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A Study Following Women in Menopause Treated With a Non-hormonal Therapy for Hot Flashes and Night Sweats

Recruiting
Conditions
Hot Flashes
Interventions
Drug: Any other non-hormonal pharmacologic therapy prescribed for the treatment of VMS not included in a category above
Drug: Any other SSRI/SNRI not already specified
Registration Number
NCT06049797
Lead Sponsor
Astellas Pharma Global Development, Inc.
Brief Summary

Hot flashes and night sweats (also known as vasomotor symptoms or VMS) are the most common symptoms which bother women in menopause. This study will follow women going through menopause who have hot flashes and night sweats that cause them bother. They will be starting a non-hormonal therapy prescribed by their healthcare provider (HCP) to treat these symptoms. The women will visit their HCP's office, research center, or both. They will receive prescriptions for the non-hormonal therapy from their HCP for up to 1 year. This real-world study will provide information on outcomes from various non-hormonal therapies. The study sponsor (Astellas) will not decide which therapy the women receive. However, the sponsor will provide instructions on when the women visit their clinic, and what is recorded during the study. Some of the visits will be in-person, but most will be virtual. The virtual visits can be carried out at home using a smartphone, tablet or computer. The main aim of the study is to check if the hot flashes and night sweats that bother women change after 12 weeks (3 months) of treatment. The study will also check the women's sleep patterns, their productivity at work, and their general well-being before and after starting treatment. The overall safety of the non-hormonal therapies will also be examined.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
1000
Inclusion Criteria
  • Participant is diagnosed with bothersome VMS due to/associated with menopause for at least 3 months based on a standard of care assessment captured in consultation with an HCP including the participant's history, routine physical examination, and routine laboratory assessments.
  • HCP has made the clinical decision to begin pharmacologic treatment with a non-HT including, a selective neurokinin 3 receptor (NK3-R) antagonist, an SSRI, SNRI, gabapentin, clonidine, pregabalin, oxybutynin or other non-HT, as part of the standard treatment for VMS. This may be the first course of treatment, a restart or a switch from one drug (HT/non- HT) to another non-HT. A restart or switch of a previous therapy requires a minimum of a 10-day period not on therapy/washout period prior to pre-baseline.
  • Participant's health status is stable based on their medical history and general physical exam and determined to be a candidate for treatment with non-HTs.
  • If participant has been prescribed an SSRI or SNRI for the treatment of depression or anxiety, they must be on a stable or consistent dose for a minimum of 3 months prior to screening.
  • Participant has a negative urine pregnancy test at screening if not post-menopausal.
  • Only for participants utilizing complementary and alternative therapies, mind-body techniques, or supplements for the treatment of VMS: participant has been on such therapies for ≥ 3 months prior to screening and intends to continue through duration of study.
  • Confirmation has been made that the participant is able to obtain the prescribed non hormonal therapy (e.g., insurance coverage verified, participant has ability to self pay, or patient support program activated for at least 12 months for the uninsured participants, if applicable).
Exclusion Criteria
  • Participant is currently enrolled in any interventional or non-interventional wearable device study.

  • Participant has any condition which makes the participant unsuitable for the study.

  • Participant has a contraindication to the non-HT they are being prescribed for the treatment of VMS.

  • Participant is currently taking hormonal contraceptives or other systemic HTs (including estrogen and/or progesterone, and/or testosterone preparations) and has not had a 10-day washout period prior to pre-baseline (vaginal/local estrogen preparations and levonorgestrel-releasing intrauterine system are not prohibited).

  • Participant has presence of moderately severe or severe depression per standard of care assessment utilizing a standardized depression screening tool.

  • Participant is currently pregnant or planning to become pregnant.

  • Participant is post-menopausal and has a history of unexplained uterine bleeding within the last 6 months.

  • Participant has pre-existing uncontrolled thyroid disease.

  • Participant has unstable angina or participant has uncontrolled hypertension based on a standard of care assessment.

    • Participants who do not meet these criteria may be re-assessed after initiation or review of antihypertensive measures.
    • Participants with a medical history of hypertension can be enrolled once they are medically clear (stable and compliant).
  • Participant has had insomnia unrelated to either menopause or bothersome VMS due to/associated with menopause.

  • Participant has known substance abuse or alcohol addiction within 6 months of screening.

  • Participant has been on intramuscular estradiol within 8 weeks of screening.

  • Participant has a current diagnosis of a malignancy or history of a malignancy within the past 2 years (This does not include basal cell carcinoma or breast cancer.)

