Vasomotor Symptoms, Vulvovaginal Atrophy
Conditions
Brief summary
An open-label study to assess the PK of estradiol, estrone and progesterone from the DARE-HRT1 intravaginal rings at two different dose strengths.
Interventions
DEVICEIVR Dose 1
Estradiol 80 ug/progesterone 4 mg
DEVICEIVR Dose 2
Estradiol 160ug/progesterone 8 mg
DRUGOral Reference
estradiol 1mg/progesterone 100 mg
Sponsors
Daré Bioscience, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Postmenopausal women with body mass index \>/= 18 and \</= 38 kg/m2 * Normal cervix and vagina * An intact uterus * An acceptable results from an endometrial biopsy * normal mammogram report within 24 months of screening
Exclusion criteria
Prior abnormal cervical screening test (CST) or Pap result within 2 years of screening. Subject can have atypical squamous cells of undetermined significance (ASCUS), if HPV negative. Subjects with any self-reported active sexually transmitted disease and/or evidence of infection based on visual vaginal exam by the investigator Subjects with a UTI during screening as assessed by urine dipstick test with abnormal test findings (any positive result for leukocytes AND any positive result for nitrites) Subjects with \> 4 mm endometrium lining at screening (on the transvaginal ultrasound) Have a history of endometrial hyperplasia or cervical or uterine carcinoma Subjects with indwelling catheters or requiring intermittent catheterization Subjects with multiple or unsuccessful (e.g., still having symptoms) pelvic reconstructive surgery, or suffers from pelvic relaxation Subjects who have had a hysterectomy Subjects taking any estrogen and/or progesterone products (see Section 4.1 for washout requirements) Subjects with concomitant use of personal lubricants (water-based lubricants are allowed) or any intravaginal product or medication, either by prescription or over-the-counter (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 Self-reported or observed vaginal irritation; vaginal, vulvar, or cervical lesions, undiagnosed vaginal bleeding; or tenderness Subjects with a finding of clinically significant uterine fibroids at screening Subjects with a known hypersensitivity to progesterone, estradiol, Femring, or the components of the IVR (e.g., ethylene vinyl acetate) Subjects with known hypersensitivity to peanuts (Prometrium capsules contain peanut oil) Subjects with prior pelvic malignancies Subjects 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 subject inappropriate for entry into the trial. This includes but is not limited to the following: Human immunodeficiency virus (HIV) infection (confirmed by medical history/ serology testing) Active chronic hepatitis B or hepatitis C infection including hepatitis B surface antigen and hepatitis C antigen positive subjects with or without abnormal liver enzymes (confirmed by medical history/serology testing) Concurrent neurodegenerative disease 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 Dementia or significantly altered mental status that would prohibit the understanding or rendering of informed consent and compliance with the requirements of the protocol History of gallbladder disease unless gallbladder removed Symptomatic bacterial vaginosis Have fasting triglyceride of \> 300 mg/dL and/or total cholesterol of \> 300 mg/dL AST or ALT \> 1.5 times the upper limit of normal Fasting glucose \> 125 mg/dL 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 two 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. 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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To Determine the Steady State Concentration (Css) for Estradiol | 28 days | To describe the Pharmacokinetic parameters of estradiol in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day) |
| To Determine the Stead State Concentration (Css) for Estrone | 28 days | To describe the Pharmacokinetic parameters of estrone in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day) |
| To Determine the Steady State Concentration (Css) for Progesterone | 28 days | To describe the Pharmacokinetic parameters of progesterone in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day) |
Countries
Australia
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| IVR: Estradiol 80 ug/Day + Progesterone 4mg/Day 28-day IVR 80/4
IVR Dose 1: Estradiol 80 ug/progesterone 4 mg | 10 |
