MedPath

LIBERTY EXTENSION: Efficacy and Safety Extension Study of Relugolix in Women With Heavy Menstrual Bleeding Associated With Uterine Fibroids

Phase 3
Completed
Conditions
Heavy Menstrual Bleeding
Uterine Fibroid
Interventions
Registration Number
NCT03412890
Lead Sponsor
Myovant Sciences GmbH
Brief Summary

The purpose of this study was to determine the long-term efficacy and safety of relugolix 40 milligrams (mg) once daily co-administered with estradiol (E2) and norethindrone acetate (NETA) for 28 weeks on heavy menstrual bleeding associated with uterine fibroids in participants who previously completed a 24-week treatment period in one of the pivotal studies (MVT-601-3001 or MVT-601-3002).

Detailed Description

This study is an international phase 3 open-label, single-arm, long-term efficacy and safety extension study that enrolled eligible participants who have completed their participation in one of the phase 3 randomized, double-blind, placebo-controlled pivotal studies, MVT-601-3001 (LIBERTY 1 - NCT03049735) or MVT-601-3002 (LIBERTY 2 - NCT 03103087). All participants received relugolix 40 mg orally once daily co-administered with E2 (1 mg) and NETA (0.5 mg) for 28 weeks.

Approximately 600 women with heavy menstrual bleeding associated with uterine fibroids were to be enrolled, after having completed a 24-week treatment period in one of the pivotal studies. The objectives of the study were to evaluate long-term efficacy and safety through up to 52 weeks of treatment (including treatment during the pivotal study) of relugolix co-administered with E2/NETA.

Screening and baseline procedures were to be done at the same visit for this extension study (referred to as the "Week 24/Baseline Visit"), which coincided with the Week 24 Visit from the pivotal study and was to be defined as the date of completion of the last Week 24 procedure in the pivotal study. Participants will have received their last dose of study drug in the pivotal study on the day prior to the Week 24/Baseline Visit and were to receive their first dose of study drug for this extension study in the clinic after the participant was determined to be eligible for this extension study and provided informed consent to participate. The administration of the first dose of study drug for MVT-601-3003 was to define enrollment into this study. Study participants were to then take the open-label study treatment orally once daily for 28 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
477
Inclusion Criteria
  1. Completed 24 weeks of study drug treatment and study participation in either pivotal study, MVT-601-3001 or MVT-601-3002

Key

Exclusion Criteria
  1. Has undergone myomectomy, ultrasound-guided laparoscopic radiofrequency ablation, or any other surgical procedure for fibroids, uterine artery embolization, magnetic resonance-guided focused ultrasound for fibroids, or endometrial ablation for abnormal uterine bleeding at any time during the pivotal study (MVT-601-3001 or MVT-601-3002)
  2. Met a withdrawal criterion in the pivotal study (MVT-601-3001 or MVT-601-3002).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Relugolix plus E2/NETAEstradiol/norethindrone acetateRelugolix co-administered with E2/NETA for 28 weeks.
Relugolix plus E2/NETARelugolixRelugolix co-administered with E2/NETA for 28 weeks.
Primary Outcome Measures
NameTimeMethod
Percentage Of Participants Who Achieved Or Maintained An MBL Volume Of <80 Milliliters (mL) And At Least A 50% Reduction From Baseline MBL Volume At Week 52/End Of TreatmentWeek 52/End of Treatment

A responder was a participant who had MBL volume of \< 80 mL and at least a 50% reduction from baseline MBL volume over the last 35 days of treatment (up to Week 52). All returned feminine products collected at each clinical visit were analyzed by the alkaline hematin method to obtain the MBL volume. MBL volume was measured over the Week 52/early termination feminine product collection interval (up to 35 days prior to the last dose of treatment). The percentage of participants who were responders are presented.

Secondary Outcome Measures
NameTimeMethod
Change From Pivotal Study Baseline In MBL Volume At Week 52Week 52

MBL volume was measured using the alkaline hematin method, which involves chemically measuring the blood content of used feminine products. The volume of MBL is measured in mL and a blood loss of 80 mL or more per cycle is considered diagnostic of heavy menstrual bleeding. The least squares (LS) mean was derived for each treatment group using a mixed-effects model with repeated measure with visit, region, and Baseline MBL as fixed effects.