  • Participants with metastatic (Stage 4) breast cancer.

  • Participants who have been prescribed adjuvant endocrine therapy (tamoxifen or aromatase inhibitors with or without gonadotropin-releasing hormone analogues) for their non-metastatic (stage 0 to 3) breast cancer but have not maintained a stable treatment regimen for at least 3 months prior to screening.

  • Participant has initiated hormone pellet therapy within 6 months of screening.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Neurokinin 3 Receptor (NK3-R) AntagonistFezolinetantParticipants prescribed NK3-R Antagonist for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)Any other SSRI/SNRI not already specifiedParticipants prescribed SSRI/SNRI for the treatment of VMS.
OtherPregabalinParticipants prescribed something other than NK3-R Antagonist or SSRI/SNRI for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)CitalopramParticipants prescribed SSRI/SNRI for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)EscitalopramParticipants prescribed SSRI/SNRI for the treatment of VMS.
OtherAny other non-hormonal pharmacologic therapy prescribed for the treatment of VMS not included in a category aboveParticipants prescribed something other than NK3-R Antagonist or SSRI/SNRI for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)DesvenlafaxineParticipants prescribed SSRI/SNRI for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)ParoxetineParticipants prescribed SSRI/SNRI for the treatment of VMS.
Selective serotonin reuptake inhibitor (SSRI)/Serotonin and norepinephrine reuptake inhibitor (SNRI)VenlafaxineParticipants prescribed SSRI/SNRI for the treatment of VMS.
OtherGabapentinParticipants prescribed something other than NK3-R Antagonist or SSRI/SNRI for the treatment of VMS.
OtherClonidineParticipants prescribed something other than NK3-R Antagonist or SSRI/SNRI for the treatment of VMS.
OtherOxybutyninParticipants prescribed something other than NK3-R Antagonist or SSRI/SNRI for the treatment of VMS.
Primary Outcome Measures
NameTimeMethod
Mean change from baseline to week 12 in symptom bother measured by the Menopause-Specific Quality of Life Domain (MENQoL) 1-week recall VMS domain scoreBaseline and week 12

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Secondary Outcome Measures
NameTimeMethod
Change from baseline in average daily wake after sleep onset (WASO), as recorded by wearable deviceBaseline to weeks 4, 8 and 12

The wearable device will capture movement and physiological signals to derive measures related to sleep.

Mean change from baseline in total score of Patient-Reported Outcomes Measurement Information System Sleep Disturbance Sexual Function (PROMIS SD SF) 8bBaseline and weeks 4, 8, 12, 24 and 52

The PROMIS SD SF 8b assesses self-reported sleep disturbance over the past 7 days and includes perceptions of restless sleep; satisfaction with sleep; refreshing sleep; difficulties sleeping, getting to sleep or staying asleep; amount of sleep; and sleep quality. Responses to each of the 8 items range from 1 to 5, and the range of possible summed raw scores is 8 to 40. Higher scores on the PROMIS SD SF 8b indicate more of the concept measured (disturbed sleep).

Total score from Patient Global Impression of Change (PGI-C) of SDUp to week 52

PGI-C SD evaluates patient perceived change in sleep disturbance from the initiation of treatment. Ratings range from (1) much better to (7) much worse.

Change from baseline in average daily sleep efficiency, as recorded by wearable deviceBaseline to weeks 4, 8 and 12

The wearable device will capture movement and physiological signals to derive measures related to sleep.

Percentage of participants classified as 2-point responders as measured by the MENQol 1-week recall VMS domainUp to week 52

Participants with a reduction (improvement) in symptom bother score ≥ 2 unit will be classified as 2-point responders.

Mean change from baseline in the MENQoL total scoreBaseline to weeks 4, 8, 12, 24 and 52

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. The total score is the mean of the domain means. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Mean change from baseline in the MENQoL 1-week recall psychosocial domain scoreBaseline to weeks 4, 8, 12, 24 and 52

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Mean change from baseline in the MENQoL 1-week recall physical domain scoreBaseline to weeks 4, 8, 12, 24 and 52

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Percentage of participants classified as 1-point responders as measured by the MENQol 1-week recall VMS domainUp to week 52

Participants with a reduction (improvement) in symptom bother score ≥ 1 unit will be classified as 1-point responders.

Total score from Patient Global Impression of Severity (PGI-S) of SDUp to week 52

The PGI-S SD evaluates patient perceived severity of sleep disturbance. Ratings range from (1) no problems to (4) severe problems.

