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Subdermální implantát-bioabsorbovatelné pelety Gestrinone pro léčbu endometriózy pánevní bolesti (GLADE)

5. listopadu 2026 aktualizováno: Science Valley Research Institute

Randomizovaná, placebem kontrolovaná, dvojitě zaslepená, multicentrická studie fáze II k prozkoumání bezpečnosti a explorační účinnosti bioabsorbovatelné pelety Gestrinonu subdermálním implantátem na bolest pánve sekundární k léčbě endometriózy

Pelvic pain is considered a symptom of multifactorial origin among which Endometriosis is the main gynecological cause affecting 5-10% of worldwide women in their reproductive years, negatively impacting their quality of life and work efficiency. Treatment of endometriosis-associated pelvic pain is challenging and there are surgical and/or hormonal treatments available with variable endpoints. Gestrinone is a synthetic derivative of 19-nortestosterone with anti-estrogen, anti-progestin, androgenic, and weak estrogen-like action. Previous studies show that the oral treatment with Gestrinone induced an improvement in symptoms associated with endometriosis but with adverse events such as androgenization and uterine bleeding. Parenteral administration of Gestrinone could be effective to treat pain symptoms secondary to endometriosis and minimize these adverse events. This study evaluates the safety and tolerability of subdermal implant-bioabsorbable gestrinone pellet use in women with pelvic pain secondary to endometriosis after 6 months of Gestrinone pellet insertion versus placebo pellet. PK profile of the gestrinone pellet will be monitored.

Přehled studie

Postavení

Dokončeno

Podmínky

Intervence / Léčba

Detailní popis

This is a Phase 2, exploratory, multicenter, randomized, double-blind, placebo-controlled study followed by an optional open-label pharmacokinetic extension.

This study aimed to assess the safety and tolerability profile of a subdermal 85-mg gestrinone bioabsorbable implant compared with a matched placebo bioabsorbable implant, in women with endometriosis-associated pelvic pain. The pharmacokinetics of the gestrinone implant will be monitored. Exploratory efficacy analyses will be descriptively reported for participant satisfaction, change in pelvic pain intensity, use of rescue pain medication, and quality of life.

One hundred patients will be randomized in a 1: 1 ratio. Initially, all the patients will undergo insertion of an intrauterine system of levonorgestrel release (Kyleena) as a contraceptive method. On the same day, after randomization, the subdermal implantation of the gestrinone (85 mg) or placebo pellet will be performed. Visits will occur after 3 and 6 months of the pellet insertion. Primary endpoint is a combination of serious adverse events (SAEs) accumulated within 6 months of pellet insertion and collected through spontaneous reporting and/or clinical findings.

Typ studie

Intervenční

Zápis (Aktuální)

100

Fáze

  • Fáze 2

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • São Paulo
      • São Paulo, São Paulo, Brazílie
        • Science Valley Research Institute

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let až 50 let (Dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Ženský

Popis

Inclusion Criteria

  1. Willingness to provide informed consent
  2. Woman aged between 18 and 50 years
  3. Body weight between 50 ± 5 kg and 90 ± 5 kg
  4. Having pelvic pain secondary to endometriosis, independent of pain intensity
  5. Endometriosis documented by biopsies (histopathological examination)
  6. Last endometriosis surgery at least 3 months before randomization
  7. Not planning to become pregnant within 12 months after the screening visit or be surgically sterilized
  8. Absence of changes in the breast (BI-RADS1 and BIRADS-2 classification) documented by an imaging report (mammogram for women aged > 40 years or bilateral breast ultrasound for women aged < 40 years) performed less than 12 months before randomization
  9. Agreement not to use other hormones (estrogens, androgens and progestins) in any pharmaceutical form during the study

