Study to Assess the Safety and Effect of Repeated Administration of Granulocyte Colony-Stimulating Factor (G-CSF; Filgrastim) on Hot Flashes and Other Vasomotor Symptoms of Menopause in Postmenopausal Women
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Postmenopausal Symptoms
- Sponsor
- MenoGeniX, Inc.
- Enrollment
- 61
- Locations
- 2
- Primary Endpoint
- Change From Baseline in White Blood Cell Counts 24 Hours After Administration of G-CSF or Placebo on Day 28
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this study is to assess the efficacy and safety of repeated administration of G-CSF for the treatment of hot flashes and vasomotor symptoms in women with naturally-occurring or surgically induced menopause. G-CSF will be administered three times at 28 day intervals to postmenopausal women, ages 40 to 65, suffering at least 49 moderate to severe hot flashes per week.
Detailed Description
This is a 12-week, multicenter, randomized, double-blind, placebo-controlled study. Eligible subjects will be stratified by natural or surgical menopause and randomized (1:1) to receive 3 single injections, 28-days apart, of either G-CSF or placebo. This study will consist of a 14-21 day screening period. Subjects enrolled will be given three single 1.0 mL subcutaneous (SC) injections (repeated 28-days apart), in the outer area of either upper arm, of either G-CSF or placebo (sterile physiological saline) at Baseline, Day 28 and Day 56. Subjects will be followed for 12 weeks and will complete hot flash diary entries every day for the duration of treatment. Safety will be assessed by adverse events, clinical laboratory tests (clinical chemistry and complete blood count with differential) and vital signs. A follow-up phone call will occur 60 days after the last dose of study drug. Eligibility will be assessed via physical examination, clinical laboratory testing, vital signs. Subjects will receive a diary in which to record daily hot flashes symptoms during the duration of the screening period. Subjects must have at least 14 days of hot flash recordings to participate in the study. The diary will be reviewed by study site staff on Baseline (Day 0) to confirm study eligibility. During the treatment period, subjects will return to the study site at Days 1, 21, 28, 29, 49, 56, 57, and 84 for assessments. The follow-up phone call will occur approximately 60 days following the last dose of study drug.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Female, aged 49 to 65 for natural postmenopausal or aged 40 to 65 for surgical postmenopausal
- •Body Mass Index (BMI) 18 to 35
- •At least 7 moderate to severe hot flashes per day on average (or at least 49 moderate to severe hot flashes per week)
- •Naturally postmenopausal or surgically postmenopausal women:
- •Naturally postmenopausal is defined as having no menstrual periods for at least 12 months prior to study entry; with a biochemical criteria of menopause (FSH \>40 IU/L)
- •Surgically postmenopausal is defined as at least 3 months after documented bilateral salpingo oophorectomy
- •Normal pelvic exam and pap smear within 2 years
- •Signed informed consent
Exclusion Criteria
- •Radiation or chemotherapy-induced (including gonadotropin-releasing hormone (GnRH) agonist) menopause
- •Prior chemotherapy or radiation therapy for cancer
- •Prior diagnosis of hematologic malignancy
- •Type 1 diabetics or Type 2 diabetics with HbA1c \> 7.0%
- •Use of hormone replacement therapy or oral contraceptives within the past three months
- •Use of alternative or complementary medicines or herbs for menopausal symptoms within 30 days (refer to Appendix 2)
- •Use of any selective serotonin reuptake inhibitor (SSRI) or serotonin norepinephrine reuptake inhibitor (SNRI) within 30 days
- •Use of selective estrogen receptor modulators within 30 days
- •Use of gabapentin within 30 days
- •Use of clonidine within 30 days
Outcomes
Primary Outcomes
Change From Baseline in White Blood Cell Counts 24 Hours After Administration of G-CSF or Placebo on Day 28
Time Frame: Baseline and day 29
Change from baseline in white blood cell counts 24 hours after administration of G-CSF or placebo on day 28. Blood samples were collected 24 hours after adminstration of G-CSF on day 28.
Number of Participants With Adverse Events
Time Frame: From first dose date up to 30 days after last dose (up to 16 weeks)
An adverse event (AE) is any untoward medical occurrence, including the exacerbation of a pre-existing condition, in a subject or clinical investigation subject administered a pharmaceutical product. This does not necessarily have a causal relationship with this treatment. A serious adverse event (SAE) is any experience that suggests a significant hazard, contraindication, side effect, or precaution. This includes any experience that results in death; is acutely life-threatening; requires inpatient hospitalization or prolongs the existing hospitalization; results in persistent or significant incapacity or substantial disruption of ability to conduct normal life functions; is a congenital anomaly/birth defect; or requires medical or surgical intervention to prevent one of the outcomes listed above.
