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The purpose of this study is to evaluate elagolix (NBI-56418) compared to placebo for its effects on endometriosis related pelvic pain and its safety.
Participants were randomized (1:1) to 150 mg elagolix once daily or placebo once daily for the first 8 weeks of the study. Following 8 weeks of dosing, participants continued in the study for an additional 16 weeks in an open-label phase where all participants still enrolled in the study received 150 mg elagolix once daily.
There was no pre-specified primary efficacy end point for this study as there is no single key efficacy outcome measure in this exploratory Phase 2 study. However, the efficacy measures of primary interest included the daily assessment of dysmenorrhea, non-menstrual pelvic pain and dyspareunia on a 4-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe) using an e-Diary.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Elagolix 150 mg | Experimental | Participants received 150 mg elagolix orally once a day for 8 weeks during the double-blind treatment period and continued to receive 150 mg elagolix for 16 additional weeks during the open-label treatment period. |
|
| Placebo | Placebo Comparator | Participants received placebo orally once a day for 8 weeks during the double-blind treatment period and switched to receive 150 mg elagolix for 16 weeks during the open-label treatment period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Drug | Matching placebo tablets taken orally once a day |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in the Monthly Mean Dysmenorrhea Score During the Double-blind Treatment Phase | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an electronic diary (e-Diary) according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each visit. | Baseline and Weeks 4 and 8 |
| Change From Baseline in the Monthly Mean Dysmenorrhea Score During the Open-label and Posttreatment Phases | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an electronic diary (e-Diary) according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline in the Monthly Mean Non-menstrual Pelvic Pain Score During the Double-Blind Treatment Phase | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each visit. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With a Response in Monthly Mean Dysmenorrhea Score at Week 8 | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an e-Diary according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each time point. Response was defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| AbbVie Inc. | AbbVie | Study Director |
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The study consisted of up to 8 weeks of screening with data collection to establish baseline pain, an 8-week double-blind placebo-controlled treatment period, a 16-week open-label treatment period with all patients receiving elagolix 150 mg once per day, and a 6-week posttreatment follow-up period.
Participants were enrolled at 37 centers in the United States.
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Participants received placebo orally once a day for 8 weeks during the double-blind treatment period and switched to receive 150 mg elagolix for 16 weeks during the open-label treatment period. |
| FG001 | Elagolix 150 mg | Participants received 150 mg elagolix orally once a day for 8 weeks during the double-blind treatment period and continued to receive 150 mg elagolix for 16 additional weeks during the open-label treatment period. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Double-blind Treatment Phase (Weeks 1-8) |
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| Open-label Treatment Phase (Weeks 8-24) |
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Participants received placebo orally once a day for 8 weeks during the double-blind treatment period and switched to receive 150 mg elagolix for 16 weeks during the open-label treatment period. |
| BG001 | Elagolix 150 mg |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Change From Baseline in the Monthly Mean Dysmenorrhea Score During the Double-blind Treatment Phase | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an electronic diary (e-Diary) according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each visit. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and Weeks 4 and 8 |
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From the first dose of any study drug through week 24. The Placebo treatment group includes data for the 8-week double-blind treatment phase. The Elagolix treatment group included data for the total 24-week treatment period for participants initially randomized to elagolix, and 16-week open-label treatment period for participants initially randomized to placebo.
