A Study to Evaluate the Effectiveness, Pharmacokinetics, Safety, and Acceptability of Sayana® Press When Injected Every Four Months
Overview
- Phase
- Phase 3
- Intervention
- Sayana® Press
- Conditions
- Contraception
- Sponsor
- FHI 360
- Enrollment
- 750
- Locations
- 3
- Primary Endpoint
- Occurrence of Pregnancy
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
This is a randomized clinical trial designed to evaluate the effectiveness, safety and acceptability of Sayana® Press when injected every 4 months (17-18 weeks) for 3 treatment cycles (12 months) of use.
Detailed Description
This is a randomized, partially-blinded, multi-center, parallel-group study to evaluate the effectiveness, PK, safety, and acceptability of Sayana® Press when injected every 4 months (17-18 weeks) rather than the currently prescribed 3-month (12-14 weeks) regimen. A total of 750 healthy, sexually active women aged 18 to 35 years with regular menstrual cycles and no DMPA use in the previous 12 months will be enrolled and followed for pregnancy. Among all enrolled, 710 will be randomized to receive injections in the abdomen or upper thigh in accordance with the PATH Sayana® injection instructions, which are consistent with prescribing information, for the primary effectiveness analysis. An additional 40 women will be randomized to receive injections subcutaneously in the back of the upper arm to assess whether differences in PK may exist which could impact the grace period for reinjections for that injection site. A single MPA serum sample will be collected from all participants at baseline. All participants will receive re-injections at month 4 and month 8, and complete their scheduled follow-up at month 12. There will be a plus 7-day grace period for re-injections, but women who are up to 28 days late may continue treatment if they have a negative urine pregnancy test. Urine pregnancy testing will be performed at month 4, at study exit and at any other time during the study if clinically indicated. Participants will be evaluated for injection site reactions and asked to provide information on adverse events, prohibited concomitant medication and other contraceptive use, vaginal bleeding, and method acceptability at all regular follow-up visits (i.e., not including the PK visits at Months 2 and 3). Serious adverse events and adverse events leading to product withdrawal, will be recorded throughout the study.
Investigators
Eligibility Criteria
Inclusion Criteria
- •not pregnant and no desire to become pregnant in the next 18 months
- •regular menstrual cycles (25 to 35 days in length when not using hormonal contraception, pregnant, or lactating)
- •at risk of pregnancy (no diagnosis of infertility, no history of tubal ligation or hysterectomy, and an average of 1 or more unprotected acts of vaginal intercourse per month)
- •in good general health as determined by a medical history
- •18 to 35 years of age, inclusive
- •willing to provide informed consent, follow all study requirements, and rely on Sayana® Press injected every 4 months as the only means of contraception for 12 months
- •has only one sexual partner and expects to have that same sexual partner for the next 12 months
Exclusion Criteria
- •has a primary partner who has received a vasectomy or is otherwise sterile
- •medical contraindications to depot medroxyprogesterone acetate (DMPA) per World Health Organization medical eligibility criteria for contraceptive use
- •known HIV-infection (for her or her partner)
- •diagnosis or treatment for a sexually transmitted infection in the past month (for her or a partner), excluding recurrent herpes or condyloma
- •received an injection of a progestin-only containing contraceptive (DMPA or norethisterone enanthate) in the past 12 months
- •received an injection of a combined injectable contraceptive in the past 6 months
- •known or suspected allergic reaction to DMPA
- •used a levonorgestrel-releasing intrauterine system, NuvaRing, contraceptive patch, oral contraceptives or a contraceptive implant in the 7 days prior to enrollment (PK cohort only)
- •previous (within 1 month prior to enrollment), current or planned (in the next 12 months) use of an investigational drug, prohibited drug per protocol or other drug which in the opinion of the site investigator could complicate study findings
- •has been pregnant in the past month
Arms & Interventions
Abdomen
Sayana® Press (MPA injectable suspension, 104 mg/0.65 mL, pre-filled in the UnijectTM delivery injection system) injected subcutaneously every 4 months (17-18 weeks) for 3 treatment cycles (12 months).
Intervention: Sayana® Press
Upper thigh
Sayana® Press (MPA injectable suspension, 104 mg/0.65 mL, pre-filled in the UnijectTM delivery injection system) injected subcutaneously every 4 months (17-18 weeks) for 3 treatment cycles (12 months).
Intervention: Sayana® Press
Back of the upper arm
Sayana® Press (MPA injectable suspension, 104 mg/0.65 mL, pre-filled in the UnijectTM delivery injection system) injected subcutaneously every 4 months (17-18 weeks) for 3 treatment cycles (12 months).
Intervention: Sayana® Press
Outcomes
Primary Outcomes
Occurrence of Pregnancy
Time Frame: 12 months after treatment initiation
Pregnancy is defined as having a positive urine pregnancy test. Positive urine tests will be confirmed by ultrasound and/or serum hCG testing whenever possible. The primary efficacy analysis will be based on the pregnancy Pearl Index, computed as the number of pregnancies that occur during the treatment period multiplied by 100 and divided by the number of WY of treatment contributed to the Treated Analysis Set among women receiving injections in the abdomen or thigh.
Secondary Outcomes
- Serum MPA Concentrations in a Subset of 120 Participants(2, 3, 4, 8, and 12 months after treatment initiation)
- Occurrence of Serious Adverse Events (SAEs) and Adverse Events (AEs) Leading to Product Withdrawal(12 months after treatment initiation)
- Acceptability of Sayana® Press(12 months after treatment initiation)