Trial Outcomes & Findings for Early Menopause Hormone Treatment and Cognition (NCT NCT01046643)

NCT ID: NCT01046643

Last Updated: 2014-05-19

Results Overview

Measure the changes in brain activity in verbal tasks with hormone use (either estradiol or progesterone) versus placebo. The test is a deep and shallow verbal processing task, where the subjects are presented lists of words, one word at a time, and are asked to make one of 2 decisions about each list. One decision is whether each word is written in upper or lower case letters (shallow processing), and the other decision is whether each word denotes an abstract or concrete concept (deep processing). The test was administered 3 months after baseline and 38 weeks after baseline.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

30 participants

Primary outcome timeframe

August 2010 - March 2012

Results posted on

2014-05-19

Participant Flow

+++\_\_Women were recruited from 3/1/2010 to 7/29/2011 through local newspaper ads, flyers, electronic newsletters, bulletin boards, clinics and the Women's Health Registry, a University of Michigan database of women interested in participating in women's health related clinical research.

Several enrolled participants were excluded from the trial prior to assignment in groups on the basis of the risk factors identified at the pre-screening appointment. Some others did not qualify due to their lab results which did not meet the inclusion criteria.

Participant milestones

Participant milestones
Measure
Estrogen Followed by Placebo
Estrogen treatment with Estradiol (E2) One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days followed by one Placebo capsule once per day for 90 days, at the same time each day
Progesterone Followed by Placebo
Progesterone (P10) treatment One Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days, followed by one Placebo capsule once per day for 90 days, at the same time each day.
Placebo Followed by Estrogen
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Estradiol capsule (E2) (1mg) once a day, at the same time each day, for 90 days.
Placebo Followed by Progesterone
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days.
First Period Treatment or Placebo
STARTED
9
7
7
7
First Period Treatment or Placebo
COMPLETED
9
6
7
7
First Period Treatment or Placebo
NOT COMPLETED
0
1
0
0
Washout Period
STARTED
9
6
7
7
Washout Period
COMPLETED
9
6
7
7
Washout Period
NOT COMPLETED
0
0
0
0
Second Period Treatment or Placebo
STARTED
9
6
7
7
Second Period Treatment or Placebo
COMPLETED
9
6
7
7
Second Period Treatment or Placebo
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Estrogen Followed by Placebo
Estrogen treatment with Estradiol (E2) One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days followed by one Placebo capsule once per day for 90 days, at the same time each day
Progesterone Followed by Placebo
Progesterone (P10) treatment One Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days, followed by one Placebo capsule once per day for 90 days, at the same time each day.
Placebo Followed by Estrogen
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Estradiol capsule (E2) (1mg) once a day, at the same time each day, for 90 days.
Placebo Followed by Progesterone
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days.
First Period Treatment or Placebo
Withdrawal by Subject
0
1
0
0

Baseline Characteristics

Early Menopause Hormone Treatment and Cognition

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Estrogen and Placebo
n=16 Participants
Estrogen treatment with Estradiol (E2) Participants received both an Estradiol capsule (E2) (1mg) and a Placebo capsule in a randomized sequence (for a total of two sequences of 90 days each, consisting of one capsule, once per day at the same time each day).
Progesterone and Placebo
n=14 Participants
Progesterone treatment (P10) Participants received both a Progesterone capsule (P10) (200 mg) and a Placebo capsule in a randomized sequence (for a total of two sequences of 90 days each, consisting of one capsule, once per day at the same time each day).
Total
n=30 Participants
Total of all reporting groups
Age, Continuous
51.8 years
STANDARD_DEVIATION 2.2 • n=5 Participants
51.2 years
STANDARD_DEVIATION 2.9 • n=7 Participants
51.5 years
STANDARD_DEVIATION 2.5 • n=5 Participants
Gender
Female
9 participants
n=5 Participants
7 participants
n=7 Participants
16 participants
n=5 Participants
Gender
Male
0 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
Region of Enrollment
United States
9 participants
n=5 Participants
7 participants
n=7 Participants
16 participants
n=5 Participants
Months since Last Menstrual Period
19.81 months
STANDARD_DEVIATION 9.57 • n=5 Participants
16.69 months
STANDARD_DEVIATION 9.80 • n=7 Participants
18.41 months
STANDARD_DEVIATION 9.63 • n=5 Participants
Education
15.75 years
STANDARD_DEVIATION 2.82 • n=5 Participants
17.19 years
STANDARD_DEVIATION 2.67 • n=7 Participants
16.4 years
STANDARD_DEVIATION 2.8 • n=5 Participants
Estradiol
17.75 pg/mL
STANDARD_DEVIATION 6.30 • n=5 Participants
14.38 pg/mL
STANDARD_DEVIATION 6.25 • n=7 Participants
16.24 pg/mL
STANDARD_DEVIATION 6.40 • n=5 Participants
Follicle-Stimulating Hormone
92.34 mIU/mL
STANDARD_DEVIATION 33.85 • n=5 Participants
80.86 mIU/mL
STANDARD_DEVIATION 21.60 • n=7 Participants
87.19 mIU/mL
STANDARD_DEVIATION 29.11 • n=5 Participants
BMI
27.13 kg/m²
STANDARD_DEVIATION 6.13 • n=5 Participants
28.38 kg/m²
STANDARD_DEVIATION 3.8 • n=7 Participants
27.69 kg/m²
STANDARD_DEVIATION 5.17 • n=5 Participants

