Estetrol för behandling av kvinnlig sexuell upphetsningsstörning hos postmenopausala kvinnor
En fas 2, randomiserad, dubbelblind, placebokontrollerad Proof-of-Concept-studie för att utvärdera effektiviteten och säkerheten av Estetrol hos postmenopausala patienter med sexuell upphetsningsstörning hos kvinnor
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Female Sexual Arousal Disorder (FSAD), a subtype of female sexual dysfunction, is an inability to attain or to maintain an adequate lubrication-swelling response of sexual excitement. FSAD may manifest as a decrease in vaginal lubrication and a decrease in genital sensation related to blood flow and can cause marked distress and/or interpersonal difficulty (Diagnostic and Statistical Manual (DSM) of Mental Disorders, 4th edition [DSMIV]). Estrogen has a role in maintaining genital tissue structural integrity and pelvic nerve-stimulated genital blood flow.
This study was conducted with estetrol (E4), assessing the efficacy and safety of estetrol monohydrate 20 mg (E4 20 mg), equivalent to estetrol 18.9 mg, for the treatment of FSAD associated with menopause in hysterectomized postmenopausal women.
The design of this Phase 2, Proof of Concept (POC) study was: randomized, double-blind, placebo-controlled, two-arm parallel group. Eligible subjects were randomized in a 1:1 ratio and received either an oral tablet of E4 20 mg or placebo, once daily for 12 weeks. Placebo tablet looked identical to E4 but had no active ingredient. During the study, participants visited the clinic 7 times and completed a daily e-diary. The results were evaluated regarding the effect of E4 and placebo on the sexual arousal of the participants, using several validated questionnaires.
The primary efficacy endpoints were the change from Baseline to Week 12:
- in feeling concerned by difficulties with sexual arousal, assessed by Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) Item 14;
- in the Sexual Function Questionnaire (SFQ-28) Arousal-Sensation Domain (Questions 6 to 9).
Secondary efficacy endpoints were the change from Baseline to Week 12:
- in arousal and lubrication assessed by Patient-Reported Outcomes Measurement Information System-Sexual Function and Satisfaction (PROMIS-SexFS) Questionnaire;
- in sexual function assessed by FSDS-DAO - total score and by percentage of Satisfying Sexual Event (SSE) captured in e-diary;
- in sexual function assessed by SFQ-28 - total score;
- in sexual function assessed by PROMIS-SexFS;
- in severity of sexual arousal disorder as assessed by Patient Global Impression of Severity (PGIS).
The secondary efficacy endpoint Patient Global Impression of Change (PGIC) was assessed at Week 12.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
Kontakter och platser
Studieorter
-
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Arizona
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Mesa, Arizona, Förenta staterna, 85209
- Estetra Study Site
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Phoenix, Arizona, Förenta staterna, 85032
- Estetra Study Site
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Tucson, Arizona, Förenta staterna, 85715
- Estetra Study Site
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California
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Pomona, California, Förenta staterna, 91767
- Estetra Study Site
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San Diego, California, Förenta staterna, 92111
- Estetra Study Site
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Florida
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Jacksonville, Florida, Förenta staterna, 32256
- Estetra Study Site
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Miami, Florida, Förenta staterna, 33173
- Estetra Study Site
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New Port Richey, Florida, Förenta staterna, 34562
- Estetra Study Site
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Ocoee, Florida, Förenta staterna, 34761
- Estetra Study Site
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Orlando, Florida, Förenta staterna, 32801
- Estetra Study Site
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West Palm Beach, Florida, Förenta staterna, 33409
- Estetra Study Site
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Georgia
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Atlanta, Georgia, Förenta staterna, 30328
- Estetra Study Site
-
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Illinois
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Chicago, Illinois, Förenta staterna, 60643
- Estetra Study Site
-
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Nebraska
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Omaha, Nebraska, Förenta staterna, 68114
- Estetra Study Site
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Nevada
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Las Vegas, Nevada, Förenta staterna, 89109
- Estetra Study Site
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New Mexico
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Albuquerque, New Mexico, Förenta staterna, 87102
