at least 6 weeks ago Have ≤ 5% superficial cells in vaginal smear cytology at screening Have a vaginal pH > 5.0 at screening Have a level of estradiol ≤ 30 pg/mL and a level of Follicle Stimulating Hormone (FSH) > 40 milli International Units (mIU)/ml at screening Have one moderate to severe vaginal atrophy symptom (vaginal irritation and itching, dyspareunia, vaginal dryness, dysuria or presence of vaginal bleeding associated with sexual activity) that has been identified by the subject as being the most bothersome to her Have a Body Mass Index (BMI) ≤32 kg/m2 Be judged by the Principal Investigator or Sub-investigator as being in otherwise good health based on a pre-study medical evaluation performed within 35 days prior to the initial dose of study medication Have endometrial thickness of < 4 mm as determined by vaginal ultrasonography, in women with an intact uterus Be willing to abstain from sexual activity and the use of vaginal douching within 24 hours prior to vaginal pH measurements at screening and at Visits 2 and 3 Exclusion Criteria: To participate in the study, a subject must not: Be currently hospitalized Have a history of ongoing cardiovascular, hepatic, renal, pulmonary, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, psychological, or musculoskeletal disease or disorder that is clinically significant in the opinion of the Principal Investigator or Sub-Investigator Have had or have any known or suspected tumor disease that is clinically significant in the opinion of the Principal Investigator or Sub-Investigator Have a history of endometrial hyperplasia or uterine/endometrial, breast or ovarian cancer Have a history of undiagnosed vaginal bleeding Have an ongoing urogenital infection at randomization visit Any contraindication to oxytocin therapy and allergy to the use of oxytocin and any components of the investigational drugs Have a history of drug and/or alcohol abuse within one year of start of study Have used any prescription or Over The Counter (OTC) medications including phytoestrogens, herbal medicinal products or hormonal intra-uterine device with known estrogenic effects within 12 weeks prior to screening procedures Have used any type of vaginal lubricants and moisturizers within 24 hours prior to screening procedures Have used estrogen alone or estrogen/progestin for any of the time periods specified in the protocol Have any reason, which in the opinion of the Principal Investigator or Sub-Investigator would prevent the subject from safely participating in the study or complying with protocol requirements Have participated in another clinical trial within 90 days prior to screening, have received an investigational drug within the three months prior to the initial dose of study medication, or be likely to participate in a clinical trial or receive another investigational medication during the study Have contraindication to any planned study procedure
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aino F Jonasson, MD
Organizational Affiliation
Karolinska Universitetssjukhuset, Huddinge
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hoftekliniken
City
Helsingborg
ZIP/Postal Code
252 21
Country
Sweden
Facility Name
Qvinnolivet Specialistläkarna Kungsbacka
City
Kungsbacka
ZIP/Postal Code
434 30
Country
Sweden
Facility Name
Kvinnoforskningsenheten, Karolinska Universitetssjukhuset, Huddinge
City
Stockholm
ZIP/Postal Code
141 86
Country
Sweden
Facility Name
Kvinnokliniken, Norrlands Universitetssjukhus
City
Umeå
ZIP/Postal Code
901 85
Country
Sweden
Facility Name
Kvinnokliniken, Akademiska sjukhuset
City
Uppsala
ZIP/Postal Code
751 85
Country
Sweden

12. IPD Sharing Statement

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An Efficacy Study of Vagitocin in Postmenopausal Women With Symptoms of Vaginal Atrophy

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