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| ID | Type | Description | Link |
|---|---|---|---|
| 2017-001632-19 | EudraCT Number |
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The purpose of this study is to determine the benefit and safety of relugolix 40 milligrams (mg) once daily, co-administered with low-dose estradiol (E2) and norethindrone acetate (NETA) compared with placebo for 24 weeks, on dysmenorrhea and on nonmenstrual pelvic pain.
This study is an international phase 3 randomized, double-blind, placebo-controlled efficacy and safety study to evaluate 24 weeks of oral, once-daily relugolix (40 mg) co-administered with either 12 or 24 weeks of low-dose E2 (1.0 mg) and NETA (0.5 mg), compared with placebo.
Approximately 600 women with endometriosis-associated pain were enrolled and randomized 1:1:1 to Group A - relugolix plus low-dose hormonal add-back therapy, Group B - relugolix monotherapy for 12 weeks followed by co-administration with low-dose hormonal add-back therapy, or Group C - placebo (N = 200 per group).
Eligible participants were randomized on Baseline Day 1 to Treatment Group A, B, or C, in the double-blind period.
Eligible participants, including those randomized to placebo, were offered the opportunity to enroll in an 80-week open label extension study where participants received relugolix co-administered with low-dose E2 and NETA. Participants who did not enroll into the extension study had a Follow-Up visit approximately 30 days after the participant's last dose of study drug.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Relugolix plus E2/NETA (Group A) | Experimental | Relugolix co-administered with E2/NETA for 24 weeks. |
|
| Relugolix plus Delayed E2/NETA (Group B) | Experimental | Relugolix co-administered with E2/NETA placebo for 12 weeks, followed by relugolix co-administered with E2/NETA for 12 weeks. |
|
| Placebo (Group C) | Placebo Comparator | Relugolix placebo co-administered with E2/NETA placebo for 24 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Relugolix | Drug | Relugolix 40-mg tablet administered orally once daily. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage Of Participants Who Meet The Dysmenorrhea Responder Criteria At Week 24 Or End Of Treatment (EOT) | Assessed using a Numerical Rating Scale (NRS) score (11-point scale) for pain recorded daily in an electronic diary (e-Diary). The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Week 24 or EOT |
| Percentage Of Participants Who Meet The Non-Menstrual Pelvic Pain (NMPP) Responder Criteria At Week 24 Or EOT | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Week 24 or EOT |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline In The Endometriosis Health Profile (EHP)-30 Pain Score At Week 24 | Assessed using the Pain Domain of the EHP-30 questionnaire. | Baseline, Week 24 |
| Change From Baseline In Dysmenorrhea NRS Score At Week 24 Or EOT |
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Key Inclusion Criteria:
Is a premenopausal female aged 18 to 50 years old (inclusive) on the day of signing of the informed consent form.
Has agreed to use only study-specified analgesic medications during the study and is not known to be intolerant to these.
Has a diagnosis of endometriosis and has had, within 10 years prior to signing the informed consent form, surgical or direct visualization and/or histopathologic confirmation of endometriosis, for example, during a laparoscopy or laparotomy.
During the Run-In Period (35 to 70 days prior to treatment period) has a dysmenorrhea NRS score ≥ 4.0 on at least 2 days and
Key Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Myovant Medical Monitor | Myovant Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Andalusia | Andalusia | Alabama | 36420 | United States | ||
| Washington DC |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37982388 | Derived | Giudice LC, As-Sanie S, Arjona Ferreira JC, Becker CM, Abrao MS, Lessey BA, Dynowski K, Wilk K, Li Y, Mathur V, Wagman RB, Johnson NP. A Plain Language Summary to learn about relugolix combination therapy for the treatment of pain associated with endometriosis. Pain Manag. 2023 Nov;13(11):631-640. doi: 10.2217/pmt-2023-0052. Epub 2023 Nov 20. | |
| 37283994 |
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| Estradiol/norethindrone acetate | Drug | Capsule containing co-formulated tablet of E2 (1.0 mg)/NETA (0.5 mg) administered orally once daily. |
|
|
| Estradiol/norethindrone acetate placebo | Drug | E2 (0 mg)/NETA (0 mg) placebo capsule administered orally once daily and designed to match the E2/NETA capsule in size, shape, color, and odor. |
|
| Relugolix placebo | Drug | Relugolix (0 mg) placebo tablet administered orally once daily and manufactured to match the relugolix tablet in size, shape, color, and odor. |
|
Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary.
