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HealthyPhase 1NCT02317809

Bioequivalence Trial of Liquid Versus Freeze-Dried Pergoveris® in Pituitary Suppressed Healthy Premenopausal Female Subjects

A Phase 1 study testing Liquid pergoveris and Freeze-dried pergoveris in people with Healthy, run by Merck KGaA, Darmstadt, Germany at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Some women cannot have children because they cannot produce enough follicle stimulating hormone (FSH) and luteinising hormone (LH). When this happens the ovaries fail to produce an egg during the menstrual cycle - a condition known as anovulation. Anovulation can be treated by giving replacement FSH and LH. Read more about this study

Who is it for?
Ages 18 to 40 years, women onlyHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
Liquid pergoveris and Freeze-dried pergoveris
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 siteGermany
Study dates
31 Jan 2015to 31 Oct 2015
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 40 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Premenopausal women aged 18 to 40 years (both inclusive) at Screening
  • Taking a combined oral contraceptive (COCP) for at least 1 year prior to Screening and willing to recommence taking their own COCP from Day 43 of the Marvelon cycle until follow-up
  • Normal follicle-stimulating hormone (FSH) (less than [<] 12 international units per liter [IU/L]) and estradiol levels (<100 picogram per milliliter [pg/mL])
  • Gave written informed consent prior to any trial-related procedure
  • Forearm veins suitable for cannulation or repeated venipuncture
  • Body weight of greater than or equal to (>=) 48 kilogram (kg) and a body mass index (BMI) between 18.5 and 29.9 kilogram per square meter (kg/m^2) (both inclusive)
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  • Clinically acceptable values for vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse rate, and body temperature), as assessed by the Investigator
  • Non-smoking or having refrained from smoking for at least 6 months prior to Screening and with a history of <10 pack years [number of pack years = (number of cigarettes per day/20)*number of years smoked]
  • Able to communicate well with the Investigator, understanding the protocol requirements and restrictions, and willing to comply with the requirements of the entire trial
  • Negative pregnancy test at Screening, before the start of the Marvelon cycle, and at admission (Day -1 Period 1 and Day -1 Period 2)
  • Willing to use additional nonhormonal contraceptives (for example, condoms or occlusive cap [diaphragm or cervical/vault cap] with spermicide, nonhormonal intrauterine device, previous sterilization of the subject or her partner, being sexually inactive) from Day 1 of the Marvelon cycle up to follow-up
  • Normal liquid-based cervical cytology assessment (Papanicolaou test score <II) within the last 12 months before Screening. If not performed as part of routine clinical care, a cervical cytology assessment must be performed as part of the Screening assessments and the result must be normal

