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ContraceptionPhase 1NCT02874248

E4/DRSP Single and Multiple Dose PK and Early QT Study

A Phase 1 study testing 15 mg E4/3 mg DRSP, 30 mg E4/6 mg DRSP and 60 mg E4/12 mg DRSP in people with Contraception, run by Estetra.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is conducted to evaluate the effect of single and multiple therapeutic and supratherapeutic oral doses of E4/DRSP combinations on PK parameters, safety, tolerability and on cardiac repolarization, as detected by QT interval corrected with Fridericia's formula (QTcF). Read more about this study

Who is it for?
Ages 18 to 50 years, women onlyHealthy volunteers can take part
Conditions the study is for
Contraception
What is being tested?
15 mg E4/3 mg DRSP, 30 mg E4/6 mg DRSP and 60 mg E4/12 mg DRSP
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
55 participants
Where
No sites listed yet
Study dates
May 2016to 21 Nov 2016
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Gender : Healthy female subject
  • Age : 18-50 years, inclusive
  • Body mass index (BMI) : 18.0-35.0 kg/m2
  • At screening, female subjects must be non-pregnant and non-lactating, or of non-childbearing potential
  • Willing to use a double-barrier method of contraception from screening until 90 days after the follow up visit.
  • Willingness to abstain from alcohol and grapefruit (juice) from 48 hours prior to admission into the clinical research center up to follow-up.
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  • Normal resting supine blood pressure and pulse showing no clinically relevant deviations as judged by the PI at screening.
  • Computerized (12-lead) ECG recording without signs of clinically relevant pathology at screening
  • Willing and able to sign the ICF.
  • Willing and able to comply with the study procedures

Who cannot join

  • Postmenopausal status
  • History or presence of clinically relevant disease of any major system organ class (e.g., cardiovascular, pulmonary, renal, hepatic, gastrointestinal, reproductive, endocrinological, neurological, psychiatric or orthopedic disease) as judged by the PI
  • Condition of hyperkalemia resulting from renal insufficiency, hepatic dysfunction, adrenal insufficiency or medication intake
  • Previous participation in the current study
  • Use of:
  • combined contraceptives (i.e., COC, Nuvaring®) within 28 days prior to the first dose administration until study completion
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  • progestogen-only contraceptive methods (e.g., minipill, implant, or hormonal intrauterine system) within 28 days prior to the first dose administration until study completion
  • depot progestogen preparations or an injectable hormonal method of contraception (e.g., Depo-Provera®) within 6 months prior to the first dose until study completion
  • Use of:
  • any prescription drugs or herbal supplements acting on CYP3A4 functions (e.g., St. John's Wort) within 28 days prior to the first study dose administration until study completion
  • any over-the-counter medication or dietary supplements (vitamins included) within 14 days prior to the first study dose administration until study completion.
  • Use of any tobacco products within the last 3 months prior to the first admission
  • History of alcohol abuse or drug addiction (including soft drugs like cannabis products)
  • Positive drug screening
  • Positive screen for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibodies or human immunodeficiency virus (HIV) 1 and 2 antibodies
  • Participation in an investigational drug study within 60 days prior to the first drug administration in the current study
  • History of relevant drug and/or food allergies
  • Donation or loss of more than 100 mL of blood within 60 days prior to the first drug administration. Donation or loss of more than 1.0 L of blood in the 10 months prior to the first drug administration in the current study
  • Significant and/or acute illness within 5 days prior to the first drug administration that may impact safety assessments, as judged by the PI
  • History and/or family history of congenital long QT syndrome, unexplained syncope or other additional risks for Torsade de Pointes, or sudden death
  • History or presence of hormone-related malignancy treated or not, whatever the time of onset. History of malignancy of any other organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years prior to screening
  • History of migraine with aura
  • Any surgical or medical condition that could significantly alter the absorption, distribution, metabolism, or excretion of drugs, or which may jeopardize the subject in case of participation in the study
  • Contraindications for the use of contraceptive steroids
  • Sponsor employees or clinical site personnel directly affiliated with this study

