Study of DARE-HRT1 Over 12 Weeks in Healthy PostMenopausal Women (DARE-HRT1)

A Phase 1/2,, Open-label, Parallel Group Study to Evaluate the Safety and Pharmacokinetics of DARE-HRT1 (80ug Estradiol/4 mg Progesterone and 160ug Estradiol/8 mg Progesterone Intravaginal Rings) Over 12 Weeks in Healthy Postmenopausal Women

Randomized, Open-label 2-arm, parallel group study in approximately 20 healthy postmenopausal women to assess the safety of DARE-HRT1 Intravaginal Rings in two different dose strengths and the PK of progesterone and estradiol from the Intravaginal Rings.

Study Overview

• Status: Completed
• Conditions: Vasomotor Symptoms; Vulvovaginal Atrophy
• Intervention / Treatment: Device: IVR Dose 1; Device: IVR Dose 2

• Study Type: Interventional
• Enrollment (Actual): 21
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• Australia
  • Southern Australia
    • Adelaide, Southern Australia, Australia, 5000
      • PARC Clinical Research
  • Western Australia
    • Nedlands, Western Australia, Australia, 6009
      • Keogh Institute for Medical Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Postmenopausal women with a body mass index (BMI) ≥ 18 and ≤ 38 kg/m2. BMI = weight (kg)/(height [m])2

   Postmenopausal is defined as 12-months of spontaneous amenorrhea or 6 months of spontaneous amenorrhea with serum follicle-stimulating hormone (FSH) levels > 40 mIU/mL or 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy (although participants who have had a hysterectomy are not eligible for this study).

   The investigator will need to determine if a participant's BMI falling within the obese-severely obese range could potentially interfere with the protocol-required procedures, specifically the pelvic examinations described in Inclusion Criterion #2. Any participant whose BMI is determined to fall into this category should be excluded from trial participation.

2. Normal cervix, vagina, uterus, and adnexa based on speculum examination and bimanual examination.

3. Normal transvaginal ultrasound, and endometrial biopsy results as follows:

   • If endometrial thickness is ≤ 4.0 mm in a participant without postmenopausal vaginal bleeding, an endometrial biopsy is not indicated for the purposes of screening,
   • If endometrial thickness is > 4.0 mm ≤ 6.0 mm in a participant without postmenopausal vaginal bleeding, an acceptable result from an evaluable screening endometrial biopsy, evaluated by a pathologist, is required for inclusion into the study. Tissue must be read as benign, inactive, or atrophic endometrium by at least 1 pathologist,
4. Current on all Australian screening requirements for cervical cancer.
5. Able and willing to correctly and independently complete all study procedures.
6. Able and willing to stop any ongoing HRT in accordance with the appropriate washout periods (see Section 4.1 for washout requirements). Participants who are using HRT that requires more than 8 weeks to wash out (e.g., progestogen implants or progestogen injectable drug therapy, estrogen alone injectable drug therapy or estrogen pellet therapy) will not be eligible.
7. Able to read, understand, and provide written informed consent after the nature of the study has been fully explained and must be willing to comply with all study requirements and procedures.
8. Normal mammogram report within 24 months of screening.

Exclusion Criteria:

1. Prior abnormal cervical screening test or Papanicolaou result within 2 years of screening. Participant can have atypical squamous cells of undetermined significance, if human papillomavirus negative.
2. Participants with any self-reported active sexually transmitted disease and/or evidence of infection based on vaginal visual examination by the investigator.
3. Participants with a urinary tract infection during screening as assessed by urine dipstick test with abnormal test findings (any positive result for leukocytes AND any positive result for nitrites).
4. Have a history of endometrial hyperplasia or cervical or uterine carcinoma.
5. Participants with indwelling catheters or requiring intermittent catheterization.
6. Participants with multiple or unsuccessful (e.g., still having symptoms) pelvic reconstructive surgery, or who suffer from pelvic relaxation.
7. Participants who have had a hysterectomy.
8. Participants taking any estrogen and/or progesterone products who are not willing to stop this treatment during their participation in this trial (see Section 4.1 for washout requirements). Participants who are using HRT that requires more than 8 weeks to wash out (e.g., progestogen implants or progestogen injectable drug therapy, estrogen alone injectable drug therapy or estrogen pellet therapy) will not be eligible.
9. Participants with concomitant use of personal lubricants (water-based lubricants are allowed) or any intravaginal product or medication, either by prescription or over-the-counter (OTC) (e.g., Femring [estradiol acetate vaginal ring], ESTRING® [estradiol vaginal ring]) with the exception of those who agree not to use these products during the IVR use period.
10. Self-reported or observed vaginal irritation unrelated to VVA; vaginal, vulvar, or cervical lesions, undiagnosed vaginal bleeding; or tenderness.
11. Participants with a finding of clinically significant uterine fibroids at screening.
12. Participants with a known hypersensitivity to progesterone, estradiol, Femring, or the components of the IVR (e.g., ethylene vinyl acetate).
13. Participants with prior pelvic malignancies.

