Relugolix, a novel oral gonadotropin-releasing hormone antagonist, in the treatment of pain symptoms associated with uterine fibroids: a randomized, placebo-controlled, phase 3 study in Japanese women

Abstract

Objective: To investigate the efficacy and safety of the oral gonadotropin-releasing hormone receptor antagonist, relugolix, in patients experiencing uterine fibroid-associated pain.

Design: Phase 3, multicenter, randomized, double-blind, placebo-controlled study.

Setting: Medical centers.

Patient(s): Premenopausal Japanese women (N = 65) experiencing moderate-to-severe uterine fibroid-associated pain with a maximum Numerical Rating Scale (NRS) score of ≥4 were randomized and completed the study.

Intervention(s): Once-daily 40 mg relugolix (n = 33) or placebo (n = 32) for 12 weeks.

Main outcome measure(s): Primary end point: proportion of patients with a maximum NRS score of ≤1 during the 28-day period before the final dose of study drug. Secondary end points: proportion of patients with no pain (NRS = 0) and percentage of days without pain during the 28-day period before the final dose of study drug; adverse events.

Result(s): More patients receiving relugolix versus placebo achieved a maximum NRS score of ≤1 during the 28-day period before the final dose of study drug (57.6% vs. 3.1%). Similarly, more patients receiving relugolix versus placebo achieved a maximum NRS score of 0 (48.5% vs. 3.1%) and experienced more days without pain (96.4% vs. 71.4%). More patients receiving relugolix versus placebo experienced treatment-emergent adverse events (TEAEs; 87.9% vs. 56.3%); however, the rate of treatment discontinuation was low and not different between groups. Most TEAEs were mild to moderate in intensity. TEAEs (≥10%) included hot flush, metrorrhagia, hyperhidrosis, and menorrhagia, consistent with relugolix's mechanism of action, and viral upper respiratory tract infection.

Conclusion(s): Relugolix improved uterine fibroid-associated pain and was well tolerated.

Clinical trial registration numbers: NCT02655224.

Japic clinical trial information: JapicCTI-163127.

Keywords: Gonadotropin-releasing hormone receptor antagonist; pain; randomized controlled trial; relugolix; uterine fibroids.

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.