A randomized study evaluating the safety and efficacy of elagolix in the management of moderate to severe endometriosis-associated pain in adult premenopausal female subjects.
The study consists of 4 periods: 1) Washout Period (if applicable); 2) a Screening Period of up to 100 days prior to first dose; 3) a 6 month Treatment Period; and 4) a Post treatment Follow-up Period of up to 12 months (if applicable). An electronic diary will be dispensed and training provided to record endometriosis-associated pain, uterine bleeding, and analgesic medication use for endometriosis-associated pain on a daily basis. Pregnancy testing will be performed monthly throughout the study. Subjects will be required to use nonhormonal dual contraception during the study, and will be counseled on appropriate and effective forms of birth control to promote pregnancy prevention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
815
Percentage of Responders at Month 3 Based on Daily Assessment of Dysmenorrhea (DYS)
The DYS pain scale ranges from 0 (none) to 3 (severe) as recorded in a daily electronic diary. The criteria for defining a participant as a responder included a reduction of -0.85 or greater from Baseline in DYS pain as well as no increased rescue analgesic use for endometriosis-associated pain.
Time frame: At Month 3 of the Treatment Period
Percentage of Responders at Month 3 Based on Daily Assessment of Non-Menstrual Pelvic Pain (NMPP)
The NMPP pain scale ranges from 0 (none) to 3 (severe) as recorded in a daily electronic diary. The criteria for defining a participant as a responder included a reduction of -0.43 or greater from Baseline in NMPP as well as no increased rescue analgesic use for endometriosis-associated pain.
Time frame: At Month 3 of Treatment Period
Change From Baseline to Month 3 in Numeric Rating Scale (NRS) Scores
The NRS for overall endometriosis-associated pain ranges 0 (none) to 10 (worst pain ever).
Time frame: Baseline, Month 3 of the Treatment Period
Change From Baseline to Month 6 in DYS
The DYS pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline, Month 6 of Treatment Period
Change From Baseline to Month 6 in NMPP
The NMPP pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline, Month 6 of Treatment Period
Change From Baseline to Month 3 in Analgesic Use Across Both Classes of Rescue Analgesics
Permitted rescue medications included the nonsteroidal anti-inflammatory drug naproxen (500 or 550 mg), and one country-specific narcotic analgesic (5 mg hydrocodone + 300 or 325 mg acetaminophen, or 30 mg codeine + 500 mg acetaminophen, or 30 mg codeine, or 37.5 mg tramadol + 325 mg acetaminophen). Assessment was based on average pill counts.
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Time frame: Baseline, Month 3 of Treatment Period
Change From Baseline to Month 6 in Analgesic Use Across Both Classes of Rescue Analgesics
Permitted rescue medications included the nonsteroidal anti-inflammatory drug naproxen (500 or 550 mg), and one country-specific narcotic analgesic (5 mg hydrocodone + 300 or 325 mg acetaminophen, or 30 mg codeine + 500 mg acetaminophen, or 30 mg codeine, or 37.5 mg tramadol + 325 mg acetaminophen). Assessment was based on average pill counts.
Time frame: Baseline, Month 6 of Treatment Period
Change From Baseline to Month 3 in Dyspareunia (DYSP)
The DYSP pain scale ranges from 0 (absent) to 3 (severe).
Time frame: Baseline, Month 3 of Treatment Period
Change From Baseline to Month 3 in Use of Narcotic Class of Medication (Opioids)
Permitted country-specific rescue narcotic analgesics included 5 mg hydrocodone + 300 or 325 mg acetaminophen, or 30 mg codeine + 500 mg acetaminophen, or 30 mg codeine, or 37.5 mg tramadol + 325 mg acetaminophen. Assessment was based on average pill counts.
Time frame: Baseline, Month 3 of Treatment Period
Percentage of Responders for Each Month, Except Month 3, in DYS
The DYS pain scale ranges from 0 (none) to 3 (severe) as recorded in a daily electronic diary. The criteria for defining a participant as a responder included a reduction of -0.85 or greater from Baseline in DYS pain as well as no increased rescue analgesic use for endometriosis-associated pain.
Time frame: Months 1, 2, 4, 5, 6 of the Treatment Period
Percentage of Responders for Each Month, Except Month 3, in NMPP
The NMPP pain scale ranges from 0 (none) to 3 (severe) as recorded in a daily electronic diary. The criteria for defining a participant as a responder included a reduction of -0.43 or greater from Baseline in NMPP as well as no increased rescue analgesic use for endometriosis-associated pain.