Change from baseline in average daily total sleep time, as recorded by wearable deviceBaseline to weeks 4, 8 and 12

The wearable device will capture movement and physiological signals to derive measures related to sleep.

Change from baseline in average daily number of nighttime awakenings, as recorded by wearable deviceBaseline to weeks 4, 8 and 12

The wearable device will capture movement and physiological signals to derive measures related to sleep.

Change from baseline in average daily sleep latency, as recorded by wearable deviceBaseline to weeks 4, 8 and 12

The wearable device will capture movement and physiological signals to derive measures related to sleep.

Mean change from baseline in the MENQoL vasomotor 1-week recall VMS domain scoreBaseline to weeks 4, 8, 24 and 52

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Mean change from baseline in the female sexual function index (FSFI) domain scoreBaseline to weeks 4, 8, 12, 24 and 52

The FSFI is comprised of 19 questions with response options varying among items and ranging from 0 to 5 or 1 to 5. The FSFI has 6 domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Within the individual domains, a domain score of zero indicates that the participant-reported having no sexual activity during the past month. The overall score can range from 2 to 36. A higher score overall or for individual domains indicates better sexual function.

Mean change from baseline in the mean number of nighttime moderate/severe VMS episodes per 24 hours self-reported by participants via an eDiaryBaseline to weeks 4, 8 and 12

Participant manually records moderate/severe VMS episodes on the eDiary.

Number of participants with Adverse Events (AEs)Up to 52 weeks

An AE is defined as any untoward medical occurrence in a participant administered a study drug, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product whether or not considered related to the medicinal (investigational) product.

Mean change from baseline in the MENQoL 1-week recall sexual domain scoreBaseline to weeks 4, 8, 12, 24 and 52

The MENQoL is a 29-item patient reported outcome (PRO) measure that assesses the impact of 4 domains of menopausal symptoms: vasomotor, psychosocial, physical, and sexual. Each item score ranges from 1 to 8, and each domain is scored separately; each domain mean ranges from 1 to 8. Higher scores represent more bothersome menopausal symptoms. A reduction (improvement) of 1 is the minimum clinically important difference for the MENQoL.

Total score from PGI-C VMSUp to week 52

PGI-C VMS evaluates participant perceived change in VMS. Ratings range from (1) much better to (7) much worse.

Mean change from baseline in the VMS-related work productivity and activity impairment (WPAI-VMS) domain scoreBaseline to weeks 4, 8, 12, 24 and 52

The WPAI-VMS is a 6-item PRO measure that examines VMS-related work productivity and activity in the preceding 7 days. It consists of 4 domains: absenteeism, presenteeism, overall work productivity loss, and activity impairment. WPAI-VMS outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity (that is, worse outcomes).

Mean change from baseline in the mean number of moderate/severe VMS episodes per 24 hours self-reported by participants via an an eDiaryBaseline to weeks 4, 8 and 12

Participant manually records moderate/severe VMS episodes on the eDiary.

Mean change from baseline in the mean number of daytime moderate/severe VMS episodes per 24 hours self-reported by participants via an eDiaryBaseline to weeks 4, 8 and 12

Participant manually records moderate/severe VMS episodes on the eDiary

Number of participants with Serious Adverse Events (SAEs)Up to 52 weeks

An AE is considered "serious" if, in the view of either the investigator or sponsor, it:

Results in death, is life-threatening, results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, is a congenital anomaly or birth defect of a child conceived during the exposure of one of the parents to the drug studied, requires inpatient hospitalization or leads to prolongation of hospitalization, is a medically important event or reaction.

Number of participants with vital sign abnormalities and/or adverse events (AEs)Up to 52 weeks

Number of participants with potentially clinically significant vital sign values.

Trial Locations

Locations (57)

Alabama Clinical Therapeutics

🇺🇸

Birmingham, Alabama, United States

Accel Research Sites-Cahaba Medical Care-OBGYN

🇺🇸

Birmingham, Alabama, United States

Precision Trials AZ, LLC

🇺🇸

Phoenix, Arizona, United States

Torrance Clinical Research Institute,Inc

🇺🇸

Lomita, California, United States

Dream Team Clinical Research

🇺🇸

Pomona, California, United States

Wake Research - Medical Center for Clinical Research WR-MCCR, LLC

🇺🇸

San Diego, California, United States

Millennium Clinical Trials

🇺🇸

Simi Valley, California, United States

Bayview Research Group, LLC

🇺🇸

Valley Village, California, United States

University of Colorado Health - Anschutz Cancer Pavilion - Anschutz Medical Campus

🇺🇸

Aurora, Colorado, United States

Red Rocks Ob/Gyn And Physicians Research Options Llc

🇺🇸

Lakewood, Colorado, United States

Accel Research Sites

🇺🇸

DeLand, Florida, United States

Nextlevel Research Center

🇺🇸

Doral, Florida, United States

Multi-Specialty Research Associates, Inc.