Who cannot join

  • Any surgical or medical condition, including findings in the medical history or in the pre-trial assessments, that in the opinion of the Investigator, constitutes a risk or a contraindication for the participation of the subject in the trial or that could interfere with the trial objectives, conduct, or evaluation
  • Any clinically relevant abnormality in the safety laboratory parameters, as judged by the Investigator
  • Any clinically significant abnormality on the 12-lead resting electrocardiogram (ECG), as judged by the Investigator
  • Positive results from the serology examination for hepatitis B surface antigen, hepatitis C virus, or the human immunodeficiency virus
  • Contraindications to COCP use shown by a history of conditions specified in the protocol
  • History of tumors of the pituitary gland or hypothalamus
Show all 23Show fewer
  • Clinically significant abnormalities of the genital organs as determined by gynecological examination and transvaginal ultrasound (TVUS) and based on the Investigator's judgment for example, ovarian tumors, nonfunctional ovarian cysts, endometrial hyperplasia)
  • Not successfully down-regulated by showing luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels above 1.0 IU/L and estradiol levels above 100 pg/mL before investigational medicinal product (IMP) administration or showing more than12 immature follicles per ovary. In that case there should be no signs of polycystic ovary syndrome (PCOS) morphology
  • Polycystic ovarian syndrome as defined in the protocol
  • Ovarian follicle-like structures larger than 13 millimeter (mm) during COCP use (at Screening)
  • Contraindication to treatment with gonadotropins (ovarian enlargement or cyst not due to PCOS and of unknown origin, gynecological hemorrhages of unknown etiology, ovarian, uterine, or mammary carcinoma, tumors of the hypothalamus and pituitary gland, hypersensitivity to gonadotropins or to any of the excipients, extrauterine pregnancy in the previous 3 months, and medical history or risk factors for thromboembolic events)
  • Pregnant or breastfeeding a child
  • Prior treatment with FSH and or LH containing products
  • Definite or suspected personal history or family history of an adverse drug reaction or hypersensitivity to drugs with a similar chemical structure to FSH or LH
  • History or presence of asthma (with the exception of childhood asthma) or any serious allergy (requiring hospitalization or prolonged systemic treatment)
  • History or presence of drug or alcohol abuse
  • Positive test for drugs of abuse (including alcohol)
  • Loss or donation of more than 500 mL of blood within 90 days prior to the first IMP administration
  • Administration of any IMP or use of any investigational device within 60 days prior to the first IMP administration
  • Use of drugs that may reduce the effectiveness of COCP from the start of the Marvelon cycle until last pharmacokinetic sample. For example, phenytoin, barbiturates, primidone, carbamazapine, oxcarbazepine, topiramate, felbamate, rifampicin, nelfinavir, ritonavir, griseofulvin, oral ketoconazole, and herbal remedies containing Hypericum perforatum (St John's Wort)
  • Unlikely to comply with the protocol requirements, instructions, and trial-related restrictions for example, uncooperative attitude, inability to return for follow-up, and improbability of completing the trial
  • Is (or is a relative of) the Principal Investigator or any Sub-investigator, Research Assistant, Pharmacist, Trial Coordinator, or other staff directly involved in the conduct of the trial
  • Vulnerable subjects (for example, persons kept in detention)

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Please contact the Merck KGaA Communication Center

    Darmstadt

Other trials in Germany

About this study

Official title: An Open-label, Randomized, Two-period, Two-sequence Crossover Trial to Assess the Bioequivalence of the Liquid Formulation Versus the Freeze-dried Formulation of 900 IU r-hFSH and 450 IU r-hLH in Pergoveris®, Administered Subcutaneously in Pituitary Suppressed Healthy Premenopausal Female Subjects

Some women cannot have children because they cannot produce enough follicle stimulating hormone (FSH) and luteinising hormone (LH). When this happens the ovaries fail to produce an egg during the menstrual cycle - a condition known as anovulation. Anovulation can be treated by giving replacement FSH and LH. Pergoveris is a medication that contains both FSH and LH. It is used for the treatment of anovulation in women who do not produce enough FSH and LH.

A new, liquid formulation of Pergoveris is being tested in this study. It will be compared with the current freeze-dried marketed formulation to see if the new formulation gets into the blood stream as easily as the current formulation.

Read more

This study will involve 38 healthy female subjects and 2 treatment periods and will last for approximately 77 days. Each subject will receive a single dose of the new liquid formulation and a single dose of the current marketed formulation separated by an interval of two weeks in a randomised (by chance) order. Blood samples will be taken at regular intervals over 2 weeks after each dose to measure levels of FSH and LH.

To participate female subjects must have normal ovaries on internal ultrasound scan, a normal result from a cervical smear test, be taking the combined oral contraceptive (OC) pill.

Eligible subjects will have their usual OC pill replaced with another called Marvelon throughout the study. After 14 days subjects will have their levels of FSH and LH checked and if sufficiently reduced will only then proceed to dosing.

Subjects will then receive one of the formulations. An ultrasound scan of the ovaries will be performed 7 days later, and another one 7 days later just before the next dose. Subjects whose ovaries show signs of stimulation will not be given the second dose. The ultrasound scan will be repeated 7 days after the second dose.

Conditions
Healthy
Being tested
Liquid pergoveris, Freeze-dried pergoveris
Keywords
Healthy, Pergoveris, Bioequivalence, Infertility
Medical subject headings
Infertility

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Liquid pergoverisDrug

    All subjects will be administered with 900 IU of r-hFSH and 450 IU of r-hLH solution (Liquid Pergoveris) as subcutaneous injection using a disposable pen-injector on Day 1 in either first intervention period or second intervention period.

