Clinical Trial Results:
Pre-treatment with Mifepristone prior to Mirena insertion for optimizing bleeding pattern in pre-menopausal women
Summary
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EudraCT number |
2009-009014-40 |
Trial protocol |
SE |
Global end of trial date |
30 Jan 2015
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Results information
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Results version number |
v1(current) |
This version publication date |
31 Mar 2021
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First version publication date |
31 Mar 2021
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
W2009M
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01931657 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Karolinska Institutet
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Sponsor organisation address |
17177, Stockholm, Sweden,
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Public contact |
Kristina Gemzell Danielsson, Karolinska Institutet, kristina.gemzell@ki.se
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Scientific contact |
Kristina Gemzell Danielsson, Karolinska Institutet, kristina.gemzell@ki.se
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
30 Jan 2015
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
30 Jan 2015
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Global end of trial reached? |
Yes
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Global end of trial date |
30 Jan 2015
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The objective of the present study is to study in pre-menopausal women requesting Mirena for contraception:
1. the effect of pre-treatment with mifepristone on the bleeding pattern in women using the Mirena contraceptive system
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Protection of trial subjects |
Follow-up was done with visits to the clinic monthly for the first 3 months, at 6 months post LNGIUS insertion and with a telephone contact at the 12 months end-of-trial evaluation. Also, a transvaginal ultrasound examination was performed at baseline, prior to LNG-IUS insertion and then monthly for 3 months after the LNG-IUS insertion as well as at 6 months after insertion.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
02 Nov 2009
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Sweden: 58
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Worldwide total number of subjects |
58
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EEA total number of subjects |
58
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
58
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
This was a prospective, randomized, double blind, placebo-controlled trial to evaluate the effect of pre-treatment with a low dose mifepristone on bleeding pattern in women requesting LNG-IUS 52 mg as a contraceptive method. The study was conducted at the Karolinska University Hospital from November 2009 to January 2015. | ||||||||||||||||||
Pre-assignment
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Screening details |
Screening criteria: healthy women, opting for LNG-IUS 52 mg for contraception, aged 18–43 with regular and normal menstrual cycles lasting 24–35 days, with no contraindications to LNG-IUS or mifepristone. | ||||||||||||||||||
Period 1
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Period 1 title |
Overall trial (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||
Roles blinded |
Subject, Investigator | ||||||||||||||||||
Blinding implementation details |
Women received mifepristone (Mifegyne®, Exelgyn, Paris, France) or visually indistinguishable vitamin B (TrioBe® Recip, Stockholm, Sweden). The tablets were divided by the study nurse.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Mifepristone | ||||||||||||||||||
Arm description |
50 mg mifepristone) was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
Mifepristone
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
50 mg every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion.
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Arm title
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Placebo | ||||||||||||||||||
Arm description |
Women in placebo received visually indistinguishable vitamin B (TrioBe® Recip, Stockholm, Sweden) and was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. | ||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||
Investigational medicinal product name |
TrioB
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
One quarter of the comparator (TrioB) was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion.
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Baseline characteristics reporting groups
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Reporting group title |
Mifepristone
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Reporting group description |
50 mg mifepristone) was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Women in placebo received visually indistinguishable vitamin B (TrioBe® Recip, Stockholm, Sweden) and was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Mifepristone
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Reporting group description |
50 mg mifepristone) was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. | ||
Reporting group title |
Placebo
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Reporting group description |
Women in placebo received visually indistinguishable vitamin B (TrioBe® Recip, Stockholm, Sweden) and was to be taken orally every other day starting on the first day of the menstrual cycle for the pre-treatment period. The pre-treatment period was 2 months (corresponding to two menstrual cycles i.e. 2 × 28 days) prior to insertion and until 3 days (±2 days) following the LNG-IUS insertion. |
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End point title |
Bleeding pattern in women after insertion of the LNG-IUS | |||||||||
End point description |
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End point type |
Primary
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End point timeframe |
3 months after insertion of the LNG-IUS.
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Statistical analysis title |
Difference in bleeding patterns | |||||||||
Statistical analysis description |
Difference in percentage days with bleeding and spotting 3 months following insertion of the LNG-IUS.
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Comparison groups |
Mifepristone v Placebo
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Number of subjects included in analysis |
38
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Analysis specification |
Pre-specified
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Analysis type |
superiority | |||||||||
P-value |
= 0.838 | |||||||||
Method |
Mann-Whitney U-test | |||||||||
Parameter type |
Median difference (final values) | |||||||||
Confidence interval |
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Adverse events information [1]
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Timeframe for reporting adverse events |
From pre-treatment with Mifepristone and up to 12 months after insertion of LNG-IUS.
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Assessment type |
Systematic | |||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
ICD | |||||||||||||||
Dictionary version |
10
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Reporting groups
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Reporting group title |
Mifepristone
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Reporting group description |
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Reporting group title |
Placebo
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Reporting group description |
- | |||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||
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Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: There were no side effects or non-serious adverse events related to the study treatment, other than bleeding. But bleeding was a main outcome, so it was not counted as an adverse event. |
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
Limitations of the study include its small sample size, and the fact that the observed difference in bleeding and spotting days between study groups was small and short lasting. | |||
Online references |
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http://www.ncbi.nlm.nih.gov/pubmed/30295731 |