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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 | Placebo | Participants received placebo orally once a day for 8 weeks during the double-blind treatment period. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ABDOMINAL PAIN LOWER | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| NAUSEA | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Global Medical Services | AbbVie | 800-633-9110 |
| ID | Term |
|---|---|
| D004715 | Endometriosis |
| D010146 | Pain |
| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| C539351 | elagolix |
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| Elagolix |
| Drug |
Immediate release (IR) tablets taken orally once a day |
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| Baseline and weeks 4 and 8 |
| Change From Baseline in the Monthly Mean Non-menstrual Pelvic Pain Score During the Open-label and Posttreatment Phases | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline in the Monthly Mean Cumulative Pain Score During the Double-Blind Treatment Phase | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time each day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) reported during the 4 weeks prior to each visit. | Baseline and weeks 4 and 8 |
| Change From Baseline in the Monthly Mean Cumulative Pain Score During the Open-label and Posttreatment Phases | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time each day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline in the Monthly Mean Dyspareunia Score During the Double-Blind Treatment Phase | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each visit. Responses of "does not apply" were not included in the calculations. | Baseline and weeks 4 and 8 |
| Change From Baseline in the Monthly Mean Dyspareunia Score During the Open-label and Posttreatment Phases | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each visit, except for week 30 which is based on 6 weeks of data. Responses of "does not apply" were not included in the calculations. | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Baseline and Week 8 |
| Percentage of Participants With a Response in Monthly Mean Non-menstrual Pelvic Pain Score at Week 8 | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each time point. Response is defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | Baseline and Week 8 |
| Percentage of Participants With a Response in Monthly Mean Cumulative Pain Score at Week 8 | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time every day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) in the 4 weeks prior to each time point. Response is the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | Baseline and Week 8 |
| Percentage of Participants With a Response in Monthly Mean Dyspareunia Score at Week 8 | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each time point. Response is defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | Baseline and Week 8 |
| Change From Baseline in the Percentage of Days of Any Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of any analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of an analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 4 and 8 |
| Change From Baseline in the Percentage of Days of Any Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of any analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of an analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline in the Percentage of Days of Prescription Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of prescription analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of a prescription analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 4 and 8 |
| Change From Baseline in the Percentage of Days of Prescription Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of prescription analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of a prescription analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline in the Percentage of Days of Narcotic Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of narcotic analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of a narcotic analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 4 and 8 |
| Change From Baseline in the Percentage of Days of Narcotic Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of narcotic analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of a narcotic analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline to the End of the Double-blind Treatment Phase in Composite Pelvic Signs and Symptoms Score (CPSSS) Total Score and Component Scores | The CPSSS consists of 5 components that address dysmenorrhea, dyspareunia, non-menstrual pelvic pain, pelvic tenderness, and pelvic induration. Each component was scored on a scale of 0 to 3 (0 = absent, 1 = mild, 2 = moderate, and 3 = severe). Dysmenorrhea, dyspareunia, and non-menstrual pelvic pain scores are based on the participant's assessment of symptoms during the past 28 days; pelvic tenderness and induration were assessed by the investigator based on findings associated with a pelvic examination. The total CPSSS has a maximum possible value of 15 (total score range: 0 to 15, where a lower score indicates less signs and symptoms of endometriosis or better functioning). Individual component scores range from 0 (absent) to 3 (severe). | Baseline and Week 8 |
| Change From Baseline to the End of the Open-label Treatment Phase in Composite Pelvic Signs and Symptoms Score (CPSSS) Total Score and Component Scores | The CPSSS consists of 5 components that address dysmenorrhea, dyspareunia, non-menstrual pelvic pain, pelvic tenderness, and pelvic induration. Each component was scored on a scale of 0 to 3 (0 = absent, 1 = mild, 2 = moderate, and 3 = severe). Dysmenorrhea, dyspareunia, and non-menstrual pelvic pain scores are based on the participant's assessment of symptoms during the past 28 days; pelvic tenderness and induration were assessed by the investigator based on findings associated with a pelvic examination. The total CPSSS has a maximum possible value of 15 (total score range: 0 to 15, where a lower score indicates less signs and symptoms of endometriosis or better functioning). Individual component scores range from 0 (absent) to 3 (severe). | Baseline and week 24 |
