Effects of Simvastatin on Uterine Leiomyoma Size
A Double-blinded, Phase II, Randomized Control Trial to Study the Effects of Simvastatin in Patients With Uterine Leiomyoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Mostafa Borahay, MD, PhD
- Phone Number: (410) 550-0337
- Email: mboraha1@jhmi.edu
Study Locations
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-
Maryland
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Baltimore, Maryland, United States, 21218
- Recruiting
- Johns Hopkins Hospital
-
Contact:
- Mostafa Borahay, MD, PhD
- Phone Number: 410-550-0337
- Email: mboraha1@jhmi.edu
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Sub-Investigator:
- James Segars, MD
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Sub-Investigator:
- Gayane Yenokyan, PhD
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Sub-Investigator:
- Paul Driggers, PhD
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Sub-Investigator:
- Bhuchitra Singh, MBBS,MPH,MS
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed informed written consent.
- Gender: female.
- Age: 18-55 years at time of signing consent.
- BMI of subjects: < 45 kg/m2.
- Uterine fibroids:
- Diagnosed by ultrasound (MRI will be used only if ultrasound is inconclusive).
- Number: any number of fibroids.
- Location: submucosal or intramural.
- At least one fibroid of diameter > 3cm.
- Symptoms: one or more of the following symptoms of heavy menstrual bleeding (HMB), defined as: Experienced cyclic (22 to 35 days) abnormal uterine bleeding (heavy or prolonged) in at least 3 of the last 6 menstrual periods, including menstrual bleeding lasting 5 or more days or heavy bleeding per participant recall. Examples of heavy bleeding may include, but are not limited to the following:
- Requires the use of double protection to manage menstrual bleeding.
- Menstrual bleeding accompanied by the sensation of "gushing" or "flooding".
- Saturates more than 1 tampon or sanitary pad per hour for 3 or more consecutive hours.
- Regularly needs to change the tampon or sanitary pad at night or regularly soils bedclothes.
- Heavy bleeding that affects work, school, or social activities.
- Pelvic pain/ pressure likely caused by fibroids.
- Plan for surgery (hysterectomy or myomectomy).
- Normal Pap smear within the last year.
- Use of contraception during study such as non-hormonal oral contraceptives, intrauterine devices (IUD)/ intrauterine systems (IUS), barrier contraceptives, abstinence or sterilization.
Exclusion Criteria:
- Pregnancy or lactation.
- Previous or current uterine, cervical or ovarian cancer.
- Current endometrial hyperplasia or history of atypical endometrial hyperplasia. Endometrial biopsy will be done during screening (if not done within last 12 months).
- Suspicion of leiomyosarcoma.
- Recent rapid growth of fibroids (i.e. doubling in size within 1-6 months period).
- Unevaluated gynecologic abnormalities (unexplained vaginal bleeding, cervical dysplasia, or abnormal adnexal/ovarian mass).
- Menopausal status.
- Surgery is urgently indicated (< 3 months) for medical or social reasons.
- Hemoglobin ≤ 6 g/dL.
- Currently enrolled in another investigational study.
- Mental condition or other barrier preventing informed written consent.
- Allergy or hypersensitivity to simvastatin.
- Current use of simvastatin or other drugs of the same class.
- Concomitant administration of strong CYP3A4 inhibitors including itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, boceprevir, telaprevir, nefazodone, and cobicistat-containing products.
- Concomitant administration of gemfibrozil, cyclosporine, or danazol, verapamil, diltiazem, amiodarone, diltiazem, dronedarone, amlodipine, ranolazine, lomitapide, and grapefruit juice.
- Active liver disease, which may include unexplained persistent elevations in hepatic transaminase levels.( elevation of aspartate transaminase and/or alanine transaminase > 2 s.d. above the normal range at screening visit)
- Known increased risk or diagnosis of a myopathy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Treatment Group
The 30 participants randomized in this group will intake Simvastatin 40mg / day of orally at the same time in the evening, every day for the study duration of 12 weeks prior to undergoing hysterectomy/ myomectomy.
The fibroid samples will be collected after the surgery to evaluate the effects of the study medication on the fibroid tissue.
|
The Treatment Group subjects will orally intake encapsulated Simvastatin 40 mg tablets daily for the 12 weeks duration with water in the evening.
Other Names:
|
|
Placebo Comparator: Placebo Group
The 30 participants randomized in this group will intake Placebo 40mg / day orally at the same time in the evening every day for the study duration of 12 weeks prior to undergoing hysterectomy/ myomectomy.
The fibroid samples will be collected after the surgery to evaluate the effects of the study medication on the fibroid tissue.
|
The Placebo group will orally intake encapsulated Starch 1500, 40 mg Placebo for 12 weeks duration with water in the evening.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Tumor size volume pre and post study intervention
Time Frame: Change from baseline to 12 weeks post intervention
|
Tumor size measured by ultrasound imaging comparing tumor volume using ultrasound imaging.
The volume will be reported in Centimeter cubes.
The largest radius of the tumor will be used to calculate the volume, this will be measured in centimeters.
|
Change from baseline to 12 weeks post intervention
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Clinical symptom improvement as determined by the Uterine Fibroid Symptom and Health Related Quality of Life Questionnaire.
Time Frame: At visit 1 (Screening), At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4( 12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy
|
The questionnaire used is the Uterine Fibroid Symptom and Health Related Quality of Life Questionnaire.
This questionnaire is an effective and validated tool for detecting differences in symptom severity and health-related quality of life among patients with uterine fibroids.
The scale for this questionnaire denotes symptom severity with lowest and highest possible scores of 8 and 40 respectively.
Higher scores indicate greater severity of symptoms.
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At visit 1 (Screening), At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4( 12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy
|
|
Adherence to the recommended treatment dosing
Time Frame: At Visit 3 (6 weeks after start of study drug), and Visit 4 (12 weeks after start of the study drug)
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Based on review of patient diaries and counting of left over medications bought back by the subject.
This will be reported as an overall percentage.
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At Visit 3 (6 weeks after start of study drug), and Visit 4 (12 weeks after start of the study drug)
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Subject retention
Time Frame: At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4 (12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy.
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Based on presence at follow up visits to the study site.
This will be determined as a simple percentage of subjects that stay in the study until the last visit.
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At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4 (12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy.
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adverse events reporting by organ systems
Time Frame: At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4 (12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy.
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Based on patient reporting and study team evaluation utilizing CTCAE v.4
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At visit 2 (start of the study drug intake), visit 3 (6 weeks after start of the study drug), visit 4 (12 weeks after start of the study drug), and follow up visit at 2 and 6 weeks post hysterectomy.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mostafa Borahay, MD, PhD, Johsn Hopkins School Of Medicine
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Connective Tissue Diseases
- Neoplasms by Histologic Type
- Neoplasms, Connective and Soft Tissue
- Neoplasms, Connective Tissue
- Neoplasms, Muscle Tissue
- Leiomyoma
- Myofibroma
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites
- Anticholesteremic Agents
- Hypolipidemic Agents
- Lipid Regulating Agents
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Simvastatin
Other Study ID Numbers
Other Study ID Numbers
- IRB00149869
- 1R01HD094380-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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