Change From Pivotal Study Baseline In Hemoglobin Concentration At Week 52Week 52

Blood samples were collected from participants for hemoglobin measurements. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In The UFS-QoL Symptom Severity Scale At Week 52Week 52

Transformed score ranges from 0 to 100 based on Likert scale (none of time, a little of time, some of the time, most of the time, and all of the time). Lower score indicates less distress and higher score indicates greater distress. A negative change from baseline indicates improvement. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In The UFS-QoL Score Health-Related Quality of Life Subscales Score At Week 52Week 52

Assessed using the UFS-QoL questionnaire. The UFS-QoL subscale scores include items related to uterine fibroid-associated limitations/impairment in activities, revised activities, concern, energy/mood, control, self-consciousness, and sexual function. The scores were transformed to normalized scores. Transformed score ranges from 0 to 100. Higher scores are indicative of better health-related quality of life (high = good). The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In The UFS-QoL Score By Health-Related Quality of Life Total Score At Week 52Week 52

Assessed using the UFS-QoL Questionnaire. The UFS-QoL total score was the sum of the subscales (concern, activities, revised activities, energy/mood, control, self-conscious, and sexual function). The raw scores were transformed to normalized scores. Transformed score ranges from 0 to 100. Higher scores are indicative of better health-related quality of life (high = good). The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In The Uterine Fibroid Symptom Health-Related Quality of Life (UFS-QoL) Bleeding And Pelvic Discomfort (BPD) Scale At Week 52Week 52

The BPD scale has been derived from the UFS-QoL symptom severity scale. The scale consists of the following 3 symptoms proximal to uterine fibroids that are experienced by most participants: heavy bleeding during the menstrual period (Question 1), passing blood clots during the menstrual period (Question 2), and feeling tightness or pressure in the pelvic area (Question 5). Raw scores were transformed to a normalized score, with a range of possible scores from 0 to 100 (none of time, a little of time, some of the time, most of the time, and all of the time), where higher scores values are indicative of greater distress and lower scores are indicative of minimal distress. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In Uterine Volume At Week 52Week 52

Volume of the uterus was measured by transvaginal or transabdominal ultrasound. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In Uterine Fibroid Volume At Week 52Week 52

Volume of the primary uterine fibroid was measured by transvaginal or transabdominal ultrasound. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Percent Change From Pivotal Study Baseline In Bone Mineral Density (BMD) At The Lumbar Spine (L1-L4), Femoral Neck, And Total Hip At Week 52Week 52

Assessed by dual-energy X-ray absorptiometry (DXA) scan at the lumbar spine (L1-L4), total hip, and femoral neck at pivotal study Baseline and at Week 52. The scans were read by the central radiology laboratory in accordance with the imaging charter. The same DXA machine was used at the local imaging center at each site and operated in the same scan mode for all images procured for an individual participant. All images were submitted for central reading. The central radiology laboratory collected and evaluated all DXA scans for acceptability and measured BMD. The LS mean was derived for each treatment group using a mixed-effects model with repeated measure.

Change From Pivotal Study Baseline In Predose Serum E2 Concentrations At Week 52Week 52

Blood samples were collected from participants at predose for E2 measurements. These were analyzed at a central laboratory.

Percentage Of Participants Who Achieved Or Maintained Amenorrhea Over The Last 35 Days Of TreatmentWeek 24 up to last 35 days of treatment (up to Week 52)

Amenorrhea was defined as meeting 1 of the following criteria for 2 consecutive visits:

* No feminine product returned due to reported amenorrhea;

* No feminine product returned due to reports of spotting/negligible bleeding coupled with other data (participant's paper diary) indicating infrequent non-cyclic bleeding/spotting; and

* Feminine product collection with a negligible observed MBL volume coupled with data (participant's paper diary) indicating infrequent non-cyclic bleeding/spotting.

Number Of Participants With Hemoglobin Increase Of ≥1 g/dL From Pivotal Study Baseline At Week 52 Among Those With A Hemoglobin Concentration Below Lower Limit Of Normal At Pivotal BaselineWeek 52

Blood samples were collected from participants for hemoglobin measurements. Percentages are based on number of participants with hemoglobin concentration below the lower limit of normal (11.6 g/dL) at pivotal study Baseline and reported at Week 52.