- Estetra Study Site
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Ohio
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Cleveland, Ohio, Förenta staterna, 44106
- Estetra Study Site
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Englewood, Ohio, Förenta staterna, 45322
- Estetra Study Site
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Tennessee
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Memphis, Tennessee, Förenta staterna, 38119
- Estetra Study Site
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Texas
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Houston, Texas, Förenta staterna, 77061
- Estetra Study Site
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Houston, Texas, Förenta staterna, 77074
- Estetra Study Site
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Utah
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Salt Lake City, Utah, Förenta staterna, 84107
- Estetra Study Site
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Virginia
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Virginia Beach, Virginia, Förenta staterna, 23456
- Estetra Study Site
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Washington
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Seattle, Washington, Förenta staterna, 98104
- Estetra Study Site
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
Huvudinkluderingskriterier:
- Hysterektomerade postmenopausala kvinnor, ≥40 upp till ≤65 år, diagnostiserade med kvinnlig sexuell upphetsningsstörning
Huvudsakliga uteslutningskriterier:
- Inte villig att stoppa några hormonella produkter under deras deltagande i studien
- Historik av olösta sexuella trauman eller övergrepp som bidrar till sexuella dysfunktionsproblem
- Har nyligen upplevt en stor livsstress eller oenighet i förhållandet som kan störa sexuell aktivitet
- Kliniskt signifikanta onormala gynekologiska fynd
- Historik av malignitet, med undantag för basalcellscancer eller skivepitelcancer i huden
- Systoliskt blodtryck högre än 140 mmHg, diastoliskt tryck högre än 90 mmHg
- Bedöms av utredaren som olämplig av någon anledning
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Estetrol
Estetrol monohydrate 20 mg, administered orally once daily for up to 12 weeks
|
Estetrol monohydrate 20 mg, equivalent to estetrol 18.9 mg
Andra namn:
|
|
Placebo-jämförare: Placebo
Matching Placebo, administered orally once daily for up to 12 weeks
|
Matcha placebo med E4
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Change From Baseline to Week 12 in Feeling Concerned by Difficulties With Sexual Arousal, Assessed by Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO), Item 14
Tidsram: Baseline, Week 12.
|
The Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) is a validated 15-item self-assessment where each item is scored from 0 (never) to 4 (always). Higher scores on this scale, which has a total range of 0-60, indicate greater distress. Item 14 assesses how often the subject has felt concerned by difficulties with sexual arousal during the past 30 days. |
Baseline, Week 12.
|
|
Change From Baseline to Week 12 in the Sexual Function Questionnaire 28 (SFQ-28) Arousal-Sensation Domain (Questions 6 to 9)
Tidsram: Baseline, Week 12.
|
The 28-item Sexual Function Questionnaire (SFQ-28) is a validated self-assessment tool to assess female sexual function. It has 8 domains, including domains for desire, arousal (sensation/lubrication/cognitive), orgasm, pain, enjoyment, and partner relationship. Questions are scored on a Likert scale (e.g., 0 to 5 or 1 to 5), where lower scores indicate higher levels of dysfunction. Questions 6, 7, 8, and 9 deal with the domain "Arousal-sensation". Score range for this domain is: 4-20 (=sum of Questions 6-9). Total score range is: 24-141 (=sum of all Questions 1-28). |
Baseline, Week 12.
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Change From Baseline to Week 12 in Arousal and Lubrication Assessed by Patient Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction (SexFS) Measures (PROMIS-SexFS Questionnaire)
Tidsram: Baseline, Week 12.
|
The PROMIS-SexFS is an instrument to measure self-reported sexual function and satisfaction. In total, 24 questions (out of 26) are rated on a 5-point scale each, so that for each question, the score range may be 1-5 or 0-5 (0=not applicable). Questions (Q) can be grouped by domains; their scores are summed to calculate the domain score. There are 11 domains in total. A higher score indicates a better outcome in the following domains: arousal and lubrication (3Q; 3-15), interest in sexual activity (2Q, score range: 2-10), orgasm-pleasure (2Q; 0-10), orgasm-ability (1Q; 0-5), and satisfaction with sex life (4Q; 3-20). A higher score indicates a worse outcome in the following domains: vaginal discomfort (2Q; 2-10), vulvar discomfort (2Q; 2-10), vulvar dysfunction (2Q; 2-10), oral discomfort (2Q; 2-10), oral dryness (2Q; 2-10), anal discomfort (2Q; 2-10). The 2 remaining questions of the questionnaire are for screening purposes. |
Baseline, Week 12.
