Long-term Safety Study of Intramuscular Injections of 750 mg and 1000 mg Testosterone Undecanoate in Hypogonadal Men

Phase 3

Completed

Conditions: Secondary Hypogonadism
Hypogonadism
Primary Hypogonadism

Interventions: Drug: Testosterone Undecanoate 750 mg
Drug: Testosterone Undecanoate 1000 mg

Registration Number: NCT00467870

Lead Sponsor: Endo Pharmaceuticals

Brief Summary: To evaluate the pharmacokinetics of TU 750 mg and TU 1000 mg via multiple measurements of serum total testosterone.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: Male

Target Recruitment: 531

Inclusion Criteria

Male with primary or secondary hypogonadism at least 18 years of age and for study part C2 weighs ≥143.3 lb (≥65 kg)
Morning screening serum testosterone concentration <300 ng/dL

Exclusion Criteria

American Urological Association (AUA) Symptom Score ≥15 or significant prostatic symptoms
History of carcinoma, tumors or induration of the prostate or the male mammary gland including suspicion thereof
Screening serum prostate-specific antigen (PSA) level >4 ng/mL or hyperplasia of the prostate (size >75 cm3 as measured by transrectal ultrasonography)
Past or present liver tumors or acute or chronic hepatic disease with impairment of liver function; liver function tests (alanine aminotransferase [ALT], aspartate aminotransferase [AST]) exceeding 1.5 times upper limit of normal
History of deep vein thrombosis in the past 5 years or any history of cerebrovascular accident
Severe acne
Hypertension (systolic blood pressure >160 mm Hg and diastolic blood pressure >95 mm Hg) or coronary heart disease not stabilized by therapy as assessed by the investigator
Insulin-dependent diabetes mellitus or uncontrolled non-insulin-dependent diabetes mellitus; patients with diabetes are excluded if screening glycated hemoglobin (HbA1C) level is >9%
Use of any sex hormones within 28 days (for injectable testosterone preparations) or 7 days (for oral, gel, patch, etc, testosterone preparations) prior to screening visit and throughout the study (exclusive of administered study drug)
Use of steroidal anabolic drugs or supplements (eg, dehydroepiandrosterone [DHEA]) by any application method within the 28 days prior to first administration of study drug and throughout the study (exclusive of administrated study drug)
Medication with substances which might interfere with testosterone metabolism within 28 days before the first administration of study drug
History of sleep apnea Insulin-dependent diabetes mellitus
Use of steroidal anabolic drugs or supplements by any application method within the 28-days prior to the first administration of the study drug and throughout the study (exclusive of the administered study drug)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Testosterone Undecanoate 750 mg	750 mg dose of testosterone undecanoate
2	Testosterone Undecanoate 1000 mg	1000 mg dose testosterone undecanoate

Primary Outcome Measures

Name	Time	Method
Percentage of Participants Meeting Serum Total Testosterone Average Concentration Criteria for Responder During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14	Responders were participants with serum total testosterone average concentration (Cavg) between 300 and 1000 ng/dL derived from the 3rd injection intensive pharmacokinetic (IPK) interval.
Serum Total Testosterone Average Concentration During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14	Serum total testosterone Cavg derived from the 3rd injection IPK interval
Serum Total Testosterone Maximum Concentration During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14	Serum total testosterone maximum concentration (Cmax) derived from the 3rd injection IPK interval
Serum Total Testosterone Concentration at the End of the Dosing Interval Following the 3rd Injection in Part C	Day 70 post injection at week 14	Serum total testosterone concentration at the end of the dosing interval (Ctrough) derived from the 3rd injection IPK interval
Percentage of Participants Meeting Serum Total Testosterone Average Concentration Criteria for Responder During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24	Responders were participants with serum total testosterone Cavg between 300 and 1000 ng/dL derived from the 4th injection IPK interval.
Serum Total Testosterone Average Concentration During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24	Serum total testosterone Cavg derived from the 4th injection IPK interval
Serum Total Testosterone Maximum Concentration During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24	Serum total testosterone Cmax derived from the 4th injection IPK interval
Serum Total Testosterone Concentration at the End of the Dosing Interval Following the 4th Injection in Part C	Day 70 post injection at week 24	Serum total testosterone Ctrough derived from the 4th injection IPK interval
Percentage of Participants Meeting Serum Total Testosterone Maximum Concentration Criteria for Success During the 2nd Injection Interval in Part C2	Days 0, 4, 7, 11, 14, and 70 post injection at week 4	Success was defined as having ≥85% of participants with Cmax ≤1500 ng/dL, ≤5% of participants with Cmax 1800-2500 ng/dL, and no participants with Cmax \>2500 ng/dL.
Serum Total Testosterone Average Concentration During the 2nd Injection Interval in Part C2	Days 0, 4, 7, 11, 14, and 70 post injection at week 4	Serum total testosterone Cavg derived from the 2nd injection IPK interval
Serum Total Testosterone Maximum Concentration During the 2nd Injection Interval in Part C2	Days 0, 4, 7, 11, 14, and 70 post injection at week 4	Serum total testosterone Cmax derived from the 2nd injection IPK interval
Serum Total Testosterone at the End of the Dosing Interval Following the 2nd Injection in Part C2	Day 70 post injection at week 4	Serum total testosterone Ctrough derived from the 2nd injection IPK interval