| Baseline, Week 24 or EOT |
| Change From Baseline In NMPP NRS Score At Week 24 Or EOT | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Change From Baseline In Overall Pelvic Pain NRS Score At Week 24 Or EOT | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Change From Baseline In Dyspareunia NRS Scores At Week 24 Or EOT | Assessed using an NRS score (11-point scale) for dyspareunia recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Percentage Of Participants Who Are Not Using Opioids For Endometriosis-associated Pain At Week 24 Or EOT | Assessed based on usage of protocol-specified opioids for endometriosis-associated pain recorded daily in an e-Diary. | Week 24 or EOT |
| Change From Baseline In Analgesic Use For Endometriosis-associated Pain Based On Mean Pill Count At Week 24 Or EOT | Assessed based on usage of protocol-specified analgesic for endometriosis-associated pain recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Percentage Of Participants Who Have A Reduction Of At Least 20 Points In The EHP-30 Pain Domain From Baseline To Week 24 | Assessed using the pain domain of the EHP-30 questionnaire. | Baseline to Week 24 |
| Dysmenorrhea Responder Rate By Month | The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Baseline to Week 24 |
| NMPP Responder Rate By Month | The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Baseline to Week 24 |
| Change In Dysmenorrhea NRS Score By Month | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline to Week 24 |
| Change In NMPP NRS Score By Month | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline to Week 24 |
| Change In Overall Pelvic Pain NRS Score By Month | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline to Week 24 |
| Change In Dyspareunia NRS Score By Month | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. | Baseline to Week 24 |
| Change From Baseline In Ibuprofen Use At Week 24 Or EOT | Assessed using ibuprofen pill counts for endometriosis-associated pain recorded daily in an e-Diary. | Baseline, Week 24 |
| Change From Baseline In Opioid Use At Week 24 Or EOT | Assessed using opioid pill counts for endometriosis-associated pain recorded daily in an e-Diary. | Baseline, Week 24 |
| Change From Baseline In The Mean Dysmenorrhea Functional Impairment At Week 24 Or EOT | Assessed using the subject modified Biberoglu and Behrman 5-point scale for dysmenorrhea recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Change From Baseline In The Mean NMPP Functional Impairment At Week 24 Or EOT | Assessed using the subject modified Biberoglu and Behrman 4-point scale for pelvic pain recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Change From Baseline In The Mean Dyspareunia Functional Impairment At Week 24 Or EOT | Assessed using the subject modified Biberoglu and Behrman 5-point scale for dyspareunia recorded daily in an e-Diary. | Baseline, Week 24 or EOT |
| Change From Baseline In Patient Global Assessment (PGA) For Dysmenorrhea Symptom Severity At Week 24 | The PGA for dysmenorrhea is a 1-item questionnaire designed to assess participants' impression of the severity of pain during their menstrual cycle. | Baseline, Week 24 |
| Percentage Of Participants With Improvement, No Change, Or Worsening From Baseline In PGA For Dysmenorrhea At Week 24 | The PGA for dysmenorrhea is a 1-item questionnaire designed to assess participants' impression of the severity of pain during their menstrual cycle. | Week 24 |
| Change From Baseline In PGA For NMPP Symptom Severity At Week 24 | The PGA for NMPP is a 1-item questionnaire designed to assess participants' impression of the severity of pain when they are not menstruating. | Baseline, Week 24 |
