MedPath

Bremelanotide in Premenopausal Women With Female Sexual Arousal Disorder and/or Hypoactive Sexual Desire Disorder

Phase 2
Completed
Conditions
Hypoactive Sexual Desire Disorder
Female Sexual Arousal Disorder
Interventions
Registration Number
NCT01382719
Lead Sponsor
Palatin Technologies, Inc
Brief Summary

This trial is designed to evaluate the efficacy and safety of 3 fixed dose levels of bremelanotide, administered subcutaneously on an as-needed basis under conditions of home use, for the treatment of female sexual arousal disorder (FSAD), hypoactive sexual desire disorder (HSDD), or mixed FSAD/HSDD in premenopausal women.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
612
Inclusion Criteria

Female, at least 21 years of age, and premenopausal Previously experienced sexual arousal during sexual activity and/or normal level of desire in the past for least 2 years.

Willing to engage in sexual activities Currently in stable relationship with a partner(male or female)for at least 6 months.

If subject has a male sexual partner, has recorded a score of "not impotent" or "minimally impotent" on Single-question Assessment of ED.

For at least 6 months before Screening, has met diagnostic criteria for FSAD, HSDD, or mixed FSAD/HSDD Has a negative serum pregnancy test (hCG) at Screening and, if subject's partner is male, has used a medically acceptable form of contraception for the 3 months before Screening (Visit 1), and is willing to continue for the duration of the trial and 1 month following the last dose of trial drug.

Has a normal pelvic examination. At Screening or documented within 12 months before Screening, has:normal Pap test results with or without history of positive HPV, dysplasia, or ASCUS that has resolved or been treated;Pap test results positive for ASCUS and negative for HPV;Pap test results positive for HPV AND no ASCUS or dysplasia on Pap or condyloma present upon examination.

At Screening and Visit 2, meets all necessary questionnaire scores.

Exclusion Criteria

Medical condition that is unstable or uncontrolled despite current therapy. History of unresolved sexual trauma or abuse. Pregnant or nursing. Lifelong anorgasmia, vaginismus, sexual pain disorder, sexual aversion disorder, or persistent sexual arousal disorder.

Female sexual dysfunction caused by untreated endocrine disease. Has or has had any of the following: hepatitis C, other infectious hepatitis, infectious blood disorders such as HIV; myocardial infarction;stroke.

Has or has had any of the following within 12 months before Screening:chronic dyspareunia not attributable to vaginal dryness; pelvic inflammatory disease; chronic or complicated UTI, or an active STD other than herpes and condyloma; cervical dysplasia, including LGSIL and HGSIL and/or ASCUS with HPV; significant cervicitis as manifested by mucopurulent discharge from the cervix.

Has had any of the following within 6 months before Screening:≥ 2 outbreaks of genital herpes; occurrence/recurrence of clinically significant condyloma;clinically unstable angina or clinically unstable arrhythmia;significant CNS diseases;AST or ALT concentrations > 3 times the ULN;serum creatinine > 2.5 mg/dL;any other clinically significant abnormal laboratory result.

Has used prohibited medications within the 3 months before Screening:

Has currently active moderate to severe vaginitis or a clinically significant vaginal infection.

Has one or more significant gynecologic conditions . Is taking or has received treatment for psychosis, bipolar disorder, depression, and/or alcohol/substance abuse within 6 months before Screening.

Is currently receiving psychotherapy for the treatment of FSAD and/or HSDD. Has any of the following: Uncontrolled hypertension;Systolic BP of ≥ 140 mm Hg at Screening;Diastolic BP of ≥ 90 mm Hg at Screening; Treatment for hypertension that has changed in the 3 months before Screening.

Had a hysterectomy with bilateral oophorectomy. Had a hysterectomy without bilateral oophorectomy AND meets several other criteria.