Exclusion Criteria

  1. Chronic severe disorders, including metastatic malignancies, end-stage renal disease with or without dialysis, clinically unstable heart disease, or any other disorder that, in the opinion of the investigator, excludes the participant from the study
  2. Suspected or confirmed diagnosis of immunodeficiency based on medical history and/or physical or laboratory examination
  3. Other medical or psychiatric conditions, including recent laboratory abnormalities (within the last 12 months) that may increase risks to the study participant or, at the discretion of the investigator, make the participant inappropriate for the study
  4. Personal history of thromboembolic events
  5. Use anticoagulant medication
  6. Contraindication to the use of hormonal contraceptives
  7. Suspected or confirmed pregnancy
  8. Breastfeeding
  9. Current or recurrent pelvic inflammatory disease or other conditions that increase the risk of pelvic infections
  10. Postpartum endometritis or septic miscarriage in the last 3 months
  11. Abnormal uterine bleeding of unknown etiology
  12. Congenital or acquired uterine anomalies, including fibroids (leiomyomas or fibromas) that cause distortion of the uterine cavity
  13. Uterine or cervical malignancy
  14. Suspected or confirmed diagnosis of estrogen-dependent neoplasm, including breast cancer
  15. Cervicitis or vaginitis, including bacterial vaginosis or another uncontrolled lower urinary tract infection
  16. Cervical dysplasia
  17. Active liver disease or dysfunction
  18. Benign or malignant liver tumors
  19. Allergy or intolerance to levonorgestrel, gestrinone or any other ingredient or component of the Kyleena® formulation or hormonal pellets
  20. Previously inserted intrauterine device or levonorgestrel-releasing intrauterine system that has not been removed
  21. History of recent trophoblastic disease and continued high HCG levels
  22. Bacterial endocarditis
  23. Hyperandrogenism at the time of randomization, defined by: hirsutism: Ferriman-Gallwey score ≥ 8; clitoromegaly: defined by the Clitoral index ≥ 35 mm2, acne: defined by the IGA scale (Investigator's global assessment) grade 5 - severe inflammatory acne dominates the area and there is a large number of comedones, pustules, papules and cystic acne; alopecia with sequelae of scalp thinning
  24. Diagnosis of polycystic ovary syndrome
  25. Participation in another pharmacotherapeutic or investigational medical device study within 30 days prior to the start of study treatment
  26. Tobacco Use
  27. Use of testosterone-derived hormones and analogues in the last month

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Čtyřnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Gestrinone

Subdermal implant-bioabsorbable gestrinone pellet (85 mg) All patients will undergo insertion of an intrauterine system of levonorgestrel release (Kyleena®) as a contraceptive method

The intradermal gestrinone/placebo pellet will be inserted on the same day as the levonorgestrel intrauterine hormonal device (Kyleena®)

Komparátor placeba: Placebo

Subdermal implant-bioabsorbable placebo pellet (cholesterol) All patients will undergo insertion of an intrauterine system of levonorgestrel release (Kyleena®) as a contraceptive method

Subdermal implant-bioabsorbable placebo pellet (cholesterol)

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Combination of serious adverse events (SAEs) accumulated within 6 months of gestrinone or placebo pellet insertion and collected through spontaneous reporting and/or clinical findings
Časové okno: From randomization to the end of study on 6 months after insertion of the gestrinone or placebo pellet

The primary safety outcome will be the proportion of patients who present serious adverse events (SAEs) over 6 months after randomization, defined as a combination of death, conditions that threat or present risk to life, conditions needing hospitalization or prolonging the pre-existing hospitalization, conditions causing disability or permanent damage, conditions leading to a congenital anomaly and any other significant medical occurrence that, based on appropriate medical judgment, may harm the participant and/or require medical or surgical intervention to prevent any of the other aforementioned occurrences.

In this study, the occurrence of thromboembolic events (such as, for example, acute myocardial infarction, pulmonary embolism, deep vein thrombosis, ischemic stroke, and transient ischemic attack) was predefined as a significant medical event.

From randomization to the end of study on 6 months after insertion of the gestrinone or placebo pellet

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Androgenization
Časové okno: pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet

Number of participants who experience androgenization defined by: Hirsutism (Ferriman-Gallwey Score ≥ 8), Clitoromegaly (Clitoridian index ≥ 35 mm2), Acne (IGA scale grade 5 - severe inflammatory acne dominates the area and there are large numbers of comedones, pustules, papules, and cystic acne), Alopecia, oiliness of the skin, and deepening of the voice

pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet
Plasma concentration of steroid hormones
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with clinically relevant laboratory values outside the reference range for plasma concentration of total testosterone, free testosterone, and SHBG

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet
Lipid profile
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with clinically relevant laboratory values outside the reference range for serum levels of total cholesterol, HDL-C, VLDL-C, and triglycerides

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet
Hematological disorders
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with decreased lymphocyte count < 500/mm3 (or < 0.5 × 109/l); decrease in neutrophil count < 500/mm3 (or < 0.5 × 109/l); decrease in platelet count < 30,000/mm3 (or < 30.0 × 109/l); and anemia with decreased Hb < 7.0 g/dl (or < 4.35 mmol/l)

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet
Hepatic adverse events
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with increased ALT or AST > 3 times ULN or baseline, alterations in ALT levels suspected hepatocellular or cholestatic hepatotoxicity

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet
Renal adverse events
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with increased serum creatinine ≥ 1.5 times ULN or baseline; clinically significant increase in serum urea