| IVR: Estradiol 160 ug/Day + Progesterone 8mg /Day 28-day IVR 160/8
IVR Dose 2: Estradiol 160ug/progesterone 8 mg | 12 |
| Oracle Estrace(R)/Prometrium(R) 29 days (estradiol 1mg/progesterone 100 mg oral capsule)
Oral Reference: estradiol 1mg/progesterone 100 mg | 11 |
| Total | 33 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Adverse Event | 0 | 1 | 0 |
| Overall Study | Protocol Violation | 0 | 0 | 1 |
| Overall Study | Withdrawal by Subject | 0 | 1 | 0 |
Baseline characteristics
| Characteristic | IVR: Estradiol 80 ug/Day + Progesterone 4mg/Day | IVR: Estradiol 160 ug/Day + Progesterone 8mg /Day | Oracle Estrace(R)/Prometrium(R) | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 2 Participants | 0 Participants | 0 Participants | 2 Participants |
| Age, Categorical Between 18 and 65 years | 8 Participants | 12 Participants | 11 Participants | 31 Participants |
| Age, Continuous | 58.8 years STANDARD_DEVIATION 6.66 | 56.0 years STANDARD_DEVIATION 3.72 | 57.2 years STANDARD_DEVIATION 4.42 | 57.2 years STANDARD_DEVIATION 4.97 |
| Body Mass Index | 28.2 kg/m^2 STANDARD_DEVIATION 3.2 | 29.3 kg/m^2 STANDARD_DEVIATION 4.98 | 28.2 kg/m^2 STANDARD_DEVIATION 3.18 | 28.6 kg/m^2 STANDARD_DEVIATION 3.86 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 10 Participants | 12 Participants | 11 Participants | 33 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 | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 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 | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) White | 10 Participants | 11 Participants | 11 Participants | 32 Participants |
| Region of Enrollment Australia | 10 participants | 12 participants | 11 participants | 33 participants |
| Sex: Female, Male Female | 10 Participants | 12 Participants | 11 Participants | 33 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 |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 10 | 0 / 12 | 0 / 12 |
| other Total, other adverse events | 8 / 10 | 9 / 12 | 8 / 12 |
| serious Total, serious adverse events | 0 / 10 | 0 / 12 | 0 / 12 |
Outcome results
Primary
To Determine the Stead State Concentration (Css) for Estrone
To describe the Pharmacokinetic parameters of estrone in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)
Time frame: 28 days
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| IVR: Estradiol 80 ug/Day + Progesterone 4mg/Day | To Determine the Stead State Concentration (Css) for Estrone | 21.6 pg/mL | Geometric Coefficient of Variation 75 |
| IVR: Estradiol 160 ug/Day + Progesterone 8mg /Day | To Determine the Stead State Concentration (Css) for Estrone | 20.4 pg/mL | Geometric Coefficient of Variation 48.7 |
| Oracle Estrace(R)/Prometrium(R) | To Determine the Stead State Concentration (Css) for Estrone | 199 pg/mL | Geometric Coefficient of Variation 32.4 |
Primary
To Determine the Steady State Concentration (Css) for Estradiol
To describe the Pharmacokinetic parameters of estradiol in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)
Time frame: 28 days
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| IVR: Estradiol 80 ug/Day + Progesterone 4mg/Day | To Determine the Steady State Concentration (Css) for Estradiol | 14.4 pg/mL | Geometric Coefficient of Variation 83.8 |
| IVR: Estradiol 160 ug/Day + Progesterone 8mg /Day | To Determine the Steady State Concentration (Css) for Estradiol | 29.7 pg/mL | Geometric Coefficient of Variation 28.23 |
| Oracle Estrace(R)/Prometrium(R) | To Determine the Steady State Concentration (Css) for Estradiol | 33.8 pg/mL | Geometric Coefficient of Variation 31.5 |
Primary
To Determine the Steady State Concentration (Css) for Progesterone
To describe the Pharmacokinetic parameters of progesterone in dose combinations (Estradiol 80 ug/progesterone 4/mg day and Estradiol 160 ug/progesterone 8/mg day)
Time frame: 28 days
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| IVR: Estradiol 80 ug/Day + Progesterone 4mg/Day | To Determine the Steady State Concentration (Css) for Progesterone | 1.31 pg/mL | Geometric Coefficient of Variation 14.72 |
| IVR: Estradiol 160 ug/Day + Progesterone 8mg /Day | To Determine the Steady State Concentration (Css) for Progesterone | 2.03 pg/mL | Geometric Coefficient of Variation 23.9 |
| Oracle Estrace(R)/Prometrium(R) | To Determine the Steady State Concentration (Css) for Progesterone | 0.501 pg/mL | Geometric Coefficient of Variation 90.8 |