Pharmacokinetic and Pharmacodynamic Study of Cyclofem
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Purpose
Cyclofem® is a monthly injectable contraceptive containing 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C), a long acting ester of estradiol. The current study will assess the steady-state pharmacokinetics and pharmacodynamics of MPA and E2 after administration of Cyclofem® and will provide critical information to determine similar bioavailability of Cyclofem to Lunelle in women residing in the USA.
| Condition | Intervention | Phase |
|---|---|---|
|
Contraception |
Drug: Injection Cyclofem |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Pharmacokinetics/Dynamics Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Pharmacokinetic and Pharmacodynamic Study of Cyclofem |
- Area Under the Curve From Time Zero to Last Quantifiable Concentration [AUC (0-t)] [ Time Frame: 3 months (cycles) ] [ Designated as safety issue: No ]AUC (0-t)= Area under the plasma concentration versus time curve from time zero (pre-dose) to time of last quantifiable concentration (0-t) MPA and E2 were estimated in 10 measurements made during the third treatment cycle (Days 58, 60, 62, 64, 67, 69, 71, 75, 78, and 85).
- Maximum Observed Plasma Concentration (Cmax) [ Time Frame: 3 months (cycles) ] [ Designated as safety issue: No ]MPA and E2 were estimated for the 10 measurements made during the third treatment cycle (Days 58, 60, 62, 64, 67, 69, 71, 75, 78, and 85).
- Serum Progesterone levels [ Time Frame: 3 months (cycles) ] [ Designated as safety issue: No ]Serum Progesterone levels were measured on Days 103, 106, 131, and 134 during the follow-up phase to determine time of return of ovulation after the third injection.
| Enrollment: | 17 |
| Study Start Date: | June 2010 |
| Study Completion Date: | December 2011 |
| Primary Completion Date: | July 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Injection Cyclofem
Injection of Cyclofem contains 25 mg medroxyprogesterone acetate (MPA) and 5 mg estradiol cypionate as a microcrystalline suspension in 0.5ml aqueous solution and is supplied in vials. Women were administered three consecutive monthly injections of Cyclofem for prevention of ovulation, and were followed until the 92nd day from the last (third) injection. |
Drug: Injection Cyclofem
Injection Cyclofem contains 25 mg medroxyprogesterone acetate (MPA) and 5 mg estradiol cypionate as a microcrystalline suspension in 0.5ml aqueous solution and is supplied in vials. Women were administered three consecutive monthly injections of Cyclofem for prevention of ovulation, and were followed until the 92nd day from the last (third) injection. Other Name: Cyclofem
|
Detailed Description:
Concept Foundation, an international nonprofit organization based in Bangkok, Thailand, was given the commercial rights to Cyclofem® by the World Health Organization (WHO) for use internationally. The brand names that the Concept Foundation has registered internationally include Cyclofem®, and Novafem® (Pharmacia Pharmaceuticals, Peapack NJ, formerly (Pharmacia and Upjohn of Kalamazoo, Michigan). The company launched its product under license from Concept Foundation with their own brand name, Lunelle™ in the US market. Lunelle™ was approved by the Food and Drug Administration (FDA) in October, 2000 following which approximately 350,000 women had used the product. However, following the acquisition of Pharmacia and Upjohn by Pfizer and due to several production problems, Pfizer withdrew Lunelle™ from the US market. Concept Foundation has licensed Sun Pharmaceutical Industries Ltd, Mumbai, India to manufacture and market Cyclofem® in India and other developing countries. US FDA approval of Cyclofem® is pivotal to the ultimate acceptance of such products in many countries because of the rigorous standards applied by the FDA for drug safety and efficacy. This initial PK study is the first step on the road to FDA approval with the ultimate goal to expand the access and range of methods available to women in the public sector. Approval of Cyclofem® by the US FDA would also allow the reintroduction of CICs to the US market.