About this study

Official title: A Randomized, Double-blind, Placebo-controlled, Parallel, Single Center Study to Investigate the Pharmacokinetics, Safety, Tolerability, and QT Concentration-effect Modelling of Estetrol in Combination With Drospirenone After Single and Multiple Dosing in Healthy Women

This study is conducted to evaluate the effect of single and multiple therapeutic and supratherapeutic oral doses of E4/DRSP combinations on PK parameters, safety, tolerability and on cardiac repolarization, as detected by QT interval corrected with Fridericia's formula (QTcF).

Read the detailed description

This will be a randomized, double-blind, placebo-controlled, parallel, single center study in healthy female subjects. A total of 42 female subjects will be enrolled in 3 groups of 14 subjects each. A potential fourth group of 14 healthy female subjects may be added. In each group, subjects will be randomized in a 2.5 to 1 ratio between active (n=10) and placebo (n=4).

Subjects will receive a single dose on Day 1 and, after a washout of at least 14 days, multiple doses on 14 consecutive days from Days 15 to 28.

Group 1 and Group 2 may be dosed in parallel. After completion of Group 1 and Group 2, a Dose Escalation Report (DER), including PK data up to at least 24 hours post-last dose, will be prepared by the Principal Investigator (PI). Escalation to the planned dose level of 60 mg E4/12 mg DRSP will only proceed if the safety and tolerability of the dose levels of 15 mg E4/3 mg DRSP and 30 mg E4/6 mg DRSP up to 24 hours post-last dose, are acceptable to the PI and the Sponsor and, if deemed necessary by the Independent Ethics Committee (IEC) following their review of the protocol, after a statement of no objection of the DER from the IEC.

After completion of Group 3, a second DER, including PK data, will be prepared by the PI. If in Group 3 the expected exposure level of approximately 4 times the exposure of Group 1 is not achieved, and treatment in Group 3 is well tolerated, an additional group with 14 subjects may be enrolled, using a dose level that is estimated to result in at least 4 times the exposure after administration of the 15 mg E4/3 mg DRSP therapeutic dose.

Conditions
Contraception
Being tested
15 mg E4/3 mg DRSP, 30 mg E4/6 mg DRSP, 60 mg E4/12 mg DRSP, Visually matching placebo, 75 mg E4/15 mg DRSP

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 15 mg E4/3 mg DRSPDrug

    Also called 15 mg estetrol and 3 mg drospirenone

    a single oral dose of 15 mg E4/3 mg DRSP (n=10) followed, after a washout of at least 14 days, by multiple oral doses of 15 mg E4/3 mg DRSP (n=10) once daily for 14 days

  • 30 mg E4/6 mg DRSPDrug

    Also called 30 mg estetrol and 6 mg drospirenone

    a single oral dose of 30 mg E4/6 mg DRSP, followed, after a washout of at least 14 days, by multiple oral doses of 30 mg E4/6 mg DRSP once daily for 14 days

  • 60 mg E4/12 mg DRSPDrug

    Also called 60 mg estetrol and 12 mg drospirenone

    a single oral dose of 60 mg E4/12 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 60 mg E4/12 mg DRSP once daily for 14 days

  • Visually matching placeboDrug

    a single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days

  • 75 mg E4/15 mg DRSPDrug

    a single oral dose of 75 mg E4/15 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 75 mg E4/15 mg DRSP once daily for 14 days

