Orgasmic Disorder
Conditions
Keywords
S1B-408, Orgasmic Disorder, Female Sexual Dysfunction
Brief summary
This is the first clinical trial of S1B-408 in women with sexual dysfunction. A prior 4-week trial in premenopausal women with Hypoactive Sexual Desire Disorder showed that orgasmic function improved with Lorexys (TM). This pilot trial tests for improvement in orgasmic function, safety, and tolerability of a different but related test article.
Detailed description
S1B-408 is a proprietary combination of agents proven safe and effective in other CNS indications. The combination drug is aimed at treating women's sexual dysfunction disorders. Its two components each have pro-sexual effects. However, the efficacy of each when given alone has been limited. Moreover, each component has side effects which, while benign, may limit the drug's utility: activation (agitation, anxiety, insomnia) with one; sedation (somnolence, fatigue, etc) with the other. The goal of this trial is to show that, when formulated in the proper (fixed) ratio, the combination of these two drugs strengthens their pro-sexual effects for orgasmic dysfunction while mitigating the opposing side effect profiles. For this pilot study, the goal for exposure is to seek rapid onset of action with minimal dosing.
Interventions
DRUGS1B-408
Medication with multiple monoamine activities
Sponsors
S1 Biopharma, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Rating scales and sexual activity log to establish baseline over one month then open-label treatment with dose titration based on results to determine change, with statistical analysis of group differences between month prior to treatment vs treatment.
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Age 25 to 60. 2. In a sexual relationship and sexually active within the past month 3. Diagnosis of ICD-10 2023 Orgasmic Dysfunction, secondary or primary. See Investigator's Brochure, section 2, Medical Need and Diagnosis for rationale. 4. Orgasmic Dysfunction is the predominant form of sexual dysfunction, is acquired rather than lifelong, and is generalized rather than situational. 5. At screen and baseline visit, scores \<8 on the raw score of the FSFI orgasm domain (at least moderate severity) 6. May have depression and/or anxiety if condition is no worse than mild with treatment and if patient will continue the same treatment for the duration of this trial 7. Side effects from any continuing concomitant medications must be stable. 8. Not pregnant or lactating for six months; using contraception that is medically reliable in the investigator's judgment, or (if the investigator finds the patient credibly monogamous) vasectomy of male partner. If hormonal contraception is used, the same medication must have been used for at least 3 months. 9. Gives informed consent for and is willing to undergo all of the scheduled evaluations 10. Prompt for screening and baseline visits, is cooperative, and takes reasonable directions without excessive explanations 11. Her sexual partner is sexually unimpaired (erectile dysfunction allowed only if adequately treated), and available to the subject at least half of the time (in days per week). 12. Agrees to have sexual activity with her partner at least once a week for the duration of her participation in this study.
Exclusion criteria
1. Masturbates to orgasm more than once a week. 2. Sexual aversion or sexual pain disorder 3. Chronic conditions that, in the investigator's judgment, are likely to deteriorate within 3 months of screening are not allowed (e.g., gastrointestinal bleeding, uncontrolled diabetes, frequent asthma attacks, uncontrolled Major Depressive disorder, history within the prior 6 months of suicidality or drug abuse; recurrence within the prior year of breast, cervical, uterine, ovarian or other systemic cancer). However, chronic conditions with a relatively stable course are allowed; see Investigator's Brochure, section 2, Medical Need and Diagnosis for rationale. 4. Requires CYP3A4, CYP 2B6, or CYP 2D6 strong inhibitor or inducer drugs 5. History of bipolar and/or psychotic disorders and/or takes an antiepileptic/mood stabilizer, antipsychotic, or opioid drug 6. History of severe, serious, or allergic adverse reaction(s) to stimulants or sedatives 7. Drinks \>2 alcoholic drinks per day (12-oz beer, 4-oz wine, 1 ½ oz liquor, etc.) 8. History of seizures or use of antiepileptic medication 9. Long QT syndrome (QTc \>480 msec), other significant cardiovascular disease 10. moderate or severe dysfunction of the liver (any LFT \>3x ULN) or renal dysfunction (BUN \> 30 or Cr \>2.0) 11. History of blood clots or abnormal bleeding tendencies, including daily use of medications adversely affecting coagulation, e.g., NSAIDs, systemic corticosteroids, or \>81 mg aspirin daily.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Female Sexual Function Index (FSFI): orgasm domain | 7 or 28 day recall | sum of 3 items on orgasmic frequency, difficulty, and satisfaction, each rated 0 or 1 (worst) to 5 (best) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient's Global Impression of Change | 4 weeks | single question rated from 1 (best) to 7 (worst) asking improvement vs none or worsening |
| Changes in Sexual Function Questionnaire (CSFQ): orgasm | 7 day recall | sum of 3 items on orgasmic frequency, pleasure, and ability, each rated 1 (worst) to 5 (best) |
| CSFQ total score | now or 7 day recall | sum of 14 items on all aspects of female sexual response, scored from 14 to 70 (best) |
| FSFI total score | Prior 7 or 28 days | sum of 19 items on 6 aspects of female sexual response, scored from 4 (worst) to 95 (best) |
| Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) items 13, 14, and 15 scores | Prior 7 or 28 days | 3 items on sexual distress re desire, arousal, and orgasm, each scored from 0 to 4 (best) |
| Sexual Activity Log (SAL), orgasms | 1-7 day recall | Sexual Activity Log count of orgasms |
| SAL proportion of sexual activities with orgasm | 1-7 day recall | Sexual Activity Log count of orgasms over times engaged in sex; best would be 1.0 |
| Sexual Activity Log (SAL) satisfying sexual events | 1-7 day recall | Count of sexual events that were satisfying |
Other
| Measure | Time frame | Description |
|---|---|---|
| Blood pressure | one half minute or less | pressures in mm of mercury when a heartbeat reaches the arm and between heartbeats |
| Q-T interval | three heartbeats up to the number of heartbeats in 30 seconds | time in milliseconds between start and end of a contraction of the ventricles of the heart as measured by electrocardiogram (ECG) |
| Cardiac rate | 1/2 to 1 minute | Number of contractions of the ventricles of the heart per minute as measured by ECG |
| Columbia Suicide Severity Rating Scale, 6-item Screening/Triage version (C-SSRS-6) | prior 30 days | 6-item self-rating scale on suicidal ideas, intent and behavior monitored by clinician; no rather than yes answer to each item is best score |
| Patient Health Questionnaire-9 Symptom Checklist (PHQ-9) | prior 2 weeks | 9 items on depressive symptoms rated from 0 (best) to 3 (worst) |
| pulse rate | one fourth to one half minute | number of heart beats per minute effective enough to reach the arm |
| Safety: adverse events | 4-week recall | All adverse outcomes in clinician's judgment in answer to a question: How do you feel? or in interpreting objective information about the patient |
Contacts
Primary ContactAnita Clayton, MD
Backup ContactRobert E Pyke, MD,PhD
Outcome results
None listed