Percentage Of Participants With A Hemoglobin Level ≤10.5 Gram/Deciliter (g/dL) At Pivotal Study Baseline Who Achieved An Increase Of >2 g/dL From Pivotal Study Baseline At Week 52Week 52

Blood samples were collected from participants for hemoglobin measurements. Percentages are based on number of participants with hemoglobin ≤10.5 g/dL at pivotal study Baseline and reported at Week 52.

Trial Locations

Locations (129)

Chicago

🇺🇸

Chicago, Illinois, United States

Houston

🇺🇸

Houston, Texas, United States

Miami

🇺🇸

Miami, Florida, United States

Las Vegas

🇺🇸

Las Vegas, Nevada, United States

Cincinnati

🇺🇸

Cincinnati, Ohio, United States

San Antonio

🇺🇸

San Antonio, Texas, United States

Nyíregyháza

🇭🇺

Nyíregyháza, Szabolcs-Szatmar-Bereg, Hungary

Lublin

🇵🇱

Lublin, Lubelskie, Poland

Debrecen

🇭🇺

Debrecen, Hungary

Durban

🇿🇦

Durban, Kwazulu-natal, South Africa

Norfolk

🇺🇸

Norfolk, Virginia, United States

Birmingham

🇺🇸

Birmingham, Alabama, United States

San Ramon

🇨🇱

San Ramón, Chile

La Louvière

🇧🇪

La Louvière, Hainaut, Belgium

Providencia

🇨🇱

Providencia, Chile

Santiago

🇨🇱

Santiago, Chile

San Diego

🇺🇸

San Diego, California, United States

Huntington Beach

🇺🇸

Huntington Beach, California, United States

Tampa

🇺🇸

Tampa, Florida, United States

Long Beach

🇺🇸

Long Beach, California, United States

Clearwater

🇺🇸

Clearwater, Florida, United States

New York

🇺🇸

New York, New York, United States

Augusta

🇺🇸

Augusta, Georgia, United States

Norcross

🇺🇸

Norcross, Georgia, United States

New Port Richey

🇺🇸

New Port Richey, Florida, United States

Ft. Lauderdale

🇺🇸

Fort Lauderdale, Florida, United States

Lakewood

🇺🇸

Lakewood, Colorado, United States

Atlanta

🇺🇸

Atlanta, Georgia, United States

Lincoln

🇺🇸

Lincoln, Nebraska, United States

Duluth

🇺🇸

Duluth, Georgia, United States

Savannah

🇺🇸

Savannah, Georgia, United States

Shawnee

🇺🇸

Shawnee Mission, Kansas, United States

Baltimore

🇺🇸

Baltimore, Maryland, United States

Columbus

🇺🇸

Columbus, Ohio, United States

Santo André

🇧🇷

Santo André, SAO Paulo, Brazil

São Bernardo Do Campo

🇧🇷

São Bernardo Do Campo, Sao Paulo, Brazil

Roma

🇮🇹

Roma, Italy

Kecskemét

🇭🇺

Kecskemét, Bacs-kiskun, Hungary

Detroit

🇺🇸

Detroit, Michigan, United States

Denver

🇺🇸

Denver, Colorado, United States

Mobile

🇺🇸

Mobile, Alabama, United States

Fort Myers

🇺🇸

Fort Myers, Florida, United States

Hialeah

🇺🇸

Hialeah, Florida, United States

Jupiter

🇺🇸

Jupiter, Florida, United States

Margate

🇺🇸

Margate, Florida, United States

Oviedo

🇺🇸

Oviedo, Florida, United States

Palm Harbor

🇺🇸

Palm Harbor, Florida, United States

Sarasota

🇺🇸

Sarasota, Florida, United States

West Palm Beach

🇺🇸

West Palm Beach, Florida, United States

Weston

🇺🇸

Weston, Florida, United States

Mesa

🇺🇸

Mesa, Arizona, United States

Aventura

🇺🇸

Aventura, Florida, United States

Canoga Park

🇺🇸

Canoga Park, California, United States

Andalusia

🇺🇸

Andalusia, Alabama, United States

La Mesa

🇺🇸

La Mesa, California, United States

Norwalk

🇺🇸

Norwalk, California, United States

Tucson

🇺🇸

Tucson, Arizona, United States

Los Angeles

🇺🇸

Los Angeles, California, United States

Little Rock

🇺🇸

Little Rock, Arkansas, United States

Washington

🇺🇸

Washington, District of Columbia, United States

Panorama

🇺🇸

Panorama City, California, United States

