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The purpose of ZA-301 is to determine the effects of Androxal on morning testosterone and reproductive status in younger overweight men with acquired hypogonadotropic hypogonadism (confirmed morning T<300 ng/dL) and normal sperm concentration, compared to changes with placebo. Subjects must not have previously been treated with testosterone products within the last 6 months.
Protocol ZA-301 is a randomized, double-blind, placebo-controlled multi-center Phase 3 study to evaluate normalization of morning testosterone levels in overweight men with acquired hypogonadotropic hypogonadism and normal baseline sperm concentrations. The study requires 10 to 12 clinic visits (2 for eye exams), and is approximately 4 to 5½ months in duration. Subjects will be treated for 12-18 weeks. At Visit 3 (Week 6) subjects who do not achieve morning T values ≥300 ng/dL will be up-titrated to 25 mg. Placebo subjects may be sham titrated. Up-titrated subjects will receive an additional 6 weeks of treatment (18 weeks total). A schedule of procedures and assessments is displayed in Section 4. The study will enroll up to 152 male subjects, up to 114 randomized to treatment with Androxal and up to 38 randomized to placebo, in a 3:1 ratio. Subjects must not have used any prior testosterone treatments within the last 6 months.
Eligible subjects must have 2 consecutive assessments of morning T below 300 ng/dL and LH below 9.4 mIU/mL. They will provide 2 sperm samples at baseline, at least 2 days apart, another 2 after 12 weeks of treatment, and up-titrated subjects will provide an additional 2 samples at the end of treatment. After 12 weeks of treatment (V5) all subjects will undergo serial T assessment for determination of the Cavg. Safety assessments will include collection of adverse events, eye examinations, physical examinations and clinical laboratory assessments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Androxal 12.5 mg | Experimental | Androxal (enclomiphene citrate), 12.5 mg oral capsules taken once daily |
|
| Androxal 25 mg | Experimental | Androxal (enclomiphene citrate), 25 mg oral capsules taken once daily |
|
| Placebo | Placebo Comparator | Placebo oral capsules taken one time daily |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Androxal | Drug | oral, capsules, taken one time daily, for 3 months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion (Percentage) of Androxal Treated Subjects With Testosterone in the Normal Range | Proportion of pooled Androxal subjects with average serum concentration (Cavg) for T in the normal range (300 - 1040 ng/dL) after 12 weeks of treatment. Cavg will be calculated as the numerical average of 24-hour serial testosterone assessments at 0, 1, 2, 3, 4, 6, 8, 12, 16 and 24 hours after dosing. If the lower limit of the 95% confidence interval for the Androxal treatment group at Week 12 is at least 67%, then the co-primary endpoint based on the Cavg for testosterone has been achieved. FDA specified primary endpoint did not include comparison to placebo, thus the proportion of placebo subjects with average serum concentration (Cavg) for T in the normal range (300 - 1040 ng/dL) after 12 weeks of treatment was not calculated. | 3 months |
| Subjects With 50% or Greater Decrease in Sperm Concentration Comparison of Proportion of Subjects With 50% or Greater Decrease in Sperm | Proportion of subjects with a 50% or greater decrease in sperm concentration from baseline after 12 weeks of treatment in Androxal treated subjects to placebo. The difference between the proportions (placebo minus Androxal) and corresponding 95% confidence interval was determined and compared to the equivalence limit of -20%. If the lower limit of the 95% confidence interval was greater than -20%, then Androxal would be concluded to be non-inferior to placebo in causing a 50% reduction in sperm concentrations. | 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joseph S Podolski | Repros Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Coastal Clinical Research | Mobile | Alabama | 36608 | United States | ||
| Baptist Health Center for Clinical Research |
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| Label | URL |
|---|---|
| Sponsor home page | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Androxal 12.5 mg | Androxal (enclomiphene citrate), 12.5 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months Subjects with morning testosterone <300ng/dL after 6 weeks of treatment were up-titrated to 25 mg/day |
| FG001 | Androxal 25 mg |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Placebo | Drug | Oral capsule taken one time daily for 3 months |
|
|
| Little Rock |
| Arkansas |
| 72205 |
| United States |
| SC Clinical Research | Garden Grove | California | 92844 | United States |
| Mission Internal Medicine Group | Mission Viejo | California | 92691 | United States |
| Rancho Cucamonga Clinical Trials | Rancho Cucamonga | California | 91730 | United States |
| San Diego Sexual Medicine | San Diego | California | 92120 | United States |
| West Coast Clinical Research | Tarzana | California | 91356 | United States |
| Florida Fertility Institute | Clearwater | Florida | 33759 | United States |
| Tampa Bay Medical Research | Clearwater | Florida | 33761 | United States |
| ALL Medical Research | Cooper City | Florida | 33024 | United States |
| Clinical Research of South Florida | Coral Gables | Florida | 33134 | United States |
| Therafirst Medical Center | Fort Lauderdale | Florida | 33308 | United States |
| Well Pharma Medical Research Group | Miami | Florida | 33143 | United States |
| Phase One Solutions | Miami Gardens | Florida | 33169 | United States |
| Meridien Research | St. Petersburg | Florida | 33709 | United States |
| Central Kentucky Research Associates | Lexington | Kentucky | 40509 | United States |
| Clinical Research Advantage | Henderson | Nevada | 89052 | United States |
