Filgrastim for Premature Ovarian Insufficiency (FIL-POI)
Primary Purpose
Premature Ovarian Failure
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Filgrastim
Saline
Sponsored by
About this trial
This is an interventional treatment trial for Premature Ovarian Failure focused on measuring Premature, Ovarian, Failure, Filgrastim
Eligibility Criteria
Inclusion Criteria:
- Women with Premature Ovarian Insufficiency (POI): For the purpose of the research women is considered to have POI if she is aged less than 40 years and has amenorrhea of at least 4 month with FSH level above 25 IU/L (repeated twice >4 weeks apart).
Exclusion Criteria:
- Abnormal karyotype
- Previous pelvic or abdominal radiotherapy
- Previous surgical removal of the ovarian pathology
- Chronic disease: renal, liver, cardiac, malignancy
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Filgrastim arm
Placebo arm
Arm Description
Intervention: Filgrastim vial (30 million IU/ml) SC injection twice daily for five consecutive days
Intervention: Injection of saline SC injection twice daily for five consecutive days.
Outcomes
Primary Outcome Measures
Return of menses
Return of menses in patients with amenorrhea of at least 4 months
Secondary Outcome Measures
Pregnancy
Occurrence of pregnancy as diagnosed by positive serum B-hCG and/or ultrasound
serum Estradiol
Normalization of serum Estradiol as tested bi-weekly
serum Anti-mullarian Hormone (AMH)
Normalization of serum AMH in patients with AMH level less than 0.9 ng/mL
serum FSH
Normalization of serum FSH in patients with FSH level above 25 IU/L
Follicular growth
Growth of follicle to size at least 18 mm as monitored by transvaginal ultrasound
endometrial thickness
increase of endometrial thickness in women with thin endometrium (less then 8 mm)
Full Information
NCT ID
NCT02783937
First Posted
May 17, 2016
Last Updated
September 20, 2021
Sponsor
South Valley University
1. Study Identification
Unique Protocol Identification Number
NCT02783937
Brief Title
Filgrastim for Premature Ovarian Insufficiency
Acronym
FIL-POI
Official Title
Filgrastim for Treatment of Premature Ovarian Insufficiency: Randomized Clinical Trial
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
November 2016 (undefined)
Primary Completion Date
December 2020 (Actual)
Study Completion Date
June 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
South Valley University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Filgrastim is a Granulocyte-Colony Stimulating factor (G-CSF). It is an FDA approved drug. Very small embryonic-like stem cells (VSELs) are found in the ovary. Animal studies showed that these cells are able to regenerate the affected ovary. Studies on mice have shown that Filgrastim result in recovery of oogenesis after chemotherapy-induced gonadal failure (in 2013, 2014, and 2015).
Detailed Description
Premature ovarian insufficiency (POI) has no curative treatment until now. Filgrastim is an FDA approved Granulocyte-Colony Stimulating factor (G-CSF). Very small embryonic-like stem cells (VSELs) are found in the testis and ovary. VSELs are stem cells that have noticed to survive chemotherapy induced gonadal failure. Data from animal studies showed that stimulation of these stem cells result in generation of the affected gonads. Studies on mice have shown a promising stimulating effect of Filgrastim on recovery of spermatogenesis and oogenesis after chemotherapy-induced gonadal failure (in 2013, 2014, and 2015).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Premature Ovarian Failure
Keywords
Premature, Ovarian, Failure, Filgrastim
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Filgrastim arm
Arm Type
Active Comparator
Arm Description
Intervention: Filgrastim vial (30 million IU/ml) SC injection twice daily for five consecutive days
Arm Title
Placebo arm
Arm Type
Placebo Comparator
Arm Description
Intervention: Injection of saline SC injection twice daily for five consecutive days.
Intervention Type
Biological
Intervention Name(s)
Filgrastim
Other Intervention Name(s)
Granulocyte-Colony Stimulating Factor (G-CSF)
Intervention Description
Each case will have two intervention phases done blindly at random with a wash-out period of 6 months:
Phase A:
Filgrastim vial (30 million IU/ml) SC injection twice daily for five consecutive days.