Secondary Outcome Measures

Name	Time	Method
Serum Total Testosterone Maximum Concentration in Part A	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, 70, and 84 post injection at week 1, week 12, week 24, and week 36; and post injection at weeks 48, 60, 72, 84, 96, 108, and 120
Serum Total Testosterone Maximum Concentration in Part B	Post injection at week 1; post injection at week 8; days 0, 4, 7, 11, 14, 21, 28, 42, 56, 70, and 84 post injection at week 20; and post injection at weeks 32, 44, 56, 68, and 80
Percentage of Participants Meeting Serum Total Testosterone Maximum Concentration Criteria for Success During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14	Success is defined as having ≥85% of participants with Cmax ≤1500 ng/dL, ≤5% of participants with Cmax 1800-2500 ng/dL, and no participants with Cmax \>2500 ng/dL.
Percentage of Participants With at Least 1 Serum Total Testosterone Level <300 ng/dL at Any Time During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14
Percentage of Participants With Serum Total Testosterone Average Concentration ≥300 ng/dL During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14
Time to First Serum Total Testosterone Concentration <300 ng/dL Following the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14
Percentage of Participants With Clinical Success During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14	Clinical success is defined as having both Cavg and Ctrough between 300 and 1000 ng/dL
Percentage of Participants With Serum Total Testosterone Maximum Concentration ≤1500, >1500 to <1800, 1800 to 2500, and >2500 ng/dL During the 3rd Injection Interval in Part C	Days 0, 4, 7, 11, 14, 21, 28, 42, 56, and 70 post injection at week 14
Percentage of Participants Meeting Serum Total Testosterone Maximum Concentration Criteria for Success During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24	Success is defined as having ≥85% of participants with Cmax ≤1500 ng/dL, ≤5% of participants with Cmax 1800-2500 ng/dL, and no participants with Cmax \>2500 ng/dL.
Percentage of Participants With at Least 1 Serum Total Testosterone Level <300 ng/dL at Any Time During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24
Percentage of Participants With Average Serum Total Testosterone Concentration ≥300 ng/dL During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24
Time to First Serum Total Testosterone Concentration <300 ng/dL Following the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24
Percentage of Participants With Clinical Success During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24	Clinical success is defined as having both Cavg and Ctrough between 300 and 1000 ng/dL
Percentage of Participants With Serum Total Testosterone Maximum Concentration ≤1500, >1500 to <1800, 1800 to 2500, and >2500 ng/dL During the 4th Injection Interval in Part C	Days 0, 4, 7, 11, 42, and 70 post injection at week 24
Percentage of Participants by Collapsed Category for Each Parameter of the Male Patient Global Assessment (M-PGA) at Day 21 of the 3rd Injection Interval in Part C	Day 21 post injection at week 14	M-PGA is a 5-item self-report questionnaire to assess perception of change from pretreatment or baseline in hypogonadal symptoms including confidence/self-esteem, sexual performance, moods/behavior, overall feeling of well-being, and satisfaction with study treatment rated on a 7-point scale where items 1-4 were rated as 1 (very much improved), 2 (much improved), 3 (minimally improved), 4 (no change), 5 (minimally worse), 6 (much worse), 7 (very much worse) and item 5 was rated as 1 (very much satisfied), 2 (much satisfied), 3 (minimally satisfied), 4 (neither satisfied nor dissatisfied), 5 (minimally dissatisfied), 6 (much dissatisfied), 7 (very much dissatisfied). Collapsed ratings: Improved=Very much, much, or minimally improved; Worsened=Very much, much, or minimally worse; No change; Satisfied=Very much, much, or minimally satisfied; Not satisfied=Very much, much, or minimally dissatisfied; No opinion (neither satisfied nor dissatisfied).
Change in Body Mass Index From Baseline to Week 24 in Part C	Baseline, Week 24	Difference in Body Mass Index (BMI) from baseline to week 24 calculated from weight (kg) divided by height squared (m2)
Change in Weight From Baseline to Week 24 in Part C	Baseline, Week 24
Percentage of Participants With at Least 1 Serum Total Testosterone Concentration >1000, >1100, >1250, and <300 or >1000 ng/dL During the 2nd Injection Interval in Part C2	Days 0, 4, 7, 11, 14, and 70 post injection at week 4
Serum Dihydrotestosterone Concentrations During the 2nd Injection Interval in Part C2	Days 0, 4, 7, 11, 14, and 70 post injection at week 4
Serum Total Testosterone Concentrations in Part C2	Screening; day 0; days 0, 4, 7, 11, and 14 post injection at week 4; weeks 14, 24, 34, and 44
Percentage of Participants With Serum Total Testosterone Concentrations Outside the Normal Range in Part C2	Screening; day 0; days 0, 4, 7, 11, and 14 post injection at week 4; weeks 14, 24, 34, and 44	Serum total testosterone concentrations outside the normal range are categorized as \<300 ng/dL (below lower limit of normal range) and \>1000 ng/dL (above upper limit of normal range)
Trough Assessments of Serum Total Testosterone Concentrations in Part C2	Screening; day 0; and weeks 4, 14, 24, 34, and 44
Serum Total Testosterone Maximum Concentration in Part C2	Screening; day 0; days 0, 4, 7, 11, and 14 post injection at week 4; and weeks 14, 24, 34, and 44