Time frame: Months 1, 2, 4, 5, 6 of the Treatment Period
Percentage of Responders at Each Month for DYSP
The DYSP pain scale ranged from 0 (absent) to 3 (severe) as recorded in a daily electronic diary. The criteria for defining a participant as a responder included a reduction of -0.29 or greater from Baseline in DYSP as well as no increased rescue analgesic use for endometriosis-associated pain.
Time frame: Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month, Except Month 6, in Mean Pain Score for DYS
The DYS pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline (Prior to administering study drug), Months 1, 2, 3, 4, 5 of Treatment Period
Percent Change From Baseline to Each Month in Mean Pain Score for DYS
The DYS pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month, Except Month 6, in Mean Pain Score for NMPP
The NMPP pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline, Months 1, 2, 3, 4, 5 of Treatment Period
Percent Change From Baseline to Each Month in the Mean Pain Score for NMPP
The NMPP pain scale ranges from 0 (none) to 3 (severe).
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month, Except Month 3, in the Mean Pain Score of DYSP
The DYSP pain scale ranged from 0 (absent) to 3 (severe).
Time frame: Baseline, Months 1, 2, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month, Except Months 3 and 6, in Analgesic Use Across Both Classes of Rescue Analgesics
Permitted rescue medications included the nonsteroidal anti-inflammatory drug naproxen (500 or 550 mg), and one country-specific narcotic analgesic (5 mg hydrocodone + 300 or 325 mg acetaminophen, or 30 mg codeine + 500 mg acetaminophen, or 30 mg codeine, or 37.5 mg tramadol + 325 mg acetaminophen). Assessment was based on average pill counts.
Time frame: Baseline, Months 1, 2, 4, 5
Patient Global Impression of Change (PGIC) Questionnaire
The PGIC questionnaire is a self-reported 7-point scale rating a participant's overall impression of change from 1 = very much improved to 7 = very much worse. Participants evaluated the change in their endometriosis-associated pain since initiation of study drug.
Time frame: Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month, Except Month 3, in NRS Scores
The NRS for overall endometriosis-associated pain ranges 0 (none) to 10 (worst pain ever).
Time frame: Baseline, Months 1, 2, 4, 5, 6 of Treatment Period
Change From Baseline to Each Scheduled Assessment in the Pain Domain of Endometriosis Health Profile-30 (EHP-30) Questionnaire Scores
The EHP-30 is a disease-specific self-administered questionnaire used to measure health-related quality of life in women with endometriosis. Each domain is calculated on a scale from 0 = best possible health status to 100 = worst possible health status.
Time frame: Baseline, Months 1, 3, 6 of Treatment Period
Change From Baseline to Each Scheduled Assessment in the Sexual Intercourse Domain of EHP-30 Questionnaire Scores
The EHP-30 is a disease-specific self-administered questionnaire used to measure health-related quality of life in women with endometriosis. Each domain is calculated on a scale from 0 = best possible health status to 100 = worst possible health status.
Time frame: Baseline, Months 1, 3, 6 of Treatment Period
Change From Baseline to Each Month in Health Related Productivity Questionnaire (HRPQ): Number of Hours of Work Lost From Workplace Due to Absenteeism
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the workplace due to absenteeism) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month in HRPQ: Number of Hours of Work Lost From Household Due to Absenteeism
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the household due to absenteeism) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month in HRPQ: Number of Hours of Work Lost From Workplace Due to Presenteeism
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the workplace due to presenteeism \[working while sick\]) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month in HRPQ: Number of Hours of Work Lost From Household Due to Presenteeism
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the household due to presenteeism \[working while sick\]) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month in HRPQ: Total (Absenteeism and Presenteeism) Number of Hours of Work Lost From Workplace
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the workplace due to absenteeism and presenteeism) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Change From Baseline to Each Month in HRPQ: Total (Absenteeism and Presenteeism) Number of Hours of Work Lost From Household
The HRPQ consists of questions measuring the impact of endometriosis-associated pain and its treatment on work productivity (number of work hours lost from the household due to absenteeism and presenteeism) in the 7 days prior to survey administration.
Time frame: Baseline, Months 1, 2, 3, 4, 5, 6 of Treatment Period
Number of Participants With Endometriosis-Related Non-Study Health Visits During the Treatment Period
This is assessed using Health Resource Utilization Questionnaire (HRUQ).
Time frame: Months 1, 2, 3, 4, 5, 6 of Treatment Period
Number of Days of Hospitalization
This is assessed using HRUQ.
Time frame: Up to Month 6 of Treatment Period
Number of Participants With Emergency Room/Outpatient Procedures During the Treatment Period, by Type
This is assessed using HRUQ.
Time frame: Up to Month 6 of Treatment Period