MsFLASH-03: Comparative Efficacy of Low-Dose Estradiol and Venlafaxine XR for Treatment of Menopausal Symptoms

Not Applicable

Completed

• Conditions: Vasomotor Disturbance; Hot Flashes; Menopause
• Interventions: Drug: Venlafaxine XR; Drug: Placebo; Drug: Low-dose 17-ß-estradiol with progesterone taper

• Registration Number: NCT01418209
• Lead Sponsor: Fred Hutchinson Cancer Center

Brief Summary

The primary objective of this study is to determine the efficacy of both low-dose oral (by mouth) 17-ß-estradiol and the non-hormonal drug venlafaxine XR compared to placebo in reducing hot flashes. Included in this objective is the intention to compare venlafaxine XR to estradiol therapy, to provide evidence of the relative efficacy of venlafaxine to what is currently considered the most established but also a controversial therapy. 17-ß-estradiol is a type of estrogen. Venlafaxine XR is the extended release (XR) version of venlafaxine. Venlafaxine XR is an serotonin-norepinephrine reuptake inhibitor (SNRI). A placebo is a substance containing no medication.

Detailed Description

The MsFLASH-03 study (Menopausal Strategies: Finding Lasting Answers for Symptoms and Health - 03), Comparative Efficacy of Low-Dose Estradiol and the SNRI Venlafaxine XR for Treatment of Menopausal Symptoms, is a randomized, double-blind, placebo-controlled, three arm clinical trial. The design includes: 3 weeks of daily recording of hot flashes prior to drug treatment; 8 weeks of double-blind treatment with oral estradiol, venlafaxine, or placebo; followed by 14 days of drug taper for those on venlafaxine and 14 days of progesterone treatment for those on estradiol; followed by 2 weeks with no treatment for all groups; and a telephone follow-up post-treatment.

Study Timeline

• Study First Submitted: 2011-08-15
• Study First Submitted QC: 2011-08-16
• Study First Posted: 2011-08-17
• Study Start: 2011-11
• Primary Completion: 2013-01
• Study Completion: 2013-01
• Results First Submitted: 2014-06-18
• Status Verified: 2014-08
• Results First Submitted QC: 2014-08-01
• Results First Posted: 2014-08-20
• Last Update Submitted: 2014-08-20
• Last Update Posted: 2014-08-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 339

Inclusion Criteria

• Females aged 40-62 years
• Postmenopausal or perimenopausal
• Having bothersome hot flashes
• In general good health
• Signed informed consent

Exclusion Criteria

• Recent use of systemic hormone therapy or hormonal contraceptives

• Recent use of any prescribed, over-the-counter or herbal therapies that are taken specifically for hot flashes

• Recent use of selective estrogen receptor modulators (SERMS) or aromatase inhibitors

• Recent use of psychotropic medications, including SSRIs (selective serotonin reuptake inhibitors), serotonin-norepinephrine reuptake inhibitors (SNRIs), MAOIs (monoamine oxidase inhibitors), and other antidepressants and anxiolytics.

• Known hypersensitivity or contraindications (reasons not to take) to venlafaxine, estrogen, or progestins

• Not using a medically approved method of birth control, if sexually active and not 12 or more months since last menstrual period

• Recent drug or alcohol abuse

• Lifetime diagnosis of psychosis or bipolar disorder

• Suicide attempt in the past 3 years or any current suicidal ideation

• Current major depression (assessed during screening)

• Pregnancy, intending pregnancy, or breast feeding

• History of:

  • Pre-breast cancer or high-risk breast cancer condition
  • Abnormal bleeding suggestive of endometrial pre-cancer or endometrial hyperplasia
  • Asthma, diabetes mellitus, epilepsy, and migraine disorders that are not stable or under medical management

• Abnormal screening blood tests

• Current participation in another drug trial or intervention study

• Inability or unwillingness to complete the study procedures

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Venlafaxine XR	Venlafaxine XR	-
Placebo	Placebo	-
Low-dose 17-ß-estradiol with progesterone taper	Low-dose 17-ß-estradiol with progesterone taper	-