14. Participants with a history of any severe acute or chronic medical or psychiatric condition or laboratory abnormality that could increase the risk associated with trial participation or study treatment administration or could interfere with the interpretation of trial results and, in the judgment of the investigator, would make the participant inappropriate for entry into the trial. This includes but is not limited to the following:

    1. Human immunodeficiency virus (HIV) infection (confirmed by medical history/ serology testing),
    2. Active chronic hepatitis B or hepatitis C infection including hepatitis B surface antigen and hepatitis C antibody positive participants with or without abnormal liver enzymes (confirmed by medical history/serology testing),
    3. Concurrent neurodegenerative disease,
    4. Cardiovascular: uncontrolled hypertension, unstable angina, myocardial infarction or symptomatic congestive heart failure within the past 6 months, serious uncontrolled cardiac arrhythmia, use of Class 1 antiarrhythmic medications, or history of venous thromboembolism or stroke,
    5. Dementia or significantly altered mental status that would prohibit the understanding or rendering of informed consent and compliance with the requirements of the protocol,
    6. Participants with known thrombophilias may not participate in this study because estrogen-based products are contraindicated for them,
    7. Symptomatic bacterial vaginosis.
15. Fasting triglyceride of > 3.39 mmol/L and/or total cholesterol of > 7.77 mmol/L.
16. Aspartate aminotransferase or alanine aminotransferase > 1.5 times the upper limit of normal.
17. Fasting glucose > 6.94 mmol/L.
18. Evidence of current alcohol or drug abuse in the past 60 days including a positive result from the urine drugs of abuse or alcohol screen, or history of drug or alcohol dependence in the last 2 years, as assessed by principal investigator. Alcohol abuse is defined as greater than 14 standard units/week for females and drug abuse is defined as known psychiatric or substance abuse disorder that would interfere with participation with the requirements of this study, including current use of any illicit drugs. Use of medical cannabis is not exclusionary.
19. Participation in any other investigational drug or device trial in which administration of an investigational study drug/device occurred within 30 days or placement of a non-drug eluting medical device within 15 days prior to screening.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: IVR: Estradiol 80 ug/day + progesterone 4mg/day; 12-week IVR 80/4	Device: IVR Dose 1; Estradiol 80 ug/day + progesterone 4 mg/day
Experimental: IVR Estradiol 160 ug/day + progesterone 8 mg/day; 12-week IVR 160/8	Device: IVR Dose 2; Estradiol 160 ug/day + progesterone 8 mg/day

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With Treatment Emergent Adverse Events	To assess the safety and tolerability of DARE-HRT1 Intravaginal rings	12 weeks
Determination of Maximum Plasma Concentration of Progesterone (Cmax) Per Cycle	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28 day cycles)
Determination of Time That Maximum Progesterone Plasma Concentration Was Observed (Tmax)	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28 day cycles)
Determination of Progesterone Steady-state Concentration (Css) Per Cycle	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28day cycles)
Determination of Time That Maximum Estradiol Plasma Concentration Was Observed (Tmax)	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28 day cycles)
Determination of Maximum Plasma Concentration of Estradiol (Cmax) Per Cycle	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28 day cycles)
Determination of Estradiol Steady-state Concentration (Css) Per Cycle	To describe the Pharmacokinetic parameters of dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)	12 weeks (3- 28day cycles)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Vaginal Cytology	To conduct a preliminary evaluation of the effect of the DARE-HRT1 intravaginal ring on Vulvarvaginal atrophy	12 weeks
Evaluation of Vaginal pH	To conduct a preliminary evaluation of the effect of the DARE-HRT1 intravaginal ring on Vulvarvaginal atrophy	12 weeks
Evaluation of Responses to The Menopause-Specific Quality-of-Life Questionnaire (MENQOL)	To assess usability and participant tolerability of the DARE-HRT1 Intravaginal Ring comparing total questionnaire score from baseline to end of study with a decrease in score showing improvement.	12 weeks
Evaluation of Most Bothersome Symptom Via Subject Self Report	To conduct a preliminary evaluation of the effect of the DARE-HRT1 intravaginal ring on Vasomotor Symptoms (VMS)	12 weeks

Collaborators and Investigators

• Sponsor: Daré Bioscience, Inc.

Study record dates

Study Major Dates

• Study Start (Actual): April 11, 2022
• Primary Completion (Actual): January 9, 2023
• Study Completion (Actual): March 23, 2023

Study Registration Dates

• First Submitted: May 2, 2022
• First Submitted That Met QC Criteria: May 5, 2022
• First Posted (Actual): May 10, 2022

Study Record Updates

• Last Update Posted (Actual): October 31, 2024
• Last Update Submitted That Met QC Criteria: October 29, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathological Conditions, Anatomical; Atrophy
• Other Study ID Numbers: DARE-HRT1-002

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No