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This is a four-arm, randomized, double-blind, parallel group, placebo-controlled study to compare the effects of two doses of DR-2041(Synthetic Conjugated Estrogens, A) Vaginal Cream on vulvovaginal atrophy in postmenopausal women with or without a hysterectomy and/or oophorectomy.
The study will include a screening period up to 4 weeks and a 12- week treatment period. The overall study duration for participants will be approximately 16 weeks. Study participants will undergo physical and gynecological exams, and blood tests for clinical laboratory assessments. All patients with a uterus will undergo transvaginal ultrasound.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental |
| |
| 2 | Experimental |
| |
| 3 | Placebo Comparator |
| |
| 4 | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DR-2041a | Drug | 1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change in the Symptom Identified by the Patient to be Most Bothersome | Change= Week 12 score - Baseline Score. The most bothersome symptom was derived from the subject self-assessment of vaginal atrophy, which consisted of 5 questions concerning severity of symptoms graded on a scale of 0-3(none, mild, moderate or severe) or 7 for not applicable. | Baseline to Week 12 |
| Mean Change in Vaginal pH | Change= Week 12 vaginal pH - Baseline vaginal pH | Baseline to Week 12 |
| Mean Change in Maturation Index | Change= Week 12 maturation index -baseline maturation index. Matuation index was calculated using the following equation: Maturation Index = (% Parabasal cells * 0) + (% Intermediate Cells * 0.5) + (% Superficial Cells * 1.0) | Baseline to Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability of DR-2041 (Synthetic Conjugated Estrogens, A) | Any adverse event reported from the beginning of the 28-day screening through the subject's last report. | Up to Week 12 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Duramed Protocol Chair | Duramed Research, Inc. | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Duramed Investigational Site | Huntsville | Alabama | 35801 | United States | ||
| Duramed Investigational Site |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19252451 | Result | Freedman M, Kaunitz AM, Reape KZ, Hait H, Shu H. Twice-weekly synthetic conjugated estrogens vaginal cream for the treatment of vaginal atrophy. Menopause. 2009 Jul-Aug;16(4):735-41. doi: 10.1097/gme.0b013e318199e734. |
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| ID | Title | Description |
|---|---|---|
| FG000 | DR-2041a | Synthetic Conjugated Estrogens, A (DR-2041)-1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
| FG001 | DR-2041b | Synthetic Conjugated Estrogens, A (DR-2041)-2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| DR-2041b | Drug | 2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
|
|
| Placebo | Other | 1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
|
| Placebo | Other | 2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
|
| Mobile |
| Alabama |
| 36608 |
| United States |
| Duramed Investigational Site | Montgomery | Alabama | 36608 | United States |
| Duramed Investigational Site | Phoenix | Arizona | 85015 | United States |
| Duramed Investigational Site | Phoenix | Arizona | 85031 | United States |
| Duramed Investigational Site | Phoenix | Arizona | 85032 | United States |
| Duramed Investigational Site | Tucson | Arizona | 85710 | United States |
| Duramed Investigational Site | Carmichael | California | 95608 | United States |
| Duramed Investigational Site | Fresno | California | 93710 | United States |
| Duramed Investigational Site | San Diego | California | 92103 | United States |
| Duramed Investigational Site | San Diego | California | 92108 | United States |
| Duramed Investigational Site | San Diego | California | 92123 | United States |
| Duramed Investigational Site | San Ramon | California | 94583 | United States |
| Duramed Investigational Site | Colorado Springs | Colorado | 80909 | United States |
| Duramed Investigational Site | Pueblo | Colorado | 81001 | United States |
| Duramed Investigational Site | New London | Connecticut | 06320 | United States |
| Duramed Investigational Site | Clearwater | Florida | 33756 | United States |