| Percentage Of Participants With Improvement, No Change, Or Worsening From Baseline In PGA For NMPP At Week 24 | The PGA for NMPP is a 1-item questionnaire designed to assess participants' impression of the severity of pain when they are not menstruating. | Week 24 |
| Change From Baseline In PGA For Pain Severity At Week 24 | The PGA for pain severity is a 1-item questionnaire designed to assess participants' impression of how their pain affected their usual activities. | Baseline, Week 24 |
| Percentage Of Participants With Improvement, No Change, Or Worsening From Baseline In PGA For Pain Severity At Week 24 | The PGA for pain severity is a 1-item questionnaire designed to assess participants' impression of how their pain affected their usual activities. | Week 24 |
| Change From Baseline In PGA For Function At Week 24 | The PGA for function is a 1-item questionnaire designed to assess participants' impression of how their pain affected their usual activities. | Baseline, Week 24 |
| Percentage Of Participants With Improvement, No Change, Or Worsening From Baseline In PGA For Function At Week 24 | The PGA for function is a 1-item questionnaire designed to assess participants' impression of how their pain affected their usual activities. | Week 24 |
| Percentage Of Participants Who Are "Better" Or "Much Better" On The Patient Global Impression Of Change (PGIC) For Dysmenorrhea At Week 24 | The PGIC for dysmenorrhea is a 1-item questionnaire designed to assess participants' impression of change in the severity of pain during their menstrual cycle. | Week 24 |
| Percentage Of Participants Who Are "Better" Or "Much Better" On The PGIC For NMPP At Week 24 | The PGIC for NMPP is a 1-item questionnaire designed to assess participants' impression of change in the severity of pain during their menstrual cycle. | Week 24 |
| Percentage Of Participants Who Are "Better" Or "Much Better" On The PGIC For Dyspareunia At Week 24 | The PGIC for dyspareunia is a 1-item questionnaire designed to assess participants' impression of change in the severity of pain during sexual intercourse. | Week 24 |
| Change From Baseline In The Non-Pain Of The EHP-30 Domains At Week 24 | Assessed using the non-pain domains (Control and Powerlessness, Social Support, Emotional Well-Being, and Self-Image) of the EHP-30 questionnaire. | Baseline, Week 24 |
| Change From Baseline In The EHP-30 Scale Total Score At Week 24 | Assessed using the total score of the EHP-30 questionnaire. | Baseline, Week 24 |
| Change From Baseline In The EHP Work Domain Score At Week 24 | The EHP Work domain is a 5-item questionnaire that assesses impact of pain on ability to work. | Baseline, Week 24 |
| Categorical Change From Baseline In Quality Of Life Assessed By European Quality Of Life Five Dimension Five Level (EQ-5D-5L) Questionnaire At Week 24 | The EQ-5D-5L is a 5-item questionnaire designed to assess quality of life. | Baseline, Week 24 |
| Change From Baseline To Week 24 In EQ-5D-5L Visual Analogue Scale Score At Week 24 | The EQ-5D-5L is a 5-item questionnaire designed to assess quality of life. | Baseline, Week 24 |
| Percentage Of Participants Who Meet The Dysmenorrhea Responder Criteria At Week 24 Or EOT For Relugolix Plus Delayed E2/NETA | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Week 24 or EOT |
| Percentage Of Participants Who Meet The NMPP Responder Criteria At Week 24 Or EOT For Relugolix Plus Delayed E2/NETA | Assessed using an NRS score (11-point scale) for pain recorded daily in an e-Diary. The criteria for a responder was based on a pre-defined threshold and accounted for analgesic use. | Week 24 or EOT |
| Change From Baseline In The EHP-30 Pain Score At Week 24 For Relugolix Plus Delayed E2/NETA | Assessed using the Pain Domain of the EHP-30 questionnaire. | Baseline, Week 24 |