Eligibility| Ages Eligible for Study: | 18 Years to 45 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Between 18 and 45 years of age, inclusive;
- In good health, as evidenced by history and procedures at screening/enrollment visit
- Without any clinically significant systemic disease;
- Not at risk for pregnancy, having undergone surgical sterilization
- Have had regular menstrual cycles (every 21-35 days) for the past two cycles;
- Planning to reside in the area for at least 7 months after enrolling in the study; and
- Willing and able to comply with study procedures
- Have a body mass index (BMI) between 18 and 30 inclusive.
Exclusion Criteria:
Contraindications to the use of Cyclofem® include:
- Smoking any number of cigarettes per day in a woman > 35 years old (or in a woman 34 years-old who will turn 35 years-old during the study),
- Symptoms of chest pain or shortness of breath,
- Screening visit blood pressure >140/90, (subjects on hypertensive medications, in good blood pressure control will be admitted).
- Past or current thrombophlebitis or thromboembolic disorders,
- Past or current cerebral vascular or coronary artery disease
- History of stroke, myocardial infarction or ischemic heart disease or complicated valvular heart disease
- Diabetes
- Past or current carcinoma of the endometrium cervix or vagina; breast or other known or suspected estrogen-depended neoplasia,
- Headaches with focal neurological symptoms,
- Unexplained abnormal vaginal bleeding,
- Liver dysfunction or disease, such as a history of hepatic adenoma or carcinoma; history of cholestatic jaundice of pregnancy or jaundice with prior hormonal contraceptive use including severe pruritus of pregnancy, severe cirrhosis, or active hepatitis (defined as aspartate aminotransferase (AST or SGOT) ≥ 120 IU/L or alanine aminotransferase (ALT or SGPT) ≥ 135 IU/L) or clinically significant laboratory abnormalities as judged by the physician evaluating the individual subject).
- Known hypersensitivity to any component of Cyclofem®
Have an abnormal Pap smear in the past 12 months defined as:
- ASC-US without a normal repeat Pap smear at least 6 months later;
- ASC-US with positive reflex high-risk HPV testing (ASC-US/HPV+) or LSIL except when a colposcopy was performed (with or without biopsy) and found no evidence of high-grade disease (CIN II or worse) unless treatment is indicated per local standard of care;
- ASC-H, atypical glandular cells, or HSIL unless treatment was received and follow-up at least 6 months after the treatment showed no evidence of disease; malignant cells;
- Current use of rifampin, griseofulvin, phenytoin, carbamazepine, barbiturates, or primidone;
- Other conditions that, in the opinion of the investigator, would constitute contraindications to participation in the study or would compromise ability to comply with the study protocol, such as any major chronic illness including cancer, serious autoimmune disease or a major psychiatric disorder (e.g. schizophrenia);
- Current participation in any other drug or device study, or any study which, in the opinion of the investigator, would jeopardize interpretation of results of this study;
- Active thyroid disease (as measured by TSH levels ≤0.3 mU/L or ≥ 5 mU/L. Subjects with thyroid disease in good control with thyroid medication will be admitted.
Contacts and Locations| United States, Virginia | |
| Clinical Research Center Norfolk, Virginia 601 Colley Avenue, | |
| Norfolk,, Virginia, United States, 23507 | |
| Principal Investigator: | David F Archer, MD | Director, Conrad Clinical Research Center. |
More Information
No publications provided
| Responsible Party: | Sun Pharmaceutical Industries Limited |
| ClinicalTrials.gov Identifier: | NCT01699022 History of Changes |
| Other Study ID Numbers: | A09-109 |
| Study First Received: | September 28, 2012 |
| Last Updated: | October 2, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Sun Pharmaceutical Industries Limited:
|
Contraceptive Injectable |
Additional relevant MeSH terms:
|
Estradiol 17 beta-cypionate Medroxyprogesterone Medroxyprogesterone Acetate CycloProvera Contraceptive Agents, Female Contraceptive Agents Reproductive Control Agents Physiological Effects of Drugs |
Pharmacologic Actions Therapeutic Uses Contraceptives, Oral, Synthetic Contraceptives, Oral Contraceptive Agents, Male Antineoplastic Agents, Hormonal Antineoplastic Agents Contraceptives, Oral, Combined |
ClinicalTrials.gov processed this record on May 22, 2013