PRIMARY outcome

Timeframe: August 2010 - March 2012

Population: Within the Estrogen/Placebo groups, 3 participants were unable to complete the needed fMRI analyses due to adverse events, and in the Progesterone/Placebo groups, 1 participant's fMRI scans were damaged and unable to be used in the analysis.

Measure the changes in brain activity in verbal tasks with hormone use (either estradiol or progesterone) versus placebo. The test is a deep and shallow verbal processing task, where the subjects are presented lists of words, one word at a time, and are asked to make one of 2 decisions about each list. One decision is whether each word is written in upper or lower case letters (shallow processing), and the other decision is whether each word denotes an abstract or concrete concept (deep processing). The test was administered 3 months after baseline and 38 weeks after baseline.

Outcome measures

Outcome measures
Measure
Estrogen
n=13 Participants
Estrogen treatment with Estradiol (E2) Estradiol (E2) : One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days
Progesterone
n=12 Participants
Progesterone treatment Progesterone (P10) : One Progesterone (200 mg) capsule once a day, at the same time each day, for 90 days
Placebo (Estrogen)
n=13 Participants
Placebo phase of Estradiol (E2) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Placebo (Progesterone)
n=12 Participants
Placebo phase of Progesterone (P10) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Changes in Brain Activation Patterns in Verbal Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Medial Frontal Cortex
.14 percent BOLD signal changes
Standard Deviation .12
.13 percent BOLD signal changes
Standard Deviation .16
.05 percent BOLD signal changes
Standard Deviation 021
.13 percent BOLD signal changes
Standard Deviation .18
Changes in Brain Activation Patterns in Verbal Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Left Hippocampus
-.04 percent BOLD signal changes
Standard Deviation .14
-.01 percent BOLD signal changes
Standard Deviation .15
-.13 percent BOLD signal changes
Standard Deviation .16
.09 percent BOLD signal changes
Standard Deviation .34
Changes in Brain Activation Patterns in Verbal Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Right Hippocampus
-.06 percent BOLD signal changes
Standard Deviation .18
-.06 percent BOLD signal changes
Standard Deviation .13
-.14 percent BOLD signal changes
Standard Deviation .16
.01 percent BOLD signal changes
Standard Deviation .24

PRIMARY outcome

Timeframe: August 2010 - March 2012

Population: Within the Estrogen/Placebo groups, 3 participants were unable to complete the needed fMRI analyses due to adverse events, and in the Progesterone/Placebo groups, 1 participant's fMRI scans were damaged.

Measure the changes in brain activity in visual tasks with hormone use (either estradiol or progesterone) versus placebo. The test is a visual working memory task, where the women are presented with 3 geometric grids on the screen. The target grid is on top, and 2 test grids are on the bottom. The women must decide if the right or left test grid matches the grid on top. There are 3 conditions: a match condition where all 3 grids are shown simultaneously, and 2 delay conditions, where the target grid is shown first, disappears, and the test grids appear after a 1 or a 4 second delay. The test was administered 3 months after baseline and 38 weeks after baseline.

Outcome measures

Outcome measures
Measure
Estrogen
n=13 Participants
Estrogen treatment with Estradiol (E2) Estradiol (E2) : One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days
Progesterone
n=12 Participants
Progesterone treatment Progesterone (P10) : One Progesterone (200 mg) capsule once a day, at the same time each day, for 90 days
Placebo (Estrogen)
n=13 Participants
Placebo phase of Estradiol (E2) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Placebo (Progesterone)
n=12 Participants
Placebo phase of Progesterone (P10) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Changes in Brain Activation Patterns in Visual Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Medial Frontal Cortex
.25 percent BOLD signal changes
Standard Deviation .17
.47 percent BOLD signal changes
Standard Deviation .28
.16 percent BOLD signal changes
Standard Deviation .41
.20 percent BOLD signal changes
Standard Deviation .43
Changes in Brain Activation Patterns in Visual Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Left Hippocampus
.21 percent BOLD signal changes
Standard Deviation .20
.38 percent BOLD signal changes
Standard Deviation .25
.23 percent BOLD signal changes
Standard Deviation .38
.21 percent BOLD signal changes
Standard Deviation .29
Changes in Brain Activation Patterns in Visual Tasks Determined With the Functional Magnetic Resonance Imaging (fMRI) Scans
Right Hippocampus
.29 percent BOLD signal changes
Standard Deviation .17
.38 percent BOLD signal changes
Standard Deviation .29
.21 percent BOLD signal changes
Standard Deviation .48
.15 percent BOLD signal changes
Standard Deviation .29

SECONDARY outcome

Timeframe: August 2010 - March 2012

Population: Within the Estrogen/Placebo groups, 3 participants were unable to complete the needed fMRI analyses due to adverse events, and in the Progesterone/Placebo groups, 1 participant's fMRI scans were damaged.