| Percentage Of Participants Who Have A Reduction Of At Least 20 Points In The EHP-30 Pain Domain From Baseline To Week 24 For Relugolix Plus Delayed E2/NETA | Assessed using the pain domain of the EHP-30 questionnaire. | Baseline to Week 24 |
| Percentage Change From Baseline In Bone Mineral Density At The Lumbar Spine (L1-L4) At Week 12 | Assessed by dual-energy X-ray absorptiometry (DXA) scan. | Baseline, Week 12 |
| Percentage Change From Baseline In Bone Mineral Density At Lumbar Spine (L1-L4), Femoral Neck, And Total Hip At Week 24 | Assessed by DXA scan. | Baseline, Week 24 |
| Percentage Of Participants Experiencing Vasomotor Symptoms At Week 12 Between Group A And B | Week 12 |
| Change From Baseline In Serum Concentrations Of Luteinizing Hormone, Follicle Stimulating Hormone, Estradiol, And Progesterone | Blood samples will be collected from participants for hormonal measurements. | Baseline, Week 24 |
| Washington D.C. |
| District of Columbia |
| 20036 |
| United States |
| Aventura | Aventura | Florida | 33180 | United States |
| Deland | DeLand | Florida | 32720 | United States |
| Hialeah | Hialeah | Florida | 33012 | United States |
| Hialeah | Hialeah | Florida | 33016 | United States |
| Margate | Margate | Florida | 33063 | United States |
| Miami | Miami | Florida | 33176 | United States |
| Port St. Lucie | Port Saint Lucie | Florida | 34952 | United States |
| Tampa | Tampa | Florida | 33606 | United States |
| Atlanta | Atlanta | Georgia | 30312 | United States |
| Idaho Falls | Idaho Falls | Idaho | 83404 | United States |
| Park Ridge | Park Ridge | Illinois | 60068 | United States |
| Lafayette | Lafayette | Indiana | 47905 | United States |
| Covington | Covington | Louisiana | 70433 | United States |
| Marrero | Marrero | Louisiana | 70072 | United States |
| Towson | Towson | Maryland | 21204 | United States |
| Saginaw | Saginaw | Michigan | 48602 | United States |
| St. Louis | St Louis | Missouri | 63141 | United States |
| Omaha | Omaha | Nebraska | 68124 | United States |
| Albuquerque | Albuquerque | New Mexico | 87102 | United States |
| New York | New York | New York | 10038 | United States |
| New Bern | New Bern | North Carolina | 28562 | United States |
| Akron | Akron | Ohio | 44313 | United States |
| Columbus | Columbus | Ohio | 43231 | United States |
| Columbus | Columbus | Ohio | 43235 | United States |
| Franklin | Franklin | Ohio | 45005 | United States |
| Columbia | Columbia | South Carolina | 29201 | United States |
| Spartanburg | Spartanburg | South Carolina | 29301 | United States |
| Chattanooga | Chattanooga | Tennessee | 37404 | United States |
| Beaumont | Beaumont | Texas | 77702 | United States |
| Corpus Christi | Corpus Christi | Texas | 78412 | United States |
| Dallas | Dallas | Texas | 75231 | United States |
| Fort Worth | Fort Worth | Texas | 76104 | United States |
| Houston | Houston | Texas | 77054 | United States |
| Irving | Irving | Texas | 75062 | United States |
| San Antonio | San Antonio | Texas | 78258 | United States |
| Sugar Land | Sugar Land | Texas | 77479 | United States |
| Pleasant Grove | Pleasant Grove | Utah | 84062 | United States |
| Salt Lake City | Salt Lake City | Utah | 84102 | United States |
| Virginia Beach | Virginia Beach | Virginia | 23502 | United States |
| Sydney | Sydney | New South Wales | 2000 | Australia |
| Wollongong | Wollongong | New South Wales | 2522 | Australia |
| Sherwood | Sherwood | Queensland | 4075 | Australia |
| Adelaide | Adelaide | South Australia | 5000 | Australia |
| Nedlands | Nedlands | Western Australia | 6009 | Australia |
| Passo Fundo | Passo Fundo | Rio Grande do Sul | 99010-080 | Brazil |
| Porto Alegre | Porto Alegre | Rio Grande do Sul | 90430-001 | Brazil |
| Porto Alegre | Porto Alegre | Rio Grande do Sul | 90510-040 | Brazil |
| Porto Alegre | Porto Alegre | Rio Grande do Sul | 90610-000 | Brazil |
