Ulipristal Use in Chinese Population

NCT ID: NCT02825719

Last Updated: 2020-04-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

31 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-02

Study Completion Date

2020-03-31

Brief Summary

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Uterine leiomyomas is the commonest benign tumour of the female genital tract. It lead to menorrhagia, anaemia, pain and pressure symptoms. Due to the enlarged uterus, the use of minimal invasive surgery is limited. There is also increase risk of intraoperative blood transfusion. Ulipristal acetate (UPA) is a selective progesterone-receptor modulator (SPRM). Preoperative use of Ulipristal for 12 weeks has been shown to decrease uterine bleeding, fibroid volume, pre-operative anaemia and symptoms severity. However there is still lacking evidence in terms of long term safety and efficacy, especially in Chinese population. The aim of the present study is to evaluate the effect and safety on preoperative use of Ulipristal on fibroid.

Detailed Description

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Uterine leiomyomas is the commonest benign tumour of the female genital tract. It is often asymptomatic, but can also lead to anaemia, pain and pressure symptoms. It is the commonest indication for hysterectomy, especially abdominal hysterectomy. Currently, the use of hormonal treatment is associated with side effects including gastrointestinal upset, bloating, weight gain and thromboembolic risks. The main stay for treatment relies on surgery.

Furthermore, the use of minimal invasive surgeries is limited by the size of the fibroids. Preoperative use of Gonadotrophic Releasing Hormone analogues (GnRHa) is effective in shrinkage of the uterine leiomyomas and reduction of uterine bleeding. However, postmenopausal symptoms including hot flushes, vaginal dryness are profound.

Ulipristal acetate (UPA), previously named CDB-2914, is a selective progesterone-receptor modulator (SPRM). It binds to the progesterone receptors with high affinity. It inhibits follicular development and ovulation, while it has no significant effects on estradiol levels and antiglucocorticoid activity. Preoperative use of Ulipristal for symptomatic uterine fibroids has been investigated in randomized controlled study with improvement in terms of uterine bleeding, fibroids volume, pre-operative anaemia and symptoms severity. However there is still lacking evidence in terms of long term safety and efficacy. Also there is lack of evidence in Chinese population.

The aim of the present study is to evaluate the effect and safety on preoperative use of Ulipristal on fibroid.

Conditions

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Fibroid

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Ulipristal

Patients will be prescribed Ulipristal acetate 5mg daily for 12 weeks before operation. If the patients have anaemia with haemoglobin less than 10g/dL, ferrous sulphate 300mg three times a day will be prescribed as well. Tranexamic Acid 500mg four times a day will be prescribed on request basis.

Group Type EXPERIMENTAL

Ulipristal acetate

Intervention Type DRUG

Ulipristal acetate 5mg daily will be prescribed

Ferrous sulphate

Intervention Type DRUG

Ferrous sulphate 300mg three times a day will be prescribed if haemoglobin level is less than 10g/dL.

Tranexamic Acid

Intervention Type DRUG

Tranexamic Acid 500mg four times a day on request basis will be prescribed if patient complained of menorrhagia.

Placebo

Patients will be prescribed placebo pills daily for 12 weeks before operation. If the patients have anaemia with haemoglobin less than 10g/dL, ferrous sulphate 300mg three times a day will be prescribed as well. Tranexamic Acid 500mg four times a day will be prescribed on request basis.

Group Type PLACEBO_COMPARATOR

Placebo pills

Intervention Type OTHER

Placebo pills will be prescribed

Ferrous sulphate

Intervention Type DRUG

Ferrous sulphate 300mg three times a day will be prescribed if haemoglobin level is less than 10g/dL.

Tranexamic Acid

Intervention Type DRUG

Tranexamic Acid 500mg four times a day on request basis will be prescribed if patient complained of menorrhagia.

Interventions

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Ulipristal acetate

Ulipristal acetate 5mg daily will be prescribed

Intervention Type DRUG

Placebo pills

Placebo pills will be prescribed

Intervention Type OTHER

Ferrous sulphate

Ferrous sulphate 300mg three times a day will be prescribed if haemoglobin level is less than 10g/dL.