| Patient Global Impression of Change During the Double-blind Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| Weeks 4 and 8 |
| Patient Global Impression of Change During the Open-Label and Posttreatment Phases | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Percentage of Participants With a PGIC Response of Much Improved or Very Much Improved During the Double-blind Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| Weeks 4 and 8 |
| Percentage of Participants With a PGIC Response of Much Improved or Very Much Improved During the Open-label Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
| Change From Baseline to the End of the Double-blind Treatment Phase in Endometriosis Health Profile-5 (EHP-5) | The EHP-5 is an instrument to measure health-related quality of life in women with endometriosis. The EHP-5 consists of two parts:
The scores associated with each possible outcome category are as follows: never (0), rarely (25), sometimes (50), often (75), and always (100). A negative change from baseline score indicates improvement in quality of life. | Baseline and week 8 |
| Change From Baseline to the End of the Open-label Treatment Phase in Endometriosis Health Profile-5 (EHP-5) | The EHP-5 is an instrument to measure health-related quality of life in women with endometriosis. The EHP-5 consists of two parts:
The scores associated with each possible outcome category are as follows: never (0), rarely (25), sometimes (50), often (75), and always (100). A negative change from baseline score indicates improvement in quality of life. | Baseline and week 24 |
| Percentage of Days With Uterine Bleeding During the Double- Blind Treatment Phase | Uterine bleeding was reported daily by participants during the study using the e-Diary. The percentage of days a participant reported any bleeding was calculated as the total number of days the participant reported any bleeding ( light, moderate, or heavy) divided by the total number of days the participant had a non-missing e-Diary report of vaginal bleeding in the phase. | Screening (8 weeks prior to day 1) and the double-blind treatment phase (Weeks 1-8) |
| Number of Days to First Posttreatment Menses | Defined as the number of days from the last dose of study drug until the start date of the first post-treatment menses. | From last day of study drug up to 6 weeks after the last dose. |
| Withdrawal by Subject |
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| Lack of Efficacy |
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| Lost to Follow-up |
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| Sponsor/Investigator Decision |
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| NOT COMPLETED |
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Participants received 150 mg elagolix orally once a day for 8 weeks during the double-blind treatment period and continued to receive 150 mg elagolix for 16 additional weeks during the open-label treatment period.
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| OG000 |
| Placebo |
Participants received placebo orally once a day for 8 weeks during the double-blind treatment period and switched to receive 150 mg elagolix for 16 weeks during the open-label treatment period. |
| OG001 | Elagolix 150 mg | Participants received 150 mg elagolix orally once a day for 8 weeks during the double-blind treatment period and continued to receive 150 mg elagolix for 16 additional weeks during the open-label treatment period. |
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| Primary | Change From Baseline in the Monthly Mean Dysmenorrhea Score During the Open-label and Posttreatment Phases | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an electronic diary (e-Diary) according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | units on a scale | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Primary | Change From Baseline in the Monthly Mean Non-menstrual Pelvic Pain Score During the Double-Blind Treatment Phase | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each visit. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and weeks 4 and 8 |
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| Primary | Change From Baseline in the Monthly Mean Non-menstrual Pelvic Pain Score During the Open-label and Posttreatment Phases | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | units on a scale | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Primary | Change From Baseline in the Monthly Mean Cumulative Pain Score During the Double-Blind Treatment Phase | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time each day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) reported during the 4 weeks prior to each visit. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and weeks 4 and 8 |
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| Primary | Change From Baseline in the Monthly Mean Cumulative Pain Score During the Open-label and Posttreatment Phases | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time each day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) reported during the 4 weeks prior to each visit, except for the week 30 value which is based on 6 weeks of data. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | units on a scale | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Primary | Change From Baseline in the Monthly Mean Dyspareunia Score During the Double-Blind Treatment Phase | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each visit. Responses of "does not apply" were not included in the calculations. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with non-missing data at each time point. If a participant's responses were all "does not apply" for that month the score was treated as missing. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and weeks 4 and 8 |