Changes in neuropsychological testing measures (verbal learning retention) with hormone use (either estradiol or progesterone) versus placebo. Subjects are given tests that present them with a series of words. They are asked to recall how many items they can remember, and then some time later, are asked to recall the items again. The retention measure is how many items they can remember at the later time point, compared to the earlier time point. Adapted from the Benton Visual Memory Test, Revised. The tests were administered 3 months after baseline and 38 weeks after baseline.

Outcome measures

Outcome measures
Measure
Estrogen
n=13 Participants
Estrogen treatment with Estradiol (E2) Estradiol (E2) : One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days
Progesterone
n=12 Participants
Progesterone treatment Progesterone (P10) : One Progesterone (200 mg) capsule once a day, at the same time each day, for 90 days
Placebo (Estrogen)
n=13 Participants
Placebo phase of Estradiol (E2) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Placebo (Progesterone)
n=12 Participants
Placebo phase of Progesterone (P10) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Neuropsychological Testing Scores - Verbal Learning Retention
96.79 percent retention
Standard Deviation 6.72
97.12 percent retention
Standard Deviation 15.30
94.94 percent retention
Standard Deviation 10.75
98.44 percent retention
Standard Deviation 12.25

SECONDARY outcome

Timeframe: August 2010 - March 2012

Population: Within the Estrogen/Placebo groups, 3 participants were unable to complete the needed fMRI analyses due to adverse events, and in the Progesterone/Placebo groups, 1 participant's fMRI scans were damaged.

Changes in neuropsychological testing measures (visual learning retention) with hormone use (either estradiol or progesterone) versus placebo. Subjects are given tests that present them with a series of pictures. They are asked to recall how many items they can remember, and then some time later, are asked to recall the items again. The retention measure is how many items they can remember at the later time point, compared to the earlier time point. Adapted from the California Verbal Learning Test - 2nd edition. The tests were administered 3 months after baseline and 38 weeks after baseline.

Outcome measures

Outcome measures
Measure
Estrogen
n=13 Participants
Estrogen treatment with Estradiol (E2) Estradiol (E2) : One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days
Progesterone
n=12 Participants
Progesterone treatment Progesterone (P10) : One Progesterone (200 mg) capsule once a day, at the same time each day, for 90 days
Placebo (Estrogen)
n=13 Participants
Placebo phase of Estradiol (E2) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Placebo (Progesterone)
n=12 Participants
Placebo phase of Progesterone (P10) treatment One Placebo capsule once a day, at the same time each day, for 90 days
Neuropsychological Testing Scores - Visual Learning Retention
93.31 percent retention
Standard Deviation 19.22
97.59 percent retention
Standard Deviation 13.67
97.01 percent retention
Standard Deviation 14.79
96.19 percent retention
Standard Deviation 12.06

Adverse Events

Estrogen Followed by Placebo

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Progesterone Followed by Placebo

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Placebo Followed by Estrogen

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Placebo Followed by Progesterone

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Estrogen Followed by Placebo
n=9 participants at risk
Estrogen treatment with Estradiol (E2) One Estradiol capsule (E2) (1mg) once a day, at the same time each day, for 90 days followed by one Placebo capsule once per day for 90 days, at the same time each day.
Progesterone Followed by Placebo
n=7 participants at risk
Progesterone treatment One Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days, followed by one Placebo capsule once per day for 90 days, at the same time each day.
Placebo Followed by Estrogen
n=7 participants at risk
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Estradiol capsule (E2) (1mg) capsule once a day, at the same time each day, for 90 days.
Placebo Followed by Progesterone
n=7 participants at risk
One Placebo capsule once per day for 90 days, at the same time each day, followed by one Progesterone (P10) (200 mg) capsule once a day, at the same time each day, for 90 days.
General disorders
Claustrophobia
11.1%
1/9 • Number of events 1 • 2 years
0.00%
0/7 • 2 years
28.6%
2/7 • Number of events 2 • 2 years
0.00%
0/7 • 2 years
General disorders
Side effects of hormone use
0.00%
0/9 • 2 years
14.3%
1/7 • Number of events 1 • 2 years
14.3%
1/7 • Number of events 1 • 2 years
14.3%
1/7 • Number of events 1 • 2 years

Additional Information

Dr. Yolanda Smith

The University of Michigan

Phone: (734) 936-7401

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place