| Duramed Investigational Site | Clearwater | Florida | 33759 | United States |
| Duramed Investigational Site | Gainesville | Florida | 32607 | United States |
| Duramed Investigational Site | Jacksonville | Florida | 32207 | United States |
| Duramed Investigational Site | Leesburg | Florida | 34748 | United States |
| Duramed Investigational Site | Miami | Florida | 33143 | United States |
| Duramed Investigational Site | Pinellas Park | Florida | 33781 | United States |
| Duramed Investigational Site | Stuart | Florida | 34996 | United States |
| Duramed Investigational Site | Tampa | Florida | 33606 | United States |
| Duramed Investigational Site | Tampa | Florida | 33607 | United States |
| Duramed Investigational Site | Venice | Florida | 34292 | United States |
| Duramed Investigational Site | West Palm Beach | Florida | 33407 | United States |
| Duramed Investigational Site | West Palm Beach | Florida | 33409 | United States |
| Duramed Investigational Site | Weston | Florida | 33331 | United States |
| Duramed Investigational Site | Alpharetta | Georgia | 30005 | United States |
| Duramed Investigational Site | Atlanta | Georgia | 30342 | United States |
| Duramed Investigational Site | Augusta | Georgia | 30901 | United States |
| Duramed Investigational Site | Decatur | Georgia | 30034 | United States |
| Duramed Investigational Site | Douglasville | Georgia | 30134 | United States |
| Duramed Investigational Site | Sandy Springs | Georgia | 30328 | United States |
| Duramed Investigational Site | Chicago | Illinois | 60611 | United States |
| Duramed Investigational Site | Chicago | Illinois | 60612 | United States |
| Duramed Investigational Site | Evansville | Indiana | 47714 | United States |
| Duramed Investigational Site | Overland Park | Kansas | 66215 | United States |
| Duramed Investigational Site | Lexington | Kentucky | 40509 | United States |
| Duramed Investigational Site | Louisville | Kentucky | 40291 | United States |
| Duramed Investigational Site | Madisonville | Kentucky | 42431 | United States |
| Duramed Investigational Site | Shreveport | Louisiana | 71106 | United States |
| Duramed Investigational Site | Baltimore | Maryland | 21224 | United States |
| Duramed Investigational Site | Livonia | Michigan | 48152 | United States |
| Duramed Investigational Site | Lincoln | Nebraska | 68510 | United States |
| Duramed Investigational Site | Las Vegas | Nevada | 89146 | United States |
| Duramed Investigational Site | Lebanon | New Hampshire | 03756 | United States |
| Duramed Investigational Site | Lawrenceville | New Jersey | 08648 | United States |
| Duramed Investigational Site | Moorestown | New Jersey | 08057 | United States |
| Duramed Investigational Site | New Brunswick | New Jersey | 08901 | United States |
| Duramed Investigational Site | Albuquerque | New Mexico | 87102 | United States |
| Duramed Investigational Site | Johnson City | New York | 13790 | United States |
| Duramed Investigational Site | Williamsville | New York | 14221 | United States |
| Duramed Investigational Site | Raleigh | North Carolina | 27607 | United States |
| Duramed Investigational Site | Winston-Salem | North Carolina | 27103 | United States |
| Duramed Investigational Site | Jamestown | North Dakota | 58401 | United States |
| Duramed Investigational Site | Minot | North Dakota | 58701 | United States |
| Duramed Investigational Site | Cincinnati | Ohio | 45236 | United States |
| Duramed Investigational Site | Cleveland | Ohio | 44122 | United States |
| Duramed Investigational Site | Columbus | Ohio | 43205 | United States |
| Duramed Investigational Site | Columbus | Ohio | 43212 | United States |
| Duramed Investigational Site | Columbus | Ohio | 43213 | United States |
| Duramed Investigational Site | Mayfield Heights | Ohio | 44124 | United States |
| Duramed Investigational Site | Medford | Oregon | 97504 | United States |
| Duramed Investigational Site | Portland | Oregon | 97210 | United States |
| Duramed Investigational Site | Portland | Oregon | 97239 | United States |
| Duramed Investigational Site | Allentown | Pennsylvania | 18104 | United States |
| Duramed Investigational Site | King of Prussia | Pennsylvania | 19406 | United States |
| Duramed Investigational Site | Media | Pennsylvania | 19063 | United States |