Is taking contraceptives that have affected the menstrual cycle or caused amenorrhea AND did not have a normal menstrual cycle before starting the contraceptive medication.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlacebobremelanotideSame formulation as the investigation product but without the active ingredient, provided as pre-filled syringes containing 0.3 mL volume. Subjects will self-administer the placebo by SC injection in the same manner as the investigational product.
bremelanotide arm 1bremelanotideLow dose: Investigational product: Bremelanotide aqueous solution for subcutaneous (SC) injection, provided as pre-filled syringes containing 0.75 mg in 0.3 mL volume. Subjects will self-administer bremelanotide by SC injection into the anterior thigh or abdomen.
bremelanotide arm 2bremelanotideMiddle dose: Investigational product: Bremelanotide aqueous solution for subcutaneous (SC) injection, provided as pre-filled syringes containing 1.25 mg in 0.3 mL volume. Subjects will self-administer bremelanotide by SC injection into the anterior thigh or abdomen.
bremelanotide arm 3bremelanotideHigh dose: Investigational product: Bremelanotide aqueous solution for subcutaneous (SC) injection, provided as pre-filled syringes containing 1.75 mg in 0.3 mL volume. Subjects will self-administer bremelanotide by SC injection into the anterior thigh or abdomen.
Primary Outcome Measures
NameTimeMethod
The Primary Efficacy Endpoint is Change From Baseline to End of Study in the Number of Satisfying Sexual Events (SSE)4 - 12 weeks from baseline to end of study (total study duration 20 weeks). Baseline was the 4-week single-blind placebo period.

The primary efficacy endpoint is change from baseline to end of study in the number of satisfying sexual events (SSEs), computed as the number of events during the last 4 weeks of treatment with FSEP-R Q10 = "Yes" minus the number of baseline events with FSEP-R Q10 = "Yes." Efficacy analyses were done with the MITT population which consisted of all randomized subjects who took at least 1 dose of double-blind treatment after the 2 in-clinic doses of double-blind medication and who had at least 1 follow-up visit (Visit 10 or later) to ensure that FSEP-R data were reviewed and confirmed by the investigative site.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline to End-of-Study in Arousal Domain Score From Female Sexual Function Index4-12 weeks from baseline to end of study (total study duration 20 weeks)

The FSFI is brief self-report questionnaire that measures female sexual function. The change from baseline to end of study in the arousal domain were obtained from the FSFI Q3 through Q6. The score range is 0-5. For each of the 2 time points, the score was computed programmatically using the algorithm described by Rosen \[6\], resulting in a score from 0 (min) to 6 (max).

Quality of Relationship With Partner as Measured by GAQ Question 44-12 weeks from baseline to end of study (total study duration 20 weeks)

This is the change in Baseline to End-of-Study in Quality of Relationship with Partner as Measured by GAQ Question 4. GAQ (Global Assessment Questions) is a questionnaire that evaluates overall satisfaction level experienced while using the study drug. Question 4 is "Compared to the start of the study (prior to taking the study drug), how has taking the study drug changed your relationship with your partner?" The score range is 1 (very much worse) to 7 (very much better).

FSDS-DAO Total Score4 - 12 weeks from baseline to end of study (total study duration 20 weeks)

FSDS-DAO (Female Sexual Distress Scale - Desire/Arousal/Orgasm) is an assessment tool to measure female sexual distress. The change from baseline to end of study in the FSDS-DAO (total score) was measured. There are 15 questions, eg, "How often do you feel: Distressed about your sex life" and the score range was 0 (Never), 1 (Rarely), 2 (Occasionally), 3 (Frequently), 4 (Always). The score for each subject at each time point was computed as the sum of the scores from the 15 questions, resulting in a possible score at each time point between 0 and 60.

Satisfaction With Arousal as Measured by GAQ Question 14-12 weeks from baseline to end of study (total study duration 20 weeks)

This is the change in Baseline to End-of-Study in Satisfaction with Arousal as measured by GAQ Question 1. GAQ (Global Assessment Questions) is a questionnaire that evaluates overall satisfaction level experienced while using the study drug. Question 1 is "Compared to the start of the study (prior to taking the study drug), how would you describe your satisfaction with your arousal while using the study drug?" The score range is 1 (very much worse) to 7 (very much better).