Jacksonville

🇺🇸

Jacksonville, Florida, United States

DeLand

🇺🇸

DeLand, Florida, United States

Loxahatchee

🇺🇸

Loxahatchee Groves, Florida, United States

Saint Cloud

🇺🇸

Saint Cloud, Florida, United States

College Park

🇺🇸

College Park, Georgia, United States

Naperville

🇺🇸

Naperville, Illinois, United States

Decatur

🇺🇸

Decatur, Georgia, United States

Oakbrook

🇺🇸

Oakbrook Terrace, Illinois, United States

Marrero

🇺🇸

Marrero, Louisiana, United States

Canton

🇺🇸

Canton, Michigan, United States

Metairie

🇺🇸

Metairie, Louisiana, United States

Covington

🇺🇸

Covington, Louisiana, United States

Towson

🇺🇸

Towson, Maryland, United States

Saginaw

🇺🇸

Saginaw, Michigan, United States

Lawrenceville

🇺🇸

Lawrenceville, New Jersey, United States

Albuquerque

🇺🇸

Albuquerque, New Mexico, United States

Brooklyn

🇺🇸

Brooklyn, New York, United States

Williamsville

🇺🇸

Williamsville, New York, United States

Durham

🇺🇸

Durham, North Carolina, United States

Bluffton

🇺🇸

Bluffton, South Carolina, United States

Raleigh

🇺🇸

Raleigh, North Carolina, United States

Englewood

🇺🇸

Englewood, Ohio, United States

Columbia

🇺🇸

Columbia, South Carolina, United States

Chattanooga

🇺🇸

Chattanooga, Tennessee, United States

Dallas

🇺🇸

Dallas, Texas, United States

Memphis

🇺🇸

Memphis, Tennessee, United States

Beaumont

🇺🇸

Beaumont, Texas, United States

Fort Worth

🇺🇸

Fort Worth, Texas, United States

Webster

🇺🇸

Webster, Texas, United States

Longview

🇺🇸

Longview, Texas, United States

Sugar Land

🇺🇸

Sugar Land, Texas, United States

Salt Lake City

🇺🇸

Salt Lake City, Utah, United States

Gent

🇧🇪

Gent, Oost-vlaanderen, Belgium

Spokane

🇺🇸

Spokane, Washington, United States

Brussels

🇧🇪

Brussels, Belgium

Jette

🇧🇪

Jette, Belgium

Sao Paulo

🇧🇷

São Paulo, Sao Paulo, Brazil

Santo Andre

🇧🇷

Santo André, Santo Andre, Brazil

Porto Alegre

🇧🇷

Porto Alegre, Brazil

Pisek

🇨🇿

Písek, Czechia

Botucatu

🇧🇷

Botucatu, Brazil

Region Metropolitana

🇨🇱

Santiago, Chile

Jihlava

🇨🇿

Jihlava, Czechia

Olomouc

🇨🇿

Olomouc, Czechia

Ceské Budejovice

🇨🇿

České Budějovice, Czechia

Szentes

🇭🇺

Szentes, Hungary

Catanzaro

🇮🇹

Catanzaro, Italy

Lódz

🇵🇱

Lódz, Lodzkie, Poland

Torino

🇮🇹

Torino, Italy

Gyula

🇭🇺

Gyula, Bekes, Hungary

Firenze

🇮🇹

Firenze, Italy

Siena

🇮🇹

Siena, Italy

Katowice

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Katowice, Slaskie, Poland

Poznan

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Poznań, Wielkopolskie, Poland

Bialystok

🇵🇱

Białystok, Poland

Centurion

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Centurion, Gauteng, South Africa

Port Elizabeth

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Port Elizabeth, South Africa

Skórzewo

🇵🇱

Skórzewo, Wielkopolskie, Poland

Cape Town

🇿🇦

Cape Town, South Africa

Warszawa

🇵🇱

Warszawa, Mazowieckie, Poland

Bloemfontein

🇿🇦

Bloemfontein, South Africa

Roodepoort

🇿🇦

Roodepoort, Gauteng, South Africa

Szczecin

🇵🇱

Szczecin, Zachodniopomorskie, Poland

Orlando

🇺🇸

Orlando, Florida, United States

Winston-Salem

🇺🇸

Winston-Salem, North Carolina, United States

Charleston

🇺🇸

Charleston, South Carolina, United States

Richmond

🇺🇸

Richmond, Virginia, United States

Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

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