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| Primary | Change From Baseline in the Monthly Mean Dyspareunia Score During the Open-label and Posttreatment Phases | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each visit, except for week 30 which is based on 6 weeks of data. Responses of "does not apply" were not included in the calculations. | Randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12 and non-missing data at each time point. If a participant's responses were all "does not apply" for that month the score was treated as missing. | Posted | Mean | Standard Error | units on a scale | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Percentage of Participants With a Response in Monthly Mean Dysmenorrhea Score at Week 8 | Participants assessed dysmenorrhea (pain during menstruation) and its impact on their daily activities at approximately the same time each day of their period in an e-Diary according to the following response options:
The monthly mean dysmenorrhea score is the average of the daily values reported during the 4 weeks prior to each time point. Response was defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with non-missing data at baseline and week 8. | Posted | Number | percentage of participants | Baseline and Week 8 |
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| Secondary | Percentage of Participants With a Response in Monthly Mean Non-menstrual Pelvic Pain Score at Week 8 | Participants assessed their pelvic pain not related to menses and its impact on their daily activities at approximately the same time each day they were not having their period in an e-Diary according to the following response options:
The monthly mean non-menstrual pelvic pain score is the average of the daily values reported during the 4 weeks prior to each time point. Response is defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with non-missing data at baseline and week 8. | Posted | Number | percentage of participants | Baseline and Week 8 |
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| Secondary | Percentage of Participants With a Response in Monthly Mean Cumulative Pain Score at Week 8 | Participants assessed dysmenorrhea or non-menstrual pelvic pain at approximately the same time every day in an e-Diary according to the following:
The monthly mean cumulative pain score is the average of the daily values for all days (menstrual and non-menstrual) in the 4 weeks prior to each time point. Response is the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with non-missing data at baseline and week 8. | Posted | Number | percentage of participants | Baseline and Week 8 |
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| Secondary | Percentage of Participants With a Response in Monthly Mean Dyspareunia Score at Week 8 | Participants assessed their dyspareunia (pain during sexual intercourse) at approximately the same time every day in an e-Diary according to the following response options:
The monthly mean dyspareunia score is the average of the daily values reported during the 4 weeks prior to each time point. Response is defined as the percentage of participants with a percent decrease from baseline in the week 8 monthly mean score that was greater than or equal to each specified threshold value (10% through 90% in steps of 10%). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with non-missing data at baseline and week 8. If a participant's responses were all "does not apply" for that month the score was treated as missing. | Posted | Number | percentage of participants | Baseline and Week 8 |
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| Secondary | Change From Baseline in the Percentage of Days of Any Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of any analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of an analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | percentage of days | Baseline and Weeks 4 and 8 |
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| Secondary | Change From Baseline in the Percentage of Days of Any Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of any analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of an analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | percentage of days | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Change From Baseline in the Percentage of Days of Prescription Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of prescription analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of a prescription analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | percentage of days | Baseline and Weeks 4 and 8 |
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| Secondary | Change From Baseline in the Percentage of Days of Prescription Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of prescription analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of a prescription analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | percentage of days | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Change From Baseline in the Percentage of Days of Narcotic Analgesic Use During the Double-Blind Treatment Phase | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of narcotic analgesic use is defined as the number of days in the 4 weeks prior to each study visit that the participant reported the use of a narcotic analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | percentage of days | Baseline and Weeks 4 and 8 |