|
|
Change From Baseline to Week 12 in Sexual Function Assessed by FSDS-DAO -- Total Score
Tidsram: Baseline, Week 12.
|
The Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) is a validated 15-item self-assessment where each item is scored from 0 (never) to 4 (always).
Higher scores on this scale, which has a total range of 0-60, indicate greater distress.
|
Baseline, Week 12.
|
|
Change From Baseline to Week 12 in Sexual Function Assessed by Percentage of Satisfying Sexual Events (SSE) -- Captured in Arousal Electronic Diary (Ediary)
Tidsram: Baseline, Week 12.
|
A higher number of Satisfying Sexual Events (SSE) indicates an improvement in sexual function. The arousal electronic diary contains a questionnaire to be completed by the subject within 24 hours of a sexual event. |
Baseline, Week 12.
|
|
Change From Baseline to Week 12 in Sexual Function Assessed by the Sexual Function Questionnaire 28 (SFQ-28) -- Total Score
Tidsram: Baseline, Week 12.
|
The 28-item Sexual Function Questionnaire (SFQ-28) is a validated self-assessment tool to assess female sexual function. It has 8 domains, including domains for desire, arousal (sensation/lubrication/cognitive), orgasm, pain, enjoyment, and partner relationship. Questions are scored on a Likert scale (e.g., 0 to 5 or 1 to 5), where lower scores indicate higher levels of dysfunction. Questions 6, 7, 8, and 9 deal with the domain "Arousal-sensation". Score range for this domain is: 4-20 (=sum of Questions 6-9). Total score range is: 24-141 (=sum of all Questions 1-28). |
Baseline, Week 12.
|
|
Change From Baseline to Week 12 in Sexual Function Assessed by PROMIS-SexFS
Tidsram: Baseline, Week 12.
|
Refer to Description of Outcome Measure #3.
|
Baseline, Week 12.
|
|
Patient Global Impression of Change (PGIC) at Week 12
Tidsram: Week 12.
|
Patient Global Impression of Change (PGIC) was used to measure changes in sexual arousal disorder. At Week 12, each enrolled subject was asked to rate their change in sexual arousal on 7-point Likert scale. The results are presented as the number of participants. The grading of responses were from 'No Change' to 'A Great Deal Better', as shown in the results table below. |
Week 12.
|
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Change From Baseline to Week 12 in Severity of Sexual Arousal Disorder as Assessed by Patient Global Impression of Severity (PGIS)
Tidsram: Baseline, Week 12.
|
Patient Global Impression of Severity (PGIS) was used to evaluate the severity of sexual arousal disorder at a given time.
The subject is asked to rate the severity of their sexual arousal dysfunction on 7-point Likert scale (1=not present, 2=very mild, 3=mild, 4=moderate, 5=moderately severe, 6=severe, and 7=extremely severe).
A lower score indicates an improvement.
|
Baseline, Week 12.
|
Andra resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Frekvens av behandlingsuppkomna biverkningar (TEAEs) (inklusive behandlingsuppkomna allvarliga biverkningar [TESAE]).
Tidsram: 12 veckor
|
12 veckor
|
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Blodtryck (systoliskt och diastoliskt) vid varje uppmätt tidpunkt.
Tidsram: 12 veckor
|
12 veckor
|
|
Andningsfrekvens vid varje uppmätt tidpunkt.
Tidsram: 12 veckor
|
12 veckor
|
|
Puls vid varje uppmätt tidpunkt.
Tidsram: 12 veckor
|
12 veckor
|
Samarbetspartners och utredare
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Studieregistreringsdatum
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Först inskickad som uppfyllde QC-kriterierna
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Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
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Andra studie-ID-nummer
- MIT-Do001-C206
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