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Overall participant satisfaction
Časové okno: 3 months after pellet insertion of the gestrinone or placebo pellet

Median of the participant satisfaction scale (ranging from 1 to 5, from very satisfied to very dissatisfied)

3 months after pellet insertion of the gestrinone or placebo pellet
Pelvic pain intensity
Časové okno: pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet

Median of pelvic pain and dysmenorrhea intensity assessed by the NPRS scale, from 0 to 10 points where 10 points indicates worst pain

pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet
Use of pain relief medication
Časové okno: pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet

Number of participants who used pain relief medication (analgesics and anti-inflammatories)

pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet
Patient-reported Quality of Life
Časové okno: pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet

Number of participants with changes in the 36-Item Short Form Health Survey (SF-36). SF-36 is a patient-reported outcome (PRO) measure evaluating a participant's health status. It comprises 36 items covering 8 domains: physical functioning, role physical, role emotional, bodily pain, vitality, social functioning, mental health, and general health. Items are answered on Likert scales of varying lengths. Items from 8 domains contribute to the PCS. The summary scores range from 0 to 100, with higher scores indicating better levels of function and/or better health

pre-insertion assessment of the pellet (baseline), 3 and 6 months after insertion of the gestrinone or placebo pellet
Endometriosis Health Profile
Časové okno: pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet

Number of participants with changes in the Endometriosis Health Profile Questionnaire (EHP-30). The Endometriosis Health Profile Questionnaire is a Health Related Quality of Life (HRQoL) patient self-report PRO, used to measure the wide range of effects that endometriosis can have on women's lives: pain, control and powerlessness, social support, emotional well-being, and self-image, range from 0-100, higher values indicate worse health status

pre-insertion of the pellet (baseline) and 3 months after pellet insertion of the gestrinone or placebo pellet
Uterine Bleeding Pattern
Časové okno: daily for 3 months after pellet insertion of the gestrinone or placebo pellet

Changes in uterine bleeding pattern (spotting/bleeding)

daily for 3 months after pellet insertion of the gestrinone or placebo pellet
Serum total gestrinone concentration
Časové okno: pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Multiple blood sample will be collected before pellet implantation and 24 hours; 7 days, 14 days , 21 days, 28 days, 56 days, 84 days, 112 days, 140 days and 168 days and will be determined by liquid chromatography (LC-MS/MS)

pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion
Area under the curve (AUC(0 ∞))
Časové okno: pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Multiple blood sample will be collected before pellet implantation and 24 hours; 7 days, 14 days , 21 days, 28 days, 56 days, 84 days, 112 days, 140 days and 168 days and will be determined by liquid chromatography (LC-MS/MS)

pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion
Maximum concentration (Cmax)
Časové okno: pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Multiple blood sample will be collected before pellet implantation and 24 hours; 7 days, 14 days , 21 days, 28 days, 56 days, 84 days, 112 days, 140 days and 168 days and will be determined by liquid chromatography (LC-MS/MS)

pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion
Time to reach maximum concentration (tmax)
Časové okno: pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Multiple blood sample will be collected before pellet implantation and 24 hours; 7 days, 14 days , 21 days, 28 days, 56 days, 84 days, 112 days, 140 days and 168 days and will be determined by liquid chromatography (LC-MS/MS)

pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion
Half Life (t1/2)
Časové okno: pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Multiple blood sample will be collected before pellet implantation and 24 hours; 7 days, 14 days , 21 days, 28 days, 56 days, 84 days, 112 days, 140 days and 168 days and will be determined by liquid chromatography (LC-MS/MS)

pre-insertion of the pellet (baseline) and 24 hours; 7 days, 14 days , 21 days , 28 days , 56 days, 84 days, 112 days, 140 days and 168 days post-insertion

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Spolupracovníci

Vyšetřovatelé

  • Studijní židle: Eduardo Ramacciotti, MD, PhD, Science Valley Research Institute
  • Vrchní vyšetřovatel: André Luiz M Oliveira, MD, MHS, Science Valley Research Institute

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Obecné publikace

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

13. února 2023

Primární dokončení (Aktuální)

21. května 2025

Dokončení studie (Aktuální)

31. října 2025

Termíny zápisu do studia

První předloženo

3. října 2022

První předloženo, které splnilo kritéria kontroly kvality

3. října 2022

První zveřejněno (Aktuální)

7. října 2022

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

10. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

5. listopadu 2026

Naposledy ověřeno

1. listopadu 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • GLADE

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Studuje produkt zařízení regulovaný americkým úřadem FDA

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