Study groups in NCT02874248
Study groupRoleWhat they receive
Group 1: 15 mg E4/3 mg DRSP (n=10)Active comparatora single oral dose of 15 mg E4/3 mg DRSP (n=10) followed, after a washout of at least 14 days, by multiple oral doses of 15 mg E4/3 mg DRSP (n=10) once daily for 14 days
Receives: Drug: 15 mg E4/3 mg DRSP
Group1: Placebo (n=4)Placebo comparatora single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days
Receives: Drug: Visually matching placebo
Group 2: 30 mg E4/6 mg DRSP (n=10)Active comparatora single oral dose of 30 mg E4/6 mg DRSP, followed, after a washout of at least 14 days, by multiple oral doses of 30 mg E4/6 mg DRSP once daily for 14 days
Receives: Drug: 30 mg E4/6 mg DRSP
Group 2: Placebo (n=4)Experimentala single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days
Receives: Drug: Visually matching placebo
Group 3: 60 mg E4/12 mg DRSP (n=10)Active comparatora single oral dose of 60 mg E4/12 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 60 mg E4/12 mg DRSP once daily for 14 days
Receives: Drug: 60 mg E4/12 mg DRSP
Group 3: Placebo (n=4)Placebo comparatora single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days
Receives: Drug: Visually matching placebo
Group 4: 75 mg E4/15 mg DRSP (n=9)Active comparatora single oral dose of 75 mg E4/15 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 75 mg E4/15 mg DRSP once daily for 14 days
Receives: Drug: 75 mg E4/15 mg DRSP
Group 4: Placebo (n=4)Placebo comparatora single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days
Receives: Drug: Visually matching placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Cmax: Maximum observed plasma concentration of E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

  2. Tmax: time to attain maximum observed plasma concentration of E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

  3. AUC0-t: Area under the plasma concentration-time curve up to time t, where t is the last point with concentrations above the lower limit of quantitation (LLOQ) - for E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

  4. AUC0-24: area under the plasma concentration-time curve up to time 24 hours (where 24 hours is the dosing interval) using linear-log trapezoidal rule - for E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 only

  5. AUC0-inf: Area under the plasma concentration-time curve from time 0 to infinity calculated as: AUC0-inf = AUC0-t + Clast/kel, where Clast is the last measurable plasma concentration

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 only

  6. Kel: terminal elimination rate constant of E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

  7. T1/2: terminal elimination half-life of E4 and DSRP, calculated as 0.693/kel

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

  8. AUC0-tau: Area under the plasma concentration time curve over a dosing interval tau - of E4 and DSRP

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 28 only

  9. Ra: Accumulation ratio for AUC

    PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35

    Measured: On day 1 and day 28 (steady state)

Secondary outcomes (3)
  1. Number of adverse events and number of subjects with AEs as a measure of safety and tolerability

    Any clinically significant observations in results of clinical laboratory tests, 12-lead ECGs, echocardiography, continuous cardiac monitoring (Holter monitoring), vital signs, or physical examinations will be recorded as AEs

    Measured: From admission until follow-up visit (between day 37 and 41)

  2. deltaQTcF as measured by Holter monitoring (continuous cardiac monitoring)

    To define the effect of E4 in combination with DRSP on QT interval corrected with Fridericia's formula (QTcF)

    Measured: Time matched on day -1 (for baseline measurements) and on day 28: 1 hour pre-dose until 24h post-dose

  3. ECG parameters

    To define the effect of E4 in combination with DRSP on heart rate (HR), PR, and QRS

    Measured: Once during screening period; on day -2, 2, 15, 28, 29; once between day 2-3 and once between day 37 and 41 (follow-up)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Aug 2016 (estimated)
  2. Study startMay 2016
  3. Primary completion21 Nov 2016
  4. Study completion21 Nov 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
55 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02874248
Sponsor's protocol ID
MIT-Es0001-C103
Other IDs
2016-000861-22, 2016
Status last verified
Aug 2016
First submitted
9 Aug 2016
Last updated
21 Apr 2017
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing 15 mg E4/3 mg DRSP, 30 mg E4/6 mg DRSP and 60 mg E4/12 mg DRSP in people with Contraception, run by Estetra.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Apr 2017. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cmax: Maximum observed plasma concentration of E4 and DSRP (time frame: On day 1 and day 28 (steady state)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Apr 2017.

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