  • Freeze-dried pergoverisDrug

    All subjects will be administered with 900 IU of r-hFSH and 450 IU of r-hLH freeze-dried powder (Freeze-dried Pergoveris) as subcutaneous injection on Day 1 in either first intervention period or second intervention period.

Study groups in NCT02317809
Study groupRoleWhat they receive
First Liquid Pergoveris, Then Freeze-dried PergoverisExperimentalNot described
Receives: Drug: Liquid pergoveris; Drug: Freeze-dried pergoveris
First Freeze-dried Pergoveris, Then Liquid PergoverisExperimentalNot described
Receives: Drug: Liquid pergoveris; Drug: Freeze-dried pergoveris

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Baseline Corrected Area Under the Concentration-Time Curve From Zero to Last Quantifiable Concentration (AUC 0-t,Adj) for Follicle-Stimulating Hormone (FSH)

    The AUC (0-t) was defined as the area under the serum concentration versus time curve from time zero (pre-dose) to time of last quantifiable concentration. Baseline-corrected AUC0-t (AUC0-t,adj) = AUC0-t - (baseline concentration * t).

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 and 168 hours post-dose in each period

  2. Baseline Corrected Area Under the Concentration-Time Curve From Zero to Last Quantifiable Concentration (AUC0-t,Adj) for Luteinizing Hormone (LH)

    The AUC (0-t) was defined as the area under the serum concentration versus time curve from time zero (pre-dose) to time of last quantifiable concentration. Baseline-corrected AUC0-t (AUC0-t,adj) = AUC0-t - (baseline concentration * t).

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96 and 120 hours post-dose in each period

  3. Baseline Corrected Maximum Serum Concentration (Cmax,Adj) for Follicle-Stimulating Hormone (FSH)

    Baseline-corrected Cmax (Cmax,adj) = Cmax - baseline concentration

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 and 168 hours post-dose in each period

  4. Baseline Corrected Maximum Serum Concentration (Cmax,Adj) for Luteinizing Hormone (LH)

    Baseline-corrected Cmax (Cmax,adj) = Cmax - baseline concentration.

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96 and 120 hours post-dose in each period

Secondary outcomes (20)
  1. Baseline Corrected Area Under the Serum Concentration-time Curve From Time 0 to Infinity (AUC0-inf, Adj) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  2. Baseline Corrected Area Under the Serum Concentration-time Curve From Time Tlast Extrapolated to Infinity (%AUCextra,Adj) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Area under the serum concentration-time curve from Tlast extrapolated to infinity given as a percentage of AUC0-inf. Data was not planned to be summarized if AUCextra,adj was less than 20%.

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  3. Apparent Terminal Elimination Rate Constant (Lambda[z]) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    The elimination rate constant was obtained from linear regression of the terminal phase of the log transformed concentration-time data.

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  4. Time to Reach the Maximum Serum Concentration (Tmax) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  5. Apparent Terminal Half-life (t1/2) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Terminal half-life is the time measured for the concentration to decrease by one half.

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  6. Apparent Serum Clearance (CL/F) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Clearance is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained is influenced by the fraction of the dose absorbed and was expressed as volume (Liter) per unit of time (hour).

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  7. Apparent Volume of Distribution During Terminal Phase (Vz/F) for Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)

    Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired concentration. Apparent volume of distribution (Vz/F) is influenced by the fraction absorbed.

    Measured: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120, 168 hours post-dose in each period for FSH; Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 hours post-dose in each period for LH

  8. Number of Subjects With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    An AE was any untoward medical occurrence in a subject, regardless of causal relationship with the treatment. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged in-patient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs include both SAEs and non-serious AEs.

    Measured: Day 1 post-IMP administration up to follow-up visit (Day 18) for IMP intervention periods

  9. Number of Subjects With Treatment Emergent Adverse Events (TEAEs) Related to Laboratory Assessments, Vital Signs or Electrocardiogram Findings

    Measured: Day 1 post-IMP administration up to follow-up visit (Day 18) for IMP intervention periods

  10. Number of Subjects With Follicle Size Greater Than (>)13 Millimeter

    Transvaginal ultrasound (TVUS) was performed to determine the follicle size and number.

    Measured: Day 1 (pre-dose) up to follow-up visit (Day 18) for IMP intervention periods

  11. Serum Estradiol Levels

    Data was planned to be presented as per the sequence of treatment received.