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| Secondary | Change From Baseline in the Percentage of Days of Narcotic Analgesic Use During the Open-Label and Posttreatment Phases | The daily use of endometriosis analgesics was reported by participants daily using the e-Diary. Participants reported whether the medication was over-the-counter (OTC) or prescription, and, if prescription, whether the medication was a narcotic. The percentage of days of narcotic analgesic use is defined as the number of days in the 4 weeks prior to each study visit (except for week 30 which is based on 6 weeks of data) that the participant reported the use of a narcotic analgesic, divided by the number of study days in the interval that the participant provided an e-Diary report regarding the use of endometriosis analgesics (including a response of "none"). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | percentage of days | Baseline and Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Change From Baseline to the End of the Double-blind Treatment Phase in Composite Pelvic Signs and Symptoms Score (CPSSS) Total Score and Component Scores | The CPSSS consists of 5 components that address dysmenorrhea, dyspareunia, non-menstrual pelvic pain, pelvic tenderness, and pelvic induration. Each component was scored on a scale of 0 to 3 (0 = absent, 1 = mild, 2 = moderate, and 3 = severe). Dysmenorrhea, dyspareunia, and non-menstrual pelvic pain scores are based on the participant's assessment of symptoms during the past 28 days; pelvic tenderness and induration were assessed by the investigator based on findings associated with a pelvic examination. The total CPSSS has a maximum possible value of 15 (total score range: 0 to 15, where a lower score indicates less signs and symptoms of endometriosis or better functioning). Individual component scores range from 0 (absent) to 3 (severe). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at baseline and week 8. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and Week 8 |
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| Secondary | Change From Baseline to the End of the Open-label Treatment Phase in Composite Pelvic Signs and Symptoms Score (CPSSS) Total Score and Component Scores | The CPSSS consists of 5 components that address dysmenorrhea, dyspareunia, non-menstrual pelvic pain, pelvic tenderness, and pelvic induration. Each component was scored on a scale of 0 to 3 (0 = absent, 1 = mild, 2 = moderate, and 3 = severe). Dysmenorrhea, dyspareunia, and non-menstrual pelvic pain scores are based on the participant's assessment of symptoms during the past 28 days; pelvic tenderness and induration were assessed by the investigator based on findings associated with a pelvic examination. The total CPSSS has a maximum possible value of 15 (total score range: 0 to 15, where a lower score indicates less signs and symptoms of endometriosis or better functioning). Individual component scores range from 0 (absent) to 3 (severe). | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 24. The analysis includes participants with non-missing data for each component at baseline and week 24. | Posted | Mean | Standard Error | units on a scale | Baseline and week 24 |
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| Secondary | Patient Global Impression of Change During the Double-blind Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Least Squares Mean | Standard Error | units on a scale | Weeks 4 and 8 |
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| Secondary | Patient Global Impression of Change During the Open-Label and Posttreatment Phases | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Mean | Standard Error | units on a scale | Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Percentage of Participants With a PGIC Response of Much Improved or Very Much Improved During the Double-blind Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at each time point. | Posted | Number | 95% Confidence Interval | percentage of participants | Weeks 4 and 8 |
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| Secondary | Percentage of Participants With a PGIC Response of Much Improved or Very Much Improved During the Open-label Treatment Phase | The Patient Global Impression of Change (PGIC) is a questionnaire-based assessment of the change in endometriosis pain since the initiation of study drug. The participant was asked to select from one of seven response categories:
| All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at each time point. | Posted | Number | percentage of participants | Weeks 12, 16, 20, 24, and 30 (6 weeks posttreatment) |
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| Secondary | Change From Baseline to the End of the Double-blind Treatment Phase in Endometriosis Health Profile-5 (EHP-5) | The EHP-5 is an instrument to measure health-related quality of life in women with endometriosis. The EHP-5 consists of two parts:
The scores associated with each possible outcome category are as follows: never (0), rarely (25), sometimes (50), often (75), and always (100). A negative change from baseline score indicates improvement in quality of life. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population). The analysis includes participants with non-missing data at baseline and week 8 for each question. | Posted | Mean | Standard Error | units on a scale | Baseline and week 8 |
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| Secondary | Change From Baseline to the End of the Open-label Treatment Phase in Endometriosis Health Profile-5 (EHP-5) | The EHP-5 is an instrument to measure health-related quality of life in women with endometriosis. The EHP-5 consists of two parts:
The scores associated with each possible outcome category are as follows: never (0), rarely (25), sometimes (50), often (75), and always (100). A negative change from baseline score indicates improvement in quality of life. | All randomized participants who received at least 1 dose of study drug and had at least 10 evaluable e-Diary reports during the double-blind period (intent-to-treat population) with data on or after Week 12. The analysis includes participants with non-missing data at baseline and week 24 for each question. | Posted | Mean | Standard Error | units on a scale | Baseline and week 24 |