| Premier Urology Associates | Lawrenceville | New Jersey | 08648 | United States |
| Rochester Clinical Research | Rochester | New York | 14609 | United States |
| Coastal Carolina Research Center | Mt. Pleasant | South Carolina | 29464 | United States |
| New Orleans Center for Clinical Research | Knoxville | Tennessee | 37920 | United States |
| Lone Peak Family Medicine | Draper | Utah | 84020 | United States |
| Granger Medical Clinic | West Valley City | Utah | 84120 | United States |
Androxal (enclomiphene citrate), 25 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months |
| FG002 | Placebo | Placebo oral capsules taken one time daily Placebo: Oral capsule taken one time daily for 3 months |
| COMPLETED |
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| NOT COMPLETED |
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Analyses were conducted on the following populations: ITT (all subjects enrolled), mITT (all ITT subjects except site 09), PP (all ITT subjects who completed Week 12) and Safety (all subjects who received any study drug)
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| ID | Title | Description |
|---|---|---|
| BG000 | Androxal 12.5 mg | Androxal (enclomiphene citrate), 12.5 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months Subjects with morning testosterone <300ng/dL after 6 weeks of treatment were up-titrated to 25 mg/day |
| BG001 | Androxal 25 mg | Androxal (enclomiphene citrate), 25 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months |
| BG002 | Placebo | Placebo oral capsules taken one time daily Placebo: Oral capsule taken one time daily for 3 months |
| BG003 | 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 |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||
| BMI | Mean | Standard Deviation | Kg/m^2 |
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| 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 | Proportion (Percentage) of Androxal Treated Subjects With Testosterone in the Normal Range | Proportion of pooled Androxal subjects with average serum concentration (Cavg) for T in the normal range (300 - 1040 ng/dL) after 12 weeks of treatment. Cavg will be calculated as the numerical average of 24-hour serial testosterone assessments at 0, 1, 2, 3, 4, 6, 8, 12, 16 and 24 hours after dosing. If the lower limit of the 95% confidence interval for the Androxal treatment group at Week 12 is at least 67%, then the co-primary endpoint based on the Cavg for testosterone has been achieved. FDA specified primary endpoint did not include comparison to placebo, thus the proportion of placebo subjects with average serum concentration (Cavg) for T in the normal range (300 - 1040 ng/dL) after 12 weeks of treatment was not calculated. | ITT population. | Posted | Number | 95% Confidence Interval | Percentage of Subjects | 3 months | 12.5 and 25 mg pooled | Participants |
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| Primary | Subjects With 50% or Greater Decrease in Sperm Concentration Comparison of Proportion of Subjects With 50% or Greater Decrease in Sperm | Proportion of subjects with a 50% or greater decrease in sperm concentration from baseline after 12 weeks of treatment in Androxal treated subjects to placebo. The difference between the proportions (placebo minus Androxal) and corresponding 95% confidence interval was determined and compared to the equivalence limit of -20%. If the lower limit of the 95% confidence interval was greater than -20%, then Androxal would be concluded to be non-inferior to placebo in causing a 50% reduction in sperm concentrations. | ITT. | Posted | Number | percentage of participants | 3 months |
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For subjects not up-titrated 13 weeks (one week follow up after end of treatment). For subjects up-titrated 18 weeks plus one week of follow up.
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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 | Androxal 12.5 mg | Androxal (enclomiphene citrate), 12.5 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months | 0 | 92 | 5 | 92 | ||
| EG001 | Androxal 25 mg | Androxal (enclomiphene citrate), 25 mg oral capsules taken once daily enclomiphene citrate: oral, capsules, taken one time daily, for 3 months | 0 | 21 | 6 | 21 | ||
| EG002 | Placebo | Placebo oral capsules taken one time daily Placebo: Oral capsule taken one time daily for 3 months | 0 | 38 | 4 | 38 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Palpitations | Cardiac disorders | MedDRA | Systematic Assessment |
| |
| Ocular discomfort | Eye disorders | MedDRA | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA | Systematic Assessment |
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| Upper respiratort tract infection | Infections and infestations | MedDRA | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA | Systematic Assessment |
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Investigator shall submit a copy of proposed publication. Sponsor shall have sixty (60) days (or such longer period as Sponsor shall determine is necessary) to review the proposed publication and, upon request, Investigator shall delete any of Sponsor's Confidential Information or withhold submission of such publication.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jennifer L Wike, Director of Regulatory Affairs | Repros Therapeutics Inc. | 281-719-3402 | jwike@reprosrx.com |
| ID | Term |
|---|---|
| D007006 | Hypogonadism |
| ID | Term |
|---|---|
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D064695 | Enclomiphene |
| ID | Term |
|---|---|
| D002996 | Clomiphene |
| D013267 | Stilbenes |
| D001597 | Benzylidene Compounds |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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| Male |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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