The pharmacodynamic endpoint of percentage of subjects with suppressed estradiol level (less than 20 pg/mL) on cycle day 29 is the primary endpoint of the study.
Objectives of this study: 1. To determine efficacy and pharmacodynamic effects of various dosing regimens of Ovarest® (within the 60-mg - 120 mg daily dosing range) in women with endometriosis. 2. To determine a minimally effective daily dosing regimen of Ovarest® with pharmacodynamic effects at least comparable to the historical data for marketed Lupron Depot formulations and for GnRH antagonists indicated for the treatment of endometriosis. 3. To evaluate safety and tolerability of the long-term administration of leuprolide within the targeted daily dosing range in women with endometriosis. The most important goal of this study is to provide adequate dose-response data for the suppression of estradiol (E2) levels below the menopausal threshold of 20 pg/mL. Results of this study in conjunction of Enteris proprietary PK data will support further development of Leuprolide Acetate Oral Tablet for the treatment of reproductive disorders, particularly endometriosis. Another reason for this trial is to support a comparative evaluation of the PD effects across the QD and BID regimens delivering the same overall dose of Ovarest
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
16
If the subject during Treatment "A" meets the pharmacodynamic success criterion (estradiol level \<20 pg/mL on Treatment Day 29 of the First Treatment Cycle), in the Second Treatment Cycle, she will be assigned Treatment "B" - 80 mg (2 x 40 mg tablets) (QD), with food-intake restrictions. If the subject during Treatment "A" fails to meet the pharmacodynamic success criterion (i.e., if estradiol level ≥20 pg/mL on Treatment Day 29 of the First Treatment Cycle), then she will be switched to the Second Treatment Cycle with Treatment "D" - 60 mg (BID) with food intake restrictions.
If the subject on Treatment "B" meets the pharmacodynamic success criterion (estradiol level \<20 pg/mL on Treatment Day 29 of the Second Treatment Cycle), then she will be switched to the Third Treatment Cycle with Treatment "C" - 60 mg (QD) with food-intake restrictions. If the subject on Treatment "B" does not meet the pharmacodynamic success criterion (i.e., if estradiol level ≥20 pg/mL on Treatment Day 29 of the Second Treatment Cycle), then she will be switched to the Third Treatment Cycle with Treatment "E" - 40 mg (BID) with food intake restrictions.
Physician Care Clinical Research, LLC
Sarasota, Florida, United States
RECRUITINGComplete Healthcare for Women
Columbus, Ohio, United States
RECRUITINGTidewater Clinical Research
Norfolk, Virginia, United States
RECRUITINGAdequacy of suppression of estradiol (E2) as assessed by the subject incidence of estradiol level below 20 pg/mL
The primary PD metric - suppression of E2 level (E2 \<20 pg/mL) - will be assessed at each on-treatment evaluation timepoint. E2 below 20 pg/mL at Day 29 is a primary endpoint for a given Treatment Cycle.
Time frame: Treatment cycle: Day 29
Suppression of ovulation (as evidenced by progesterone levels <3 ng/mL)
It will be evaluated with Treatment Cycle Day 22 and Treatment Cycle Day 29 (separately and combined) positioned as most important timepoints for this analyte.
Time frame: Treatment cycle: Day 22 and 29
Number of vaginal (menstrual) bleeding days
The onset of menstrual period is defined as at least three consecutive bleeding/spotting days during the 14-day postdosing period.
Time frame: 28 days of therapy and 14 days post study follow up
Composite Pelvic Signs and Symptoms (CPSS) scores
CPSS scores (composite and for the individual items) and changes from the pre-dosing baseline will be summarized by treatment received. CPSSS values are derived from the Biberoglu and Behrman scale, with 5 components addressing dysmenorrhea (0-none and 3-severe), dyspareunia (0-none and 3-severe), non-menstrual pelvic pain (0-none and 3-severe), pelvic tenderness (0-none and 3-severe), and pelvic induration (0-none and 3-severe). In composite score (total symptom and sign severity score) 0 being none and 11-15 being very severe.
Time frame: Treatment day 29
(Pre-dose leuprolide level) Subject incidence of Leuprolide below detectable level
The summaries will be provided for each PK evaluation timepoint and across the entire treatment cycle
Time frame: Treatment Cycle: Days 1, 8, 15, 22 and 29 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
For up to 29 consecutive days with food-intake restrictions
If the subject on Treatment "D" fails to meet the pharmacodynamic success criterion (i.e., if estradiol level ≥20 pg/mL on Treatment Day 29 of the Second Treatment Cycle), she will be discontinued from the study following completion of the Second Treatment Cycle. If the subject during Treatment "D" meets the pharmacodynamic success criterion (estradiol level \<20 pg/mL on Treatment Day 29 of her Second Treatment Cycle), then she will be switched to the Third Treatment Cycle with Treatment "E" - 40 mg (BID) with food intake restrictions.
For up to 29 consecutive days with food-intake restrictions
Seattle Clinical Research Center
Seattle, Washington, United States
RECRUITINGLuteinizing hormone (LH) levels
Serum concentration measured immediately prior to dosing
Time frame: Treatment days: 1,8, 15, 22 and 29; Post dosing day 14
Follicle Stimulating Hormone (FSH) levels
Serum concentration measured immediately prior to dosing
Time frame: Treatment days: 1,8, 15, 22 and 29; Post dosing day 14