Phase B:
Injection of saline SC injection twice daily for five consecutive days.
Intervention Type
Drug
Intervention Name(s)
Saline
Other Intervention Name(s)
placebo
Intervention Description
Injection of saline SC injection twice daily for five consecutive days
Primary Outcome Measure Information:
Title
Return of menses
Description
Return of menses in patients with amenorrhea of at least 4 months
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Pregnancy
Description
Occurrence of pregnancy as diagnosed by positive serum B-hCG and/or ultrasound
Time Frame
6 months
Title
serum Estradiol
Description
Normalization of serum Estradiol as tested bi-weekly
Time Frame
6 months
Title
serum Anti-mullarian Hormone (AMH)
Description
Normalization of serum AMH in patients with AMH level less than 0.9 ng/mL
Time Frame
6 months
Title
serum FSH
Description
Normalization of serum FSH in patients with FSH level above 25 IU/L
Time Frame
6 months
Title
Follicular growth
Description
Growth of follicle to size at least 18 mm as monitored by transvaginal ultrasound
Time Frame
6 months
Title
endometrial thickness
Description
increase of endometrial thickness in women with thin endometrium (less then 8 mm)
Time Frame
6 months
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Women with Premature Ovarian Insufficiency (POI): For the purpose of the research women is considered to have POI if she is aged less than 40 years and has amenorrhea of at least 4 month with FSH level above 25 IU/L (repeated twice >4 weeks apart).
Exclusion Criteria:
Abnormal karyotype
Previous pelvic or abdominal radiotherapy
Previous surgical removal of the ovarian pathology
Chronic disease: renal, liver, cardiac, malignancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohammad AM Ahmed, MD
Organizational Affiliation
Egypt, Qena, South Valley University, faculty of Medicine
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
23453120
Citation
Skaznik-Wikiel ME, McGuire MM, Sukhwani M, Donohue J, Chu T, Krivak TC, Rajkovic A, Orwig KE. Granulocyte colony-stimulating factor with or without stem cell factor extends time to premature ovarian insufficiency in female mice treated with alkylating chemotherapy. Fertil Steril. 2013 Jun;99(7):2045-54.e3. doi: 10.1016/j.fertnstert.2013.01.135. Epub 2013 Feb 26.
Results Reference
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PubMed Identifier
25142624
Citation
Akdemir A, Zeybek B, Akman L, Ergenoglu AM, Yeniel AO, Erbas O, Yavasoglu A, Terek MC, Taskiran D. Granulocyte-colony stimulating factor decreases the extent of ovarian damage caused by cisplatin in an experimental rat model. J Gynecol Oncol. 2014 Oct;25(4):328-33. doi: 10.3802/jgo.2014.25.4.328. Epub 2014 Jun 18.
Results Reference
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PubMed Identifier
25439845
Citation
Benavides-Garcia R, Joachim R, Pina NA, Mutoji KN, Reilly MA, Hermann BP. Granulocyte colony-stimulating factor prevents loss of spermatogenesis after sterilizing busulfan chemotherapy. Fertil Steril. 2015 Jan;103(1):270-80.e8. doi: 10.1016/j.fertnstert.2014.09.023. Epub 2014 Nov 5.
Results Reference
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PubMed Identifier
26576728
Citation
Bhartiya D, Anand S, Parte S. VSELs may obviate cryobanking of gonadal tissue in cancer patients for fertility preservation. J Ovarian Res. 2015 Nov 17;8:75. doi: 10.1186/s13048-015-0199-2.
Results Reference
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PubMed Identifier
24833728
Citation
Roness H, Kalich-Philosoph L, Meirow D. Prevention of chemotherapy-induced ovarian damage: possible roles for hormonal and non-hormonal attenuating agents. Hum Reprod Update. 2014 Sep-Oct;20(5):759-74. doi: 10.1093/humupd/dmu019. Epub 2014 May 15.
Results Reference
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Filgrastim for Premature Ovarian Insufficiency
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