Female Sexual Dysfunction
Conditions
Keywords
testosterone, pharmacokinetics
Brief summary
The purpose of this study was to assess the bioavailability of total testosterone through pharmacokinetic profiles obtained following (a) single administration of three doses of TBS-2 b) multiple administration TBS-2. In addition, assessing the bioavailability of free testosterone, dihydrotestosterone, SHBG and estradiol through pharmacokinetic profiles was also conducted.
Detailed description
This is a 2 Period study that requires overnight stays in clinic. Blood samples are required at all visits including sampling at predefined time periods during the overnight stays. Period I Subjects were checked-in on Day 1 Period I to start their baseline testosterone measurement (dependant on menstrual cycle, preferably within 48hr of start of the menstrual cycle). They remained institutionalized until Day 4 morning, and were checked out after the 48 hour blood draw and study close-out for those that did not continue with Period II. Period II (Multi-Dose) At the end of Period 1, a total of 8 subjects sampled from these 3 cohorts, who were willing and able to continue with the multiple-dose portion of the study were selected to participate in Period 2. Subjects were institutionalized starting on Day 1 of Visit 3 until Day 5 morning of Visit 3, and were checked out after the 48 hour blood draw and study close-out.
Interventions
DRUGLow dose testosterone nasal gel, single dose
Low dose testosterone nasal gel, single dose
DRUGMedium dose testosterone nasal gel, single dose
Medium dose testosterone nasal gel, single dose
DRUGHigh dose testosterone nasal gel, single dose
High dose testosterone nasal gel, single dose
DRUGMedium dose testosterone nasal gel, multiple dose
Medium dose testosterone nasal gel, multiple dose
Sponsors
Acerus Pharmaceuticals Corporation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Subjects having regular menstrual cycles between 26-32 days. * Women of childbearing potential must agree to use one of the following reliable birth control methods prior to the study, during the study and up until one month after the end of the study: * Surgically sterile * Intrauterine device in place for at least 3 months prior to study initiation * Barrier method (condom with spermicidal agent use by partner) * Abstinence * Negative for drugs of abuse, hepatitis B-surface antigen, hepatitis C, HIV, and pregnancy (serum ß-HCG). * Body Mass Index greater than or equal to 18.5 kg/m² and less than or equal to 35 kg/m². * Subjects with a normal ENT exam. * Subjects with normal TSH values. * No clinically significant findings in the physical examination, 12-lead ECG and vital signs * Normal thyroid function. Physiological prolactin concentration. * All clinical laboratory test values within the acceptable ranges (any clinically significant findings will require investigator/sponsor approval) * Able to understand and provide written informed consent. * Availability of the subject for the entire study period and willingness of the subject to adhere to protocol requirements, as evidenced by a signed ICF
Exclusion criteria
* Known history of hypersensitivity to Testosterone (e.g. Intrinsa patch) and/or related drugs. * Known history of polycystic ovarian syndrome. * Known history or presence of cardiac, pulmonary, gastrointestinal, endocrine, musculoskeletal, neurological, psychiatric, hematological, reproductive, liver or kidney disease, unless judged not clinically significant by the Principal Investigator or medical designate. * Presence of or known history of Estrogen-responsive tumors such as breast cancer and /or history of any cancer, excluding basal cell carcinoma. * Known history of frequent clinically significant acne. * Known history of hirsutism * History of nasal surgery, specifically turbinoplasty, septoplasty, rhinoplasty, nose job, or sinus surgery. * Prior nasal fractures. * Active allergies, such as rhinitis, rhinorrhea, and nasal congestion. * Mucosal inflammatory disorders, specifically pemphigus, and Sjogren's syndrome. * Sinus disease, specifically acute sinusitis, chronic sinusitis, or allergic fungal sinusitis. * History of nasal disorders or sleep apnea. * Use of any form of intra-nasal medication delivery, specifically nasal corticosteroids and oxymetazoline containing nasal sprays * History of Hepatitis B, a positive test for Hepatitis B surface antigen, a history of Hepatitis C, a positive test for Hepatitis C antibody, a history of HIV infection or demonstration of HIV antibodies. * Any history of severe allergic reaction (including drugs, food, insect bites, environmental allergens or any condition known to interfere with the absorption, distribution, metabolism or excretion of drugs. * Any history of drug abuse or alcohol abuse as per DSM-IV criteria within 6 months of study drug administration. * Current treatment with any hormone replacement therapy within previous 12 months, treatment with drugs which interfere with metabolism of Testosterone within 30 days of study drug administration and/or any other prescription medications. Difficulty in abstaining from OTC medication for the duration of study. * Use of oral, transdermal and implant contraceptives within 30 days prior to drug administration or a depot contraceptives injection within one year prior to drug administration. * Evidence of pregnancy or lactation. * Subjects who are breast feeding or have breast fed within the last six (6) months prior to the Screening Visit. * Administration of another investigational drug within 30 days prior to study medication administration. * Blood donation within 56 days prior to study medication administration. * Any participation as a plasma donor in a plasmapheresis program within seven days preceding screening in this study. * Intolerance to venipuncture. * History of abnormal bleeding tendencies or thrombophlebitis unrelated to venipuncture or intravenous cannulation. * History of Deep Venous Thrombosis or coagulation disorders.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles | Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing | Area under the concentration time curve from time zero to the last measurable concentration time point (AUC0-t) for single dose and AUCtau shown for multiple dose. |
| Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles | Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing | Cmax - maximum concentration of total testosterone observed after dosing of TBS-2 |
| Medium Dose TBS-2 Multiple Dose Average Steady-state Concentration (Cavg) of Total Testosterone | -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 24, 32, 40, 48h after Day 3 dosing | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2 | Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing | AUCt shown for single dose and AUCtau for multiple dose. |
| Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2 | Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing | AUCt shown for single dose and AUCtau for multiple dose. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Low Dose TBS-2 Low dose testosterone nasal gel: Single dose administration | 8 |
| Medium Dose TBS-2 Medium dose testosterone nasal gel: Single dose administration
Medium dose testosterone nasal gel: Multiple dose administration | 8 |
| High Dose TBS-2 High dose testosterone nasal gel: Single dose administration | 8 |
| Total | 24 |
Baseline characteristics
| Characteristic | Low Dose TBS-2 | Medium Dose TBS-2 | High Dose TBS-2 | Total |
|---|---|---|---|---|
| Age, Continuous | 32.5 years STANDARD_DEVIATION 5.73 | 29.8 years STANDARD_DEVIATION 4.43 | 27.0 years STANDARD_DEVIATION 6.57 | 29.8 years STANDARD_DEVIATION 5.86 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 5 Participants | 4 Participants | 11 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 6 Participants | 3 Participants | 4 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 2 Participants | 1 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 7 Participants | 6 Participants | 6 Participants | 19 Participants |
| Sex: Female, Male Female | 8 Participants | 8 Participants | 8 Participants | 24 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 8 | 0 / 8 | 0 / 8 | 0 / 8 |
| other Total, other adverse events | 4 / 8 | 4 / 8 | 3 / 8 | 4 / 8 |
| serious Total, serious adverse events | 0 / 8 | 0 / 8 | 0 / 8 | 0 / 8 |
Outcome results
Primary
Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles
Area under the concentration time curve from time zero to the last measurable concentration time point (AUC0-t) for single dose and AUCtau shown for multiple dose.
Time frame: Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Low Dose TBS-2 Single Dose | Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles | 223.981 ng*h/dL | Geometric Coefficient of Variation 39 |
| Medium Dose TBS-2 Single Dose | Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles | 328.002 ng*h/dL | Geometric Coefficient of Variation 35.8 |
| High Dose TBS-2 Single Dose | Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles | 834.391 ng*h/dL | Geometric Coefficient of Variation 49.7 |
| Medium Dose TBS-2 Multiple-Dose | Bioavailability (AUC0-t) of Total Testosterone Through Pharmacokinetic (PK) Profiles | 553.325 ng*h/dL | Geometric Coefficient of Variation 41.4 |
Primary
Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles
Cmax - maximum concentration of total testosterone observed after dosing of TBS-2
Time frame: Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Low Dose TBS-2 Single Dose | Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles | 34.058 ng/dL | Geometric Coefficient of Variation 61.1 |
| Medium Dose TBS-2 Single Dose | Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles | 62.880 ng/dL | Geometric Coefficient of Variation 48.6 |
| High Dose TBS-2 Single Dose | Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles | 113.912 ng/dL | Geometric Coefficient of Variation 44.3 |
| Medium Dose TBS-2 Multiple-Dose | Bioavailability (Cmax) of Total Testosterone Through Pharmacokinetic Profiles | 137.555 ng/dL | Geometric Coefficient of Variation 41.5 |
Primary
Medium Dose TBS-2 Multiple Dose Average Steady-state Concentration (Cavg) of Total Testosterone
Time frame: -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 24, 32, 40, 48h after Day 3 dosing
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Low Dose TBS-2 Single Dose | Medium Dose TBS-2 Multiple Dose Average Steady-state Concentration (Cavg) of Total Testosterone | 0.944 ng/dL | Standard Deviation 0.408 |
Secondary
Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2
AUCt shown for single dose and AUCtau for multiple dose.
Time frame: Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Low Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2 | 23.515 ng*h/dL | Geometric Coefficient of Variation 74.9 |
| Medium Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2 | 38.457 ng*h/dL | Geometric Coefficient of Variation 49.1 |
| High Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2 | 85.180 ng*h/dL | Geometric Coefficient of Variation 64.2 |
| Medium Dose TBS-2 Multiple-Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Dihydrotestosterone Following TBS-2 | 122.194 ng*h/dL | Geometric Coefficient of Variation 40 |
Secondary
Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2
AUCt shown for single dose and AUCtau for multiple dose.
Time frame: Based on blood samples collected -0.25, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 12, 16, 20, 23.5h relative to dosing
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Low Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2 | 105.763 pg*h/mL | Geometric Coefficient of Variation 118.7 |
| Medium Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2 | 75.97 pg*h/mL | Geometric Coefficient of Variation 82.2 |
| High Dose TBS-2 Single Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2 | 43.97 pg*h/mL | Geometric Coefficient of Variation 197.9 |
| Medium Dose TBS-2 Multiple-Dose | Area Under the Plasma Concentration Versus Time Curve (AUC) for Estradiol Following TBS-2 | 400.264 pg*h/mL | Geometric Coefficient of Variation 54 |