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| Secondary | Percentage of Days With Uterine Bleeding During the Double- Blind Treatment Phase | Uterine bleeding was reported daily by participants during the study using the e-Diary. The percentage of days a participant reported any bleeding was calculated as the total number of days the participant reported any bleeding ( light, moderate, or heavy) divided by the total number of days the participant had a non-missing e-Diary report of vaginal bleeding in the phase. | Participants who received at least one dose of randomized, double-blind study drug (safety analysis set) with non-missing data. | Posted | Mean | Standard Error | percentage of days | Screening (8 weeks prior to day 1) and the double-blind treatment phase (Weeks 1-8) |
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| Secondary | Number of Days to First Posttreatment Menses | Defined as the number of days from the last dose of study drug until the start date of the first post-treatment menses. | Participants who received at least one dose of randomized, double-blind study drug (safety analysis set) with non-missing post-treatment data. | Posted | Median | Full Range | days | From last day of study drug up to 6 weeks after the last dose. |
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|
| 0 |
| 69 |
| 3 |
| 69 |
| 13 |
| 69 |
| EG001 | Elagolix | Participants initially randomized to elagolix received 150 mg elagolix orally once a day for 8 weeks during the double-blind treatment period and continued to receive 150 mg elagolix for 16 additional weeks during the open-label treatment period. Participants originally randomized to placebo were switched to receive 150 mg elagolix for 16 weeks during the open-label treatment period. | 0 | 131 | 1 | 131 | 49 | 131 |
| CONVULSION | Nervous system disorders | MedDRA (6.1) | Systematic Assessment |
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| ABORTION SPONTANEOUS | Pregnancy, puerperium and perinatal conditions | MedDRA (6.1) | Systematic Assessment |
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| DEPRESSION SUICIDAL | Psychiatric disorders | MedDRA (6.1) | Systematic Assessment |
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| NASOPHARYNGITIS | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
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| SINUSITIS | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
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| UPPER RESPIRATORY TRACT INFECTION | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
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| HEADACHE | Nervous system disorders | MedDRA (6.1) | Systematic Assessment |
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| HOT FLUSH | Vascular disorders | MedDRA (6.1) | Systematic Assessment |
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AbbVie requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. AbbVie requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if AbbVie needs to secure patent or proprietary protection.
| D000091662 | Genital Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| Week 16 |
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| Week 20 |
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| Week 24 |
|
|
| Week 30 |
|
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0066 |
| LS Mean Difference |
| -0.28 |
| Standard Error of the Mean |
| 0.101 |
| 2-Sided |
| 95 |
| -0.48 |
| -0.08 |
| Superiority |
| Week 16 |
|
|
| Week 20 |
|
|
| Week 24 |
|
|
| Week 30 |
|
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0011 |
| LS Mean Difference |
| -0.33 |
| Standard Error of the Mean |
| 0.100 |
| 2-Sided |
| 95 |
| -0.53 |
| -0.14 |
| Superiority |
| Week 16 |
|
|
| Week 20 |
|
|
| Week 24 |
|
|
| Week 30 |
|
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0070 |
| LS Mean Difference |
| -0.38 |
| Standard Error of the Mean |
| 0.137 |
| 2-Sided |
| 95 |
| -0.65 |
| -0.11 |
| Superiority |
| Week 16 |
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| Week 20 |
|
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| Week 24 |
|
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| Week 30 |
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| 30% Reduction |
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| 40% Reduction |
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| 50% Reduction |
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| 60% Reduction |
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| 70% Reduction |
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| 80% Reduction |
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| 90% Reduction |
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| 30% Reduction |
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| 40% Reduction |
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| 50% Reduction |
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| 60% Reduction |
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| 70% Reduction |
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| 80% Reduction |
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| 90% Reduction |
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| 30% Reduction |
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| 40% Reduction |
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| 50% Reduction |
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| 60% Reduction |
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| 70% Reduction |
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| 80% Reduction |
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| 90% Reduction |
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| 30% Reduction |
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| 40% Reduction |
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| 50% Reduction |
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| 60% Reduction |
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| 70% Reduction |
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| 80% Reduction |
