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A Trial to Evaluate the Efficacy of Low Dose Vaginal Estrogens in the Treatment of Atrophic Vaginitis

NCT ID: NCT00816556

Last Updated: 2017-11-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2011-12-31

Brief Summary

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Atrophic vaginitis is a common problem that occurs in up to 40% of postmenopausal women. The main symptoms are dryness, itching and burning in and around the vagina. These symptoms in turn can cause pain with intercourse. Other symptoms can include urinary frequency and urinary urgency. These symptoms are caused by the decreasing levels of estrogens in postmenopausal women.

The current treatment options include hormone replacement therapy by mouth and patch and vaginal creams, tablets and rings. The current guideline recommend using hormone therapy at the lowest dose for the shortest time. We are trying to find the lowest effective dose of estrogen cream that helps with symptoms without causing an increase in estrogens in the blood stream.

We want to compare two estrogen creams, estradiol and estriol, each at very low doses, with a placebo cream. Estradiol cream is available on prescription but we want to see how effective it is at one tenth the commonly prescribed dose. Estriol cream is not commonly prescribed and is only available at compounding pharmacies. We want to see if either of these estrogens is effective at one tenth the usual dose. We also want to see if these creams are effective when massaged onto the outer part of the vagina, rather than the usual method of treatment, which is inserting them into the vagina.

Detailed Description

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This trial will measure the effects of very low doses of estradiol or estriol cream applied to the vaginal introitus for the treatment of atrophic vaginitis, a common condition affecting up to 40% of postmenopausal women. We will conduct a randomized controlled trial with three arms-estradiol, estriol and placebo. The intervention will last for 12 weeks. The outcomes we will be most interested in are the efficacy of the treatments for symptoms of atrophic vaginitis compared to placebo and whether there is any measurable systemic absorption from the locally applied estrogen creams. These outcomes will be measured, primarily, by the use of patient questionnaires and secondarily, clinical examination scores. Safety will be evaluated with serum estrogen concentrations. All measures will be collected at baseline and at the termination of the study. Hormone concentrations will be collected, additionally, at week 2. This trial will answer important questions regarding the impact of very low doses of locally applied estrogens and symptoms of atrophic vaginitis. It will provide information on effect size and validity of outcome measures. It will also give information about whether low doses of estrogen creams, locally applied to the vaginal introitus, result in systemic absorption

Conditions

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Atrophic Vaginitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Estriol

Estriol 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Group Type ACTIVE_COMPARATOR

Estriol

Intervention Type DRUG

Estriol 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for 2 weeks and then twice weekly for 10 weeks.

Estradiol

Estradiol valerate 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Group Type ACTIVE_COMPARATOR

Estradiol valerate

Intervention Type DRUG

Estradiol valerate 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Vanicream Lite

Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Group Type PLACEBO_COMPARATOR

Vanicream Lite

Intervention Type DRUG

Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Interventions

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Estriol

Estriol 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for 2 weeks and then twice weekly for 10 weeks.

Intervention Type DRUG

Estradiol valerate

Estradiol valerate 10 micrograms added to Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Intervention Type DRUG

Vanicream Lite

Vanicream Lite 0.5 grams applied to vaginal introitus daily for two weeks and then twice weekly for 10 weeks

Intervention Type DRUG

Other Intervention Names

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Delestrogen

Eligibility Criteria

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Inclusion Criteria

* Postmenopausal women (no menses for the previous 12 months)
* Dryness, itching or burning in and around the vagina
* Discontinued hormone replacement therapy (either local or systemic) at least 3 months

Exclusion Criteria

* Known, suspected, or history of cancer of the breast.
* Known, or suspected estrogen dependent neoplasia (ovarian, endometrial).
* Known hypersensitivity to any component of the medications or base creams.
* Active deep vein thrombosis, pulmonary embolism, or history of these conditions.
* Active or recent (within the past year) arterial thromboembolic disease (stroke, myocardial infarct).
* Liver dysfunction or disease with elevation of aspartate aminotransferase (AST)\>1.5x upper level of normal (ULN); Normal for females is 8-43 U/L.
* Undiagnosed abnormal genital bleeding.
* Known chronic lichen sclerosis.
* Known, untreated vaginal infection.
* Not had a normal screening mammogram within the last 15 months.
* Hysterectomy without oophorectomy unless 60 years or older.
* Women taking aromatase inhibitors or tamoxifen.
* Hgb \<12.0 or \>15.5 g/dL
* Urinalysis showing a urinary tract infection (UTI).
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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National Center for Advancing Translational Sciences (NCATS)

NIH

Sponsor Role collaborator

Maire Mac Bride

OTHER

Sponsor Role lead

Responsible Party

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Maire Mac Bride

M.B., B. Ch., Assistant Professor of Medicine, College of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Maire B Mac Bride, MB BCh

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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UL1TR000135

Identifier Type: NIH

Identifier Source: secondary_id

View Link

07-008730

Identifier Type: -

Identifier Source: org_study_id