- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02528383
Trial of Vaginal Estrogen for Urogenital Symptom Relief in Women on Aromatase Inhibitors
Trial of Vaginal Estrogen for Urogenital Symptom Relief in Women on Aromatase Inhibitors: Systemic Impact Versus Local Objective Benefits and Quality of Life
Study Overview
Detailed Description
Breast cancers are made of different subtypes but by far the most common characteristic is their estrogen receptor positivity. Seventy percent of breast cancers are estrogen receptor positive and therefore responsive to the hormone estrogen, which acts as a stimulus for growth and survival of the cancer. Studies have repeatedly shown that estrogen deprivation results in prevention of breast cancer in high-risk women, and reduced recurrence of the cancer both locally and systemically as well as overall survival improvement in those women. The majority of women with estrogen sensitive breast cancer are placed on anti-estrogen therapy to prevent the cancer from returning. Even in menopause, women have estrogen produced in their bodies. Many parts of a woman's body require estrogen for normal functioning and reducing the amount of estrogen can affect women significantly in different ways. Some women have significant symptoms like vaginal dryness, which may result in painful sexual relations, discomfort, and frequent urinary tract (bladder) infections. Although the investigators goal is to reduce estrogen to prevent breast cancer from returning, quality of life (how women feel) matters during treatment which can last 5-10 years. A major question is: how medications such as Vagifem that are used to treat vaginal symptoms affect the rest of the body?
This question has not been fully answered and is the reason this study is being done. The safest topical estrogen, Vagifem, is a commercially available tablet which is placed in the vagina. Vagifem works well in many women and is considered to be safe. It is used by gynecologists and cancer doctors in this setting all the time. It is not a new product and has been on the market for many years. Its effects on other parts of the body have not been tested. The investigators are poised to help answer this question by hypothesizing the following:
- It is impossible to know what impact a given estrogen level has in distant sites, the investigators will however measure these to see if estrogen levels rise in the blood when women are treated with vaginal estrogen tablets that are commercially available. The investigators hypothesize that there will not be any elevation in measurable estrogen levels using very sensitive assays.
- The investigators also propose using a topical vaginal estrogen application (one that is commercially available) while carefully monitoring its' effects locally in the vagina and its possible impact on bone health. The investigators expect women to have improved vaginal exams as well as improvement in overall quality of life with this treatment. It is also expected that there will be no impact on bone turnover by this topical estrogen replacement.
Postmenopausal women on aromatase inhibitors interested in study participation will be asked to participate for a three month period.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Connecticut
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Farmington, Connecticut, United States, 06032
- UCONN Health
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Treatment of Urogenital symptoms with Vagifem, as deemed appropriate by the treating physician
- History of breast cancer stages 0-III
- Currently being treated with Aromatase Inhibitors (brand not restrictive) for 3 months or longer
- Postmenopausal women including those with medically induced menopause
- Urogenital symptoms consistent with vaginal atrophy.
- Age 18 years or greater
- Able to participate in informed consent process
- Able to read/speak English
- Able to take daily doses of Vitamin D and Calcium
Exclusion Criteria:
- Abnormal or unexplained uterine bleeding
- Unable to give informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Vagifem
Postmenopausal women diagnosed with breast cancer, are currently on an anti-estrogen called an aromatase inhibitor and you have agreed to undergo treatment with Vagifem based on your physician's recommendation.
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Women participating in the study will undergo clinical assessments, blood work and complete the quality of life questionnaire at baseline, 6 weeks and 12 weeks study time points. The following will be assessed:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in serum estrogen levels
Time Frame: 12 Weeks
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Changes in serum estrogen levels will be measured up to 12 weeks in post-menopausal women receiving adjuvant aromatase inhibitors during treatment with low dose vaginal estradiol 10 ug tablet, Vagifem.
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12 Weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of Life
Time Frame: 12 Weeks
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Measure changes in bone health biomarkers up to 12 weeks in post-menopausal women receiving adjuvant aromatase inhibitors during treatment with low dose vaginal estradiol 10 ug tablet, Vagifem to evaluate wellness of quality of life.
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12 Weeks
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Susan Tannenbaum, MD, UCONN Health
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 15-143-3
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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Clinical Trials on Vagifem
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Sun Pharmaceutical Industries LimitedTerminated
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Albert Einstein College of MedicineNovo Nordisk A/S; National Institute on Aging (NIA)CompletedHIV Infection | Menopause | Aging | Dysbiosis | Vaginitis | Atrophic Vaginitis | Vaginal Atrophy | Menopause Related Conditions | Premature AgingUnited States
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University of AarhusNot yet recruitingCervical Cancer
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University Hospitals Cleveland Medical CenterWithdrawnMenopause | Surgery | Pelvic Floor Disorders | EstrogenUnited States
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University of California, IrvineRecruitingRecurrent Urinary Tract Infection | HypoestrogenismUnited States
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Amneal Pharmaceuticals, LLCCompletedAtrophic Vaginitis Due to MenopauseUnited States
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Instituto PalaciosNovo Nordisk A/SCompleted
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Fred Hutchinson Cancer CenterMassachusetts General Hospital; University of California, San Diego; University... and other collaboratorsCompleted
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Glenmark Pharmaceuticals Ltd. IndiaCompletedVulvar and Vaginal AtrophyUnited States