| Porto Alegre | Porto Alegre | São Paulo | 90035-903 | Brazil |
| São Bernardo do Campo | São Bernardo do Campo | São Paulo | 09715-090 | Brazil |
| São Paulo | São Paulo | São Paulo | 01317-000 | Brazil |
| São Paulo | São Paulo | São Paulo | 01323-900 | Brazil |
| São Paulo | São Paulo | São Paulo | 04023-062 | Brazil |
| São Paulo | São Paulo | São Paulo | 04266-010 | Brazil |
| São Paulo | São Paulo | São Paulo | 04708-001 | Brazil |
| Santiago | Santiago | 7510186 | Chile |
| Santiago | Santiago | 8320165 | Chile |
| Santiago | Santiago | 8360160 | Chile |
| Santiago | Santiago | 8880465 | Chile |
| Tábor | Tábor | Jihormoravsky KRAJ | 390 03 | Czechia |
| Praha 2 | Prague | Prague | 128 08 | Czechia |
| Písek | Písek | South Bohemian Region | 39701 | Czechia |
| Ceské Budejovice | České Budějovice | 370 01 | Czechia |
| Tbilisi | Tbilisi | Borjomi | 0159 | Georgia |
| Monserrato | Monserrato | Cagliari | 09042 | Italy |
| Catanzaro | Catanzaro | 88100 | Italy |
| Napoli | Naples | 80131 | Italy |
| Pavia | Pavia | 27100 | Italy |
| Roma | Roma | 00168 | Italy |
| Birkenhead | Birkenhead | Auckland | 0626 | New Zealand |
| Remuera | Remuera | Auckland | 1050 | New Zealand |
| Tauranga | Tauranga | Bay of Plenty | 3112 | New Zealand |
| Palmerston North | Palmerston North | Manawatu-Wanganui | 4442 | New Zealand |
| Christchurch | Christchurch | 8013 | New Zealand |
| Poznan | Poznan | Greater Poland Voivodeship | 60-185 | Poland |
| Lublin | Lublin | Lublin Voivodeship | 20-064 | Poland |
| Lublin | Lublin | Lublin Voivodeship | 20-093 | Poland |
| Warszawa | Warsaw | Masovian Voivodeship | 02-066 | Poland |
| Warszawa | Warsaw | Masovian Voivodeship | 02-201 | Poland |
| Warszawa | Warsaw | Masovian Voivodeship | 02-929 | Poland |
| Bialystok | Bialystok | Podlaskie Voivodeship | 15-224 | Poland |
| Białystok | Bialystok | Podlaskie Voivodeship | 15-464 | Poland |
| Katowice | Katowice | Silesian Voivodeship | 40-301 | Poland |
| Lodz | Lodz | Łódź Voivodeship | 90-602 | Poland |
| București | Bucharest | Bucharest | 20475 | Romania |
| Brasov | Brasov | 500091 | Romania |
| Bucuresti | Bucharest | 012071 | Romania |
| Bucuresti | Bucharest | 022441 | Romania |
| Malmö | Malmö | Skåne County | 20502 | Sweden |
| Hunsche E, Gauthier M, Witherspoon B, Rakov V, Agarwal SK. Endometriosis Symptoms and Their Impacts on the Daily Lives of US Women: Results from an Interview Study. Int J Womens Health. 2023 Jun 1;15:893-904. doi: 10.2147/IJWH.S409733. eCollection 2023. |
| 35717987 | Derived | Giudice LC, As-Sanie S, Arjona Ferreira JC, Becker CM, Abrao MS, Lessey BA, Brown E, Dynowski K, Wilk K, Li Y, Mathur V, Warsi QA, Wagman RB, Johnson NP. Once daily oral relugolix combination therapy versus placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2). Lancet. 2022 Jun 18;399(10343):2267-2279. doi: 10.1016/S0140-6736(22)00622-5. |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 2, 2022 | Sep 29, 2022 | 30 | ||
| May 28, 2024 | Jun 20, 2024 | 31 | ||
| May 7, 2025 | May 8, 2025 | 32 | ||
| May 20, 2025 | May 21, 2025 | 33 |
| ID | Term |
|---|---|
| D004715 | Endometriosis |
| D010146 | Pain |
| D004412 | Dysmenorrhea |
| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008599 | Menstruation Disturbances |
| D010335 | Pathologic Processes |
| D017699 | Pelvic Pain |
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| ID | Term |
|---|---|
| C561634 | relugolix |
| C418365 | estradiol, norethindrone drug combination |
| D004958 | Estradiol |
| ID | Term |
|---|---|
| D004963 | Estrenes |
| D004962 | Estranes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D045166 | Estradiol Congeners |
| D012739 | Gonadal Steroid Hormones |
| D042341 | Gonadal Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
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