| Duramed Investigational Site | Philadelphia | Pennsylvania | 19107 | United States |
| Duramed Investigational Site | Philadelphia | Pennsylvania | 19114 | United States |
| Duramed Investigational Site | Pittsburgh | Pennsylvania | 15206 | United States |
| Duramed Investigational Site | Rosemont | Pennsylvania | 19010 | United States |
| Duramed Investigational Site | Strafford | Pennsylvania | 19087 | United States |
| Duramed Investigational Site | Warwick | Rhode Island | 02886 | United States |
| Duramed Investigational Site | Charleston | South Carolina | 29401 | United States |
| Duramed Investigational Site | Charleston | South Carolina | 29425-0100 | United States |
| Duramed Investigational Site | Columbia | South Carolina | 29201 | United States |
| Duramed Investigational Site | Watertown | South Dakota | 57201 | United States |
| Duramed Investigational Site | Memphis | Tennessee | 38120 | United States |
| Duramed Investigational Site | Nashville | Tennessee | 37203 | United States |
| Duramed Investigational Site | Austin | Texas | 78748 | United States |
| Duramed Investigational Site | Austin | Texas | 78759 | United States |
| Duramed Investigational Site | Corpus Christi | Texas | 78414 | United States |
| Duramed Investigational Site | Dallas | Texas | 75390-9032 | United States |
| Duramed Investigational Site | Houston | Texas | 77015 | United States |
| Duramed Investigational Site | Houston | Texas | 77024 | United States |
| Duramed Investigational Site | Houston | Texas | 77030 | United States |
| Duramed Investigational Site | Houston | Texas | 77074 | United States |
| Duramed Investigational Site | San Antonio | Texas | 78229 | United States |
| Duramed Investigational Site | Waco | Texas | 76712 | United States |
| Duramed Investigational Site | Williston | Vermont | 05495 | United States |
| Duramed Investigational Site | Newport News | Virginia | 23602 | United States |
| Duramed Investigational Site | Spokane | Washington | 99207 | United States |
| Duramed Investigational Site | Tacoma | Washington | 98405 | United States |
| FG002 | Placebo-a | 1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
| FG003 | Placebo-b | 2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
| COMPLETED |
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| NOT COMPLETED |
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|
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| ID | Title | Description |
|---|---|---|
| BG000 | DR-2041a | Synthetic Conjugated Estrogens, A (DR-2041)-1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
| BG001 | DR-2041b | Synthetic Conjugated Estrogens, A (DR-2041)-2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
| BG002 | Placebo-a | 1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter |
| BG003 | Placebo-b | 2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Age, Customized | Number | participants |
| ||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Mean Change in the Symptom Identified by the Patient to be Most Bothersome | Change= Week 12 score - Baseline Score. The most bothersome symptom was derived from the subject self-assessment of vaginal atrophy, which consisted of 5 questions concerning severity of symptoms graded on a scale of 0-3(none, mild, moderate or severe) or 7 for not applicable. | Modifed Intent-to-Treat: All subjects meeting study protocol requirements at baseline for all 3 primary efficacy inclusion criteria, randomized to treatment, received at least 1 dose of study drug, and had a baseline assessment and at least 1 post-randomization assessment of vulvovaginal atrophy consisting of all 3 co-primary efficacy endpoints | Posted | Least Squares Mean | Standard Error | Scores on a scale | Baseline to Week 12 |
|
|
| ||||||||||||||||||||||||||||||||||
| Primary | Mean Change in Vaginal pH | Change= Week 12 vaginal pH - Baseline vaginal pH | Modifed Intent-to-Treat: All subjects who met study protocol requirements at baseline for all 3 primary efficacy inclusion criteria, who were randomized to treatment, received at least 1 dose of study drug, for whom there were a baseline assessment and at least 1 post-randomization assessment of VVA consisting of all 3 co-primary efficacy endpoints | Posted | Least Squares Mean | Standard Error | pH | Baseline to Week 12 |