🇺🇸

Lake City, Florida, United States

Altus Research

🇺🇸

Lake Worth, Florida, United States

Suncoast Research Associates, LLC

🇺🇸

Miami, Florida, United States

Dr. Jarrett's Wellness Center

🇺🇸

Miami, Florida, United States

Complete Health Research

🇺🇸

Ormond Beach, Florida, United States

Physician Care Clinical Research, LLC

🇺🇸

Sarasota, Florida, United States

GCP Clinical Research

🇺🇸

Tampa, Florida, United States

Comprehensive Clinical Trials, Llc

🇺🇸

West Palm Beach, Florida, United States

Agile Clinical Research Trials, LLC

🇺🇸

Atlanta, Georgia, United States

Alpha Clinical Research Georgia

🇺🇸

Dunwoody, Georgia, United States

Clinical Research Prime

🇺🇸

Idaho Falls, Idaho, United States

Rosemark Women Care Specialists

🇺🇸

Idaho Falls, Idaho, United States

Chicago Clinical Research Institute Inc.

🇺🇸

Chicago, Illinois, United States

Investigators Research Group, Llc

🇺🇸

Brownsburg, Indiana, United States

Tekton Research

🇺🇸

Austin, Texas, United States

Praetorian Pharmaceutical Research

🇺🇸

Marrero, Louisiana, United States

ClinRx Research

🇺🇸

Plano, Texas, United States

Southern Clinical Research Associates

🇺🇸

Metairie, Louisiana, United States

Saginaw Valley Medical Research Group, LLC

🇺🇸

Saginaw, Michigan, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Montana Medical Research, Inc.

🇺🇸

Missoula, Montana, United States

Bosque Women's Care

🇺🇸

Albuquerque, New Mexico, United States

SUNY Downstate Health Sciences University

🇺🇸

Brooklyn, New York, United States

Mohawk Valley Health System - Womens Health Center

🇺🇸

Utica, New York, United States

Upstate Clinical Research Associates

🇺🇸

Williamsville, New York, United States

Premier Gynecology & Wellness

🇺🇸

Charlotte, North Carolina, United States

Eastern Carolina Women's Center

🇺🇸

New Bern, North Carolina, United States

Unified Women's Clinical Research

🇺🇸

Winston-Salem, North Carolina, United States

Axia Women's Health - Seven Hills Women's Health Centers - Anderson

🇺🇸

Cincinnati, Ohio, United States

HWC Women's Research Center

🇺🇸

Englewood, Ohio, United States

Institute for Female Pelvic Medicine and Reconstructive Surgery

🇺🇸

Allentown, Pennsylvania, United States

Clinical Research Of Philadelphia, Llc

🇺🇸

Philadelphia, Pennsylvania, United States

Reading Hospital / Tower Health

🇺🇸

West Reading, Pennsylvania, United States

Biocentric Health Research

🇺🇸

West Columbia, South Carolina, United States

Chattanooga Medical Research, Llc

🇺🇸

Chattanooga, Tennessee, United States

Signature Gyn Services

🇺🇸

Fort Worth, Texas, United States

UT Health Women's Research Center at Memorial City

🇺🇸

Houston, Texas, United States

TMC Life Research, Inc

🇺🇸

Houston, Texas, United States

Biopharma Informatic Research Center

🇺🇸

Houston, Texas, United States

Pioneer Research Solutions, Inc

🇺🇸

Houston, Texas, United States

DCT - Stone Oak, LLC dba Discovery Clinical Trials

🇺🇸

San Antonio, Texas, United States

Corner Canyon Obstetrics and Gynecology

🇺🇸

Draper, Utah, United States

Granger Medical Clinic

🇺🇸

Riverton, Utah, United States

Tidewater Clinical Research Inc

🇺🇸

Virginia Beach, Virginia, United States

Seattle Clinical Research Center

🇺🇸

Seattle, Washington, United States

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