Desire Domain From Female Sexual Function Index4-12 weeks from baseline to end of study (total study duration 20 weeks)

The FSFI is brief self-report questionnaire that measures female sexual function. The change from baseline to end of study in the desire domain were obtained from the FSFI Q1 and Q2. The score range is 1-5. For each of the 2 time points, the score was computed programmatically using the algorithm described by Rosen \[6\], resulting in a score from 0 (min) to 6 (max).

Satisfaction With Desire as Measured by GAQ Question 24-12 weeks from baseline to end of study (total study duration 20 weeks)

This is the change in Baseline to End-of-Study in Satisfaction with Desire as Measured by GAQ Question 2. GAQ (Global Assessment Questions) is a questionnaire that evaluates overall satisfaction level experienced while using the study drug. Question 2 is "Compared to the start of the study (prior to taking the study drug), how would you describe your satisfaction with your desire while using the study drug?" The score range is 1 (very much worse) to 7 (very much better).

Trial Locations

Locations (68)

Site 26

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Huntsville, Alabama, United States

Site 64

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Mobile, Alabama, United States

Site 52

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National City, California, United States

Site 32

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Washington, District of Columbia, United States

Site 61

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Orlando, Florida, United States

Site 82

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Atlanta, Georgia, United States

Site 55

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Decatur, Georgia, United States

Site 70

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Chicago, Illinois, United States

Site 54

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Peoria, Illinois, United States

Site 63

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South Bend, Indiana, United States

Site 13

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Wichita, Kansas, United States

Site 48

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Lexington, Kentucky, United States

Site 9

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Baltimore, Maryland, United States

Site 19

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Cleveland, Ohio, United States

Site 23

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Beachwood, Ohio, United States

Site 30

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Columbus, Ohio, United States

Site 42

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Philadelphia, Pennsylvania, United States

Site 81

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Englewood, Ohio, United States

Site 77

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Pittsburgh, Pennsylvania, United States

Site 76

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Dallas, Texas, United States

Site 31

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Dallas, Texas, United States

Site 59

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Corpus Christi, Texas, United States

Site 17

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Houston, Texas, United States

Site 65

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Richmond, Virginia, United States

Site 22

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Seattle, Washington, United States

Site 25

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Tucson, Arizona, United States

Site 45

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Chandler, Arizona, United States

Site 78

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Hot Springs, Arkansas, United States

Site 16

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Jonesboro, Arkansas, United States

Site 8

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Avon, Connecticut, United States

Site 75

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Farmington, Connecticut, United States

Site 33

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New London, Connecticut, United States

Site 10

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Aventura, Florida, United States

Site 27

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Fort Myers, Florida, United States

Site 66

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Melbourne, Florida, United States

Site 1

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West Palm Beach, Florida, United States

Site 57

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Zachary, Louisiana, United States

Site 60

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Rockville, Maryland, United States

Site 35

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Lincoln, Nebraska, United States

Site 2

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Eugene, Oregon, United States

Site 58

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Greer, South Carolina, United States

Site 4

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North Vancouver, British Columbia, Canada

Site 49

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Mt. Pleasant, South Carolina, United States

Site 53

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Chattanooga, Tennessee, United States

Site 50

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Murray, Utah, United States

Site 36

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Sandy, Utah, United States

Site 41

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Barrie, Ontario, Canada

Site 21

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Burlington, Ontario, Canada

Site 73

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Newport Beach, California, United States

Site 80

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Sacramento, California, United States

Site 74

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St. Louis, Missouri, United States

Site 3

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Raleigh, North Carolina, United States

Site 38

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Purchase, New York, United States

Site 47

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Winston-Salem, North Carolina, United States

Site 18

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New York, New York, United States

Site 69

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Canton, Ohio, United States

Site 7

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Charlottesville, Virginia, United States

Site 43

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Warwick, Rhode Island, United States

Site 12

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San Diego, California, United States

Site 72

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Las Vegas, Nevada, United States

Site 24

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Las Vegas, Nevada, United States

Site 71

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Cincinnati, Ohio, United States

Site 62

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San Antonio, Texas, United States

Site 40

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Lakewood, Colorado, United States

Site 39

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Phoenix, Arizona, United States

Site 56

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Birmingham, Alabama, United States

Site 37

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Denver, Colorado, United States

Site 68

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Norfolk, Virginia, United States

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