| ||||||||||||||||||||||||||||||||||||
| Primary | Mean Change in Maturation Index | Change= Week 12 maturation index -baseline maturation index. Matuation index was calculated using the following equation: Maturation Index = (% Parabasal cells * 0) + (% Intermediate Cells * 0.5) + (% Superficial Cells * 1.0) | Modifed Intent-to-Treat: All subjects who met study protocol requirements at baseline for all 3 primary efficacy inclusion criteria, who were randomized to treatment, received at least 1 dose of study drug, for whom there were a baseline assessment and at least 1 post-randomization assessment of VVA consisting of all 3 co-primary efficacy endpoints | Posted | Least Squares Mean | Standard Error | Index | Baseline to Week 12 |
| ||||||||||||||||||||||||||||||||||||
| Secondary | Safety and Tolerability of DR-2041 (Synthetic Conjugated Estrogens, A) | Any adverse event reported from the beginning of the 28-day screening through the subject's last report. | All randomized subjects who received at least one dose of study medication | Posted | Number | Participants | Up to Week 12 |
|
Adverse event reporting began on the first day of signing the informed consent and ended at the end of study drug treatment (approximately 16 weeks).
Adverse events were reported during the subject's regularly scheduled visits at the investigational site. Adverse events reported are those that emerged during the treatment period.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | DR-2041a | Synthetic Conjugated Estrogens, A (DR-2041)-1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter | 1 | 150 | 34 | 150 | ||
| EG001 | DR-2041b | Synthetic Conjugated Estrogens, A (DR-2041)-2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter | 1 | 161 | 36 | 161 | ||
| EG002 | Placebo-a | 1 gram administered vaginally daily for the 1st 7 days then twice a week thereafter | 1 | 155 | 18 | 155 | ||
| EG003 | Placebo-b | 2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter | 3 | 156 | 33 | 156 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cardiac Chest Pain | Cardiac disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Chronic Sinusitus | Infections and infestations | MedDRA (9.0) | Systematic Assessment |
| |
| Deep Vein Thrombosis | Vascular disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Hodgkin's Disease | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (9.0) | Systematic Assessment |
| |
| Hyponatraemia | Metabolism and nutrition disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Pulmonary Embolism | Respiratory, thoracic and mediastinal disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Ventricular Tachycardia | Cardiac disorders | MedDRA (9.0) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain | Gastrointestinal disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Genital Pruritus Female | Reproductive system and breast disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Hot Flush | Vascular disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA (9.0) | Systematic Assessment |
| |
| Upper Respiratory Tract Infection | Infections and infestations | MedDRA (9.0) | Systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | MedDRA (9.0) | Systematic Assessment |
| |
| Vulvovaginal Mycotic Infection | Infections and infestations | MedDRA (9.0) | Systematic Assessment |
|
The sponsor can (i) review results communications prior to public release and can embargo communications regarding trial results for a period of at least 60 days but no more than 180 days from the time submitted to the sponsor for review; and (ii) require in instances of a multi-center study, that a single PI not disclose study data until after the multi-center results are published, provided such results are published within eighteen (18) months of the conclusion of the study.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Duramed Research Protocol Chair | Duramed Research | 215-293-7279 | medicalaffairs@barrlabs.com |
| ID | Term |
|---|---|
| C509653 | estrogens, conjugated synthetic A |
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| Male |
|
|
|
| Placebo-b |
2 grams administered vaginally daily for the 1st 7 days then twice a week thereafter |
|
|
| Units | Counts |
|---|---|
| Participants |
|
|