    Measured: Screening (up to 28 days), Day 1 (pre-dose) and Day 8 in Period 1, Day 1 (pre-dose), Day 8 and follow-up (Day 18) in Period 2

  12. Number of Subjects With Local Tolerability/Injection Site Reactions (ISRs)

    Injection site was assessed by the study site staff for any local reaction (redness, swelling, bruising, and itching). Redness and bruising were scaled as None (no visible redness or bruising); Mild (less than or equal to [<=] 2.0 centimeters [cm] redness or bruising); Moderate (greater than [>] 2 to <=5.0 cm redness or bruising); Severe (>5.0 cm redness or bruising). Swelling was scaled as None (no swelling detected); Mild (palpable 'firmness' only); Moderate (<= 4 cm swelling); Severe (>4 cm swelling). Itching was scaled as None (no itching); Mild itching; Moderate itching and Severe itching. Only those scale categories which report at least 1 subject were presented.

    Measured: 5 minutes, 1, 2, 4, 6, 12, and 24 hours post-dose in each period

  13. Pain Visual Analogue Scale (VAS) Score

    The severity of pain was evaluated by the subject and recorded using a 100 millimeter (mm) visual analogue scale (VAS) ranging from 0 to 100, where 0 mm = no pain and 100 mm = worst possible pain.

    Measured: 5 minutes, 1, 2, 4, 6, 12, and 24 hours post-dose in each period

  14. Number of Subjects With Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) for Luteinizing Hormone (LH)

    Measured: Day 1 pre-dose up to follow-up visit (Day 18) for IMP intervention periods

  15. Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) Titers for Luteinizing Hormone (LH)

    Measured: Day 1 pre-dose up to follow-up visit (Day 18) for IMP intervention periods

  16. Number of Subjects With Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) for Follicle-stimulating Hormone (FSH)

    Measured: Day 1 pre-dose and Day 8 post-dose for IMP intervention periods

  17. Number of Subjects With Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) for Follicle-stimulating Hormone (FSH) at Follow-up Visit

    Measured: At follow-up visit (Day 49)

  18. Anti-Drug Antibodies (ADAs) Titers for Follicle-stimulating Hormone (FSH)

    Measured: Day 1 pre-dose and Day 8 post-dose for IMP intervention periods.

  19. Anti-Drug Antibodies (ADAs) Titers for Follicle-stimulating Hormone (FSH) at Follow-up Visit

    Measured: At follow-up visit (Day 49)

  20. Neutralizing Antibodies (NAbs) Titers for Follicle-stimulating Hormone (FSH)

    Measured: Day 1 pre-dose, Day 8 post-dose, follow-up visit (Day 49)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Dec 2014 (estimated)
  2. Study start31 Jan 2015
  3. Primary completion31 Oct 2015
  4. Study completion31 Oct 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
34 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02317809
Sponsor's protocol ID
200061-006
Other IDs
2014-003506-32, 2014
Status last verified
Oct 2017
First submitted
11 Dec 2014
Last updated
16 Jul 2018
Data monitoring committee
No

Publications

  • Bagchus W, Yalkinoglu O, Wolna P. Open-Label, Randomized, Two-Way, Crossover Study Assessing the Bioequivalence of the Liquid Formulation versus the Freeze-Dried Formulation of Recombinant Human FSH and Recombinant Human LH in a Fixed 2:1 Combination (Pergoveris(R)) in Pituitary-Suppressed Healthy Women. Front Endocrinol (Lausanne). 2018 Jan 11;8:371. doi: 10.3389/fendo.2017.00371. eCollection 2017.

    PubMed 29375477

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Liquid pergoveris and Freeze-dried pergoveris in people with Healthy, run by Merck KGaA, Darmstadt, Germany at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 23 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Jul 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 Dec 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Baseline Corrected Area Under the Concentration-Time Curve From Zero to Last Quantifiable Concentration (AUC 0-t,Adj) for Follicle-Stimulating Hormone (FSH) (time frame: Pre-dose, 2, 4, 6, 7, 8, 9, 10, 12, 15, 18, 24, 36, 48, 60, 72, 96, 120 and 168 hours post-dose in each period). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02317809, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2018.

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