Change From Baseline in White Blood Cell Counts 24 Hours After Administration of G-CSF or Placebo on Day 0
Time Frame: Baseline and day 1
Change from baseline in white blood cell counts 24 hours after administration of G-CSF or placebo on day 0. Blood samples were collected 24 hours after adminstration of G-CSF on day 0.
Change From Baseline in the Mean Frequency of Moderate and Severe (M+S) Hot Flashes at Week 4
Time Frame: Baseline and week 4
The frequency of moderate to severe hot flashes was the number of moderate to severe hot flashes per 24 hours. A daily frequency per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Change From Baseline in the Mean Daily Severity of Hot Flashes (HFSS) at Week 12
Time Frame: Baseline and week 12
HFSS (Daily Hot Flash Severity Score) was calculated as follows: \[(number of mild hot flashes per day x 1) + (number of moderate hot flashes per day x 2) + (number of severe hot flashes per day x 3)\]/daily total hot flashes), where total hot flashes (THF) = number of daily mild, moderate, and severe hot flashes. A daily severity score per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Change From Baseline in White Blood Cell Counts 24 Hours After Administration of G-CSF or Placebo on Day 56.
Time Frame: Baseline and day 57
Change from baseline in white blood cell counts 24 hours after administration of G-CSF or placebo on day 56. Blood samples were collected 24 hours after adminstration of G-CSF on day 56.
Change From Baseline in White Blood Cell Counts on Day 84 (28 Days After Last Administration of G-CSF or Palcebo)
Time Frame: Baseline and day 84
Change from baseline in white blood cell counts on day 84. Blood samples were collected 24 hours after adminstration of G-CSF on day 84.
Change From Baseline in the Mean Frequency of Moderate and Severe (M+S) Hot Flashes at Week 12
Time Frame: Baseline and week 12
The frequency of moderate to severe hot flashes was the number of moderate to severe hot flashes per 24 hours. A daily frequency per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Change From Baseline in the Mean Composite Daily Severity of Hot Flashes (CDS) at Week 4
Time Frame: Baseline and week 4
CDS (Composite Daily Hot Flash Severity) was calculated as follows: \[(number of mild hot flashes per day x 1) + (number of moderate hot flashes per day x 2) + (number of severe hot flashes per day x 3)\]. A daily frequency per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Change From Baseline in the Mean Composite Daily Severity of Hot Flashes (CDS) at Week 12
Time Frame: Baseline and week 12
CDS (Composite Daily Hot Flash Severity) was calculated as follows: \[(number of mild hot flashes per day x 1) + (number of moderate hot flashes per day x 2) + (number of severe hot flashes per day x 3)\]. A daily frequency per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Change From Baseline in the Mean Daily Severity of Hot Flashes (HFSS) at Week 4
Time Frame: Baseline and week 4
HFSS (Daily Hot Flash Severity Score) was calculated as follows: \[(number of mild hot flashes per day x 1) + (number of moderate hot flashes per day x 2) + (number of severe hot flashes per day x 3)\]/daily total hot flashes), where total hot flashes (THF) = number of daily mild, moderate, and severe hot flashes. A daily severity score per week was derived by taking the mean of the data over 7 days. All subjects who were randomized and received at least one dose of study drug are included in this subset. Subjects are analysed according to the randomized treatment group regardless of treatment received.
Secondary Outcomes
- Net Change in HFRDIS Score(Baseline and week 12)
- Number of Subjects Achieving >50% Reduction in the Mean Frequency of Moderate and Severe (M+S) Hot Flashes up to Week 12(Weeks 1-12)
- Net Change in FSS Score at 12 Weeks(Baseline and week 12)
- Number of Subjects Acheiving >0.30 Reduction in the Mean Daily Hot Flash Severity Score (HFSS) up to Week 12(Weeks 1-12)
- Percent Change in M+S at 12 Weeks in Demographic Subgroups(Baseline and Week 12)
- Net Change in HFSS at 12 Weeks in Demographic Subgroups(Baseline and Week 12)
- Net Change in ISI Score at 12 Weeks(Baseline and week 12)
- Number of Subjects Acheiving >50% Reduction in the Mean Composite Daily Hot Flash Severity (CDS) up to Week 12(Weeks 1-12)
- Net Change in MENQOL VMS Score(Baseline and week 12)