Primary Outcome Measures

Name	Time	Method
Frequency of Hot Flashes (Vasomotor Symptom [VMS] Frequency) -- Week 4	Week 4	Measured by self-report diary twice daily (day and night). The day and night frequencies were summed to produce a single number of hot flashes per day. The single number of hot flashes per day were summed and averaged for one week prior to the week 4 study assessment to produce a mean daily frequency for week 4.
Frequency of Hot Flashes (Daily Vasomotor Symptom [VMS] Frequency) -- Week 8	Week 8	Measured by self-report diary twice daily (day and night). The day and night frequencies were summed to produce a single number of hot flashes per day. The single number of hot flashes per day were summed and averaged for one week prior to the week 8 study assessment to produce a mean daily frequency for week 8.

Secondary Outcome Measures

Name	Time	Method
Severity of Hot Flashes -- Week 4	Week 4	Measured by self-report diary twice daily (day and night) for 7 days. Severity ratings ranged from 0 to 3 with lower numbers being less severe and higher numbers being more severe. Data from the day and night severity ratings were averaged for a single daily score. The single daily scores for the week prior to the week 4 study assessment were summed and averaged to produce a mean daily VMS severity for week 4.
Severity of Hot Flashes -- Week 8	Week 8	Measured by self-report diary twice daily (day and night) for 7 days. Severity ratings ranged from 0 to 3 with lower numbers being less severe and higher numbers being more severe. Data from the day and night severity ratings were averaged for a single daily score. The single daily scores for the week prior to the week 8 study assessment were summed and averaged to produce a mean daily VMS severity for week 8.
Bothersomeness of Hot Flashes -- Week 4	Week 4	Measured by self-report diary twice daily (day and night) for 7 days. Bothersomeness ratings ranged from 0 to 3 with lower numbers being less bothersome and higher numbers being more bothersome. Data from the day and night bothersomeness ratings were averaged for a single daily score. The single daily scores for the week prior to the week 4 study assessment were summed and averaged to produce a mean daily VMS bothersomeness for week 4.
Bothersomeness of Hot Flashes -- Week 8	Week 8	Measured by self-report diary twice daily (day and night) for 7 days. Bothersomeness ratings ranged from 0 to 3 with lower numbers being less bothersome and higher numbers being more bothersome. Data from the day and night bothersomeness ratings were averaged for a single daily score. The single daily scores for the week prior to the week 8 study assessment were summed and averaged to produce a mean daily VMS bothersomeness for week 8.
Perceived Hot Flash Interference (Hot Flash Related Daily Interference Scale; HFRDIS) -- Week 4	Week 4	The perceived hot flash related daily interference scale (HFRDIS) is a tool for assessing the impact of hot flashes on quality of life. There are 10 questions with each having a score ranging from 0 to 10. The scores from each question are summed for a total score ranging from 0 to 100. Lower numbers indicate less interference and higher numbers indicate more interference.
Perceived Hot Flash Interference (Hot Flash Related Daily Interference Scale; HFRDIS) -- Week 8	Week 8	The perceived hot flash related daily interference scale (HFRDIS) is a tool for assessing the impact of hot flashes on quality of life. There are 10 questions with each having a score ranging from 0 to 10. The scores from each question are summed for a total score ranging from 0 to 100. Lower numbers indicate less interference and higher numbers indicate more interference.

Trial Locations

Locations (4)

Brigham and Women's Hospital; 🇺🇸 Chestnut Hill, Massachusetts, United States

Massachusetts General Hospital, Harvard Medical School (HU); 🇺🇸 Boston, Massachusetts, United States

University of Pennsylvania, UP; 🇺🇸 Philadelphia, Pennsylvania, United States

Group Health Research Institute (GHRI); 🇺🇸 Seattle, Washington, United States