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| 90% Reduction |
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0019 |
| LS Mean Difference |
| -12.44 |
| Standard Error of the Mean |
| 3.913 |
| 2-Sided |
| 95 |
| -20.19 |
| -4.70 |
| Superiority |
| Week 16 |
|
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| Week 20 |
|
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| Week 24 |
|
|
| Week 30 |
|
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0141 |
| LS Mean Difference |
| -6.35 |
| Standard Error of the Mean |
| 2.549 |
| 2-Sided |
| 95 |
| -11.39 |
| -1.30 |
| Superiority |
| Week 16 |
|
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| Week 20 |
|
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| Week 24 |
|
|
| Week 30 |
|
|
| Week 8 |
|
|
Comparison of change from baseline at week 8
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| 0.0720 |
| LS Mean Difference |
| -3.52 |
| Standard Error of the Mean |
| 1.938 |
| 2-Sided |
| 95 |
| -7.35 |
| 0.32 |
| Superiority |
| Week 16 |
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| Week 20 |
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| Week 24 |
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| Week 30 |
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| Dysmenorrhea Component |
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| Non-menstrual Pelvic Pain Component |
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| Dyspareunia Component |
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| Pelvic Tenderness Component |
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| Pelvic Induration Component |
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|
Comparison of change from baseline in CPSSS component of dysmenorrhea score |
| ANCOVA |
ANCOVA model including baseline value as a covariate. |
| < 0.0001 |
| LS Mean Difference |
| -1.05 |
| Standard Error of the Mean |
| 0.180 |
| 2-Sided |
| 95 |
| -1.41 |
| -0.69 |
| Superiority |
| Comparison of change from baseline in CPSSS component of non-menstrual pelvic pain score | ANCOVA | ANCOVA model including baseline value as a covariate. | 0.0139 | LS Mean Difference | -0.36 | Standard Error of the Mean | 0.143 | 2-Sided | 95 | -0.64 | -0.07 | Superiority |
| Comparison of change from baseline in CPSSS component of dyspareunia score | ANCOVA | ANCOVA model including baseline value as a covariate. | 0.1052 | LS Mean Difference | -0.28 | Standard Error of the Mean | 0.173 | 2-Sided | 95 | -0.63 | 0.06 | Superiority |
| Comparison of change from baseline in CPSSS component of pelvic tenderness score | ANCOVA | ANCOVA model including baseline value as a covariate. | 0.0081 | LS Mean Difference | -0.39 | Standard Error of the Mean | 0.143 | 2-Sided | 95 | -0.67 | -0.10 | Superiority |
| Comparison of change from baseline in CPSSS component of induration score | ANCOVA | ANCOVA model including baseline value as a covariate. | 0.0240 | LS Mean Difference | -0.29 | Standard Error of the Mean | 0.125 | 2-Sided | 95 | -0.53 | -0.04 | Superiority |
| Dysmenorrhea Component |
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| Non-menstrual Pelvic Pain Component |
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| Dyspareunia Component |
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| Pelvic Tenderness Component |
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| Pelvic Induration Component |
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| Week 8 |
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| ANOVA |
| 0.0002 |
| LS Mean Difference |
| -1.0 |
| Standard Error of the Mean |
| 0.26 |
| 2-Sided |
| 95 |
| -1.5 |
| -0.5 |
| Superiority |
| Week 16 |
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| Week 20 |
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| Week 24 |
|
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| Week 30 |
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| Week 8 |
|
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| 0.0007 |
| Difference |
| 30.2 |
| 2-Sided |
| 95 |
| 13.6 |
| 46.7 |
| Superiority |
| Week 16 |
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| Week 20 |
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| Week 24 |
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| Week 30 |
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| Control and Powerlessness |
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| Emotional Well-being |
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| Social Support |
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| Self-image |
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| Work |
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| Relationship with Children |
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| Sexual Intercourse |
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| Medical Profession |
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| Frustration with Treatment |
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| Concerns with Infertility |
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| Control and Powerlessness |
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| Emotional Well-being |
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| Social Support |
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| Self-image |
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| Work |
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| Relationship with Children |
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| Sexual Intercourse |
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| Medical Profession |
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| Frustration with Treatment |
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| Concerns with Infertility |
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| Double-Blind Treatment Phase (Weeks 1-8) |
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