Intervention Type DRUG

Tranexamic Acid

Tranexamic Acid 500mg four times a day on request basis will be prescribed if patient complained of menorrhagia.

Intervention Type DRUG

Other Intervention Names

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Esyma Ferasul Transamin

Eligibility Criteria

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Inclusion Criteria

* Scheduled for hysterectomy for symptomatic fibroid
* Be a Chinese
* Pre-menopausal
* With a Pictorial bleeding assessment chart score \> 100 during menstruation at the preceding month
* Non-pregnant
* With a body-mass index between 18 to 30.

Exclusion Criteria

* History of uterine surgery (apart from Caesarean section or cervical conization), endometrial ablation or uterine artery embolization
* History of gynaecological malignancies
* History of endometrial hyperplasia
* Known haemoglobinopathy (e.g. thalassaemia)
* Known severe coagulation disorder
* Has one or more ovarian cysts \>= 4 cm in diameter diagnosed by ultrasound
* History of use of Selective Progesterone Receptor Modulator (SPRM)
* Current (within 12 months) problem with alcohol or drug abuse.
* Known allergy to SPRM or ferrous sulphate
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Queen Mary Hospital, Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Lui Man Wa

Dr

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ernest H. Y. Ng

Role: STUDY_DIRECTOR

The University of Hong Kong, HONG KONG

Locations

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Department of Obstetrics and Gynaecology, Queen Mary Hospital

Hong Kong, , Hong Kong

Site Status

Countries

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Hong Kong

References

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Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007 Apr;87(4):725-36. doi: 10.1016/j.fertnstert.2007.01.093.

Reference Type BACKGROUND
PMID: 17430732 (View on PubMed)

Jacobson GF, Shaber RE, Armstrong MA, Hung YY. Hysterectomy rates for benign indications. Obstet Gynecol. 2006 Jun;107(6):1278-83. doi: 10.1097/01.AOG.0000210640.86628.ff.

Reference Type BACKGROUND
PMID: 16738152 (View on PubMed)

Jacoby VL, Autry A, Jacobson G, Domush R, Nakagawa S, Jacoby A. Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol. 2009 Nov;114(5):1041-1048. doi: 10.1097/AOG.0b013e3181b9d222.

Reference Type BACKGROUND
PMID: 20168105 (View on PubMed)

Lethaby A, Vollenhoven B, Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2001;(2):CD000547. doi: 10.1002/14651858.CD000547.

Reference Type BACKGROUND
PMID: 11405968 (View on PubMed)

Blithe DL, Nieman LK, Blye RP, Stratton P, Passaro M. Development of the selective progesterone receptor modulator CDB-2914 for clinical indications. Steroids. 2003 Nov;68(10-13):1013-7. doi: 10.1016/s0039-128x(03)00118-1.

Reference Type BACKGROUND
PMID: 14667994 (View on PubMed)

Nieman LK, Blocker W, Nansel T, Mahoney S, Reynolds J, Blithe D, Wesley R, Armstrong A. Efficacy and tolerability of CDB-2914 treatment for symptomatic uterine fibroids: a randomized, double-blind, placebo-controlled, phase IIb study. Fertil Steril. 2011 Feb;95(2):767-72.e1-2. doi: 10.1016/j.fertnstert.2010.09.059. Epub 2010 Nov 5.

Reference Type BACKGROUND
PMID: 21055739 (View on PubMed)

Donnez J, Tatarchuk TF, Bouchard P, Puscasiu L, Zakharenko NF, Ivanova T, Ugocsai G, Mara M, Jilla MP, Bestel E, Terrill P, Osterloh I, Loumaye E; PEARL I Study Group. Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med. 2012 Feb 2;366(5):409-20. doi: 10.1056/NEJMoa1103182.

Reference Type RESULT
PMID: 22296075 (View on PubMed)

Other Identifiers

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UW 15-022

Identifier Type: -

Identifier Source: org_study_id

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