Levonorgestrel-releasing Intrauterine System Versus a Low-dose Combined Oral Contraceptive for Management of Adenomyosis Uteri

NCT ID: NCT03037944

Last Updated: 2017-01-31

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

UNKNOWN

Clinical Phase

EARLY_PHASE1

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-01

Study Completion Date

2018-12-01

Brief Summary

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This study aims to compare the efficacy of LNG - IUD (Levonorgestrel releasing intrauterine device) Versus Low dose COCs (combined oral contraceptive pills) on management of heavy menstrual bleeding and Dysmenorrhea caused by Adenomyosis.

Detailed Description

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Levonorgestrel releasing intrauterine device will be MetraPlant-E, which is used in this study in group A, is a modified Levonorgestrel -releasing intrauterine system from the old IUD - Intrauterine Device "Metraplant", MetraPlant-E design has a T-shaped frame containing Levonorgestrel and Ethylene Vinyl Acetate as well as Barium Sulphate to make it radio-opaque, All the "T" frame, the bulb of 20 mm length and sleeves contain: Ethylene Vinyl Acetate, Levonorgestrel and Barium Sulphate, which ensures more exposure of the endometrial surface to the system and hence expected more endometrial suppression.

It consists of Levonorgestrel Hormone (60 mg), Ethylene Vinyl Acetate (120 mg) \& Barium Sulphate (20 mg) Metraplant-E is designed without any coat membrane, which will help in more rise in Levonorgestrel level (higher initial release). The high initial release of Levonorgestrel (reached more than 28µg/24hrs in Metraplant-E in this study of in-vitro release) may help in early stoppage of bleeding in patients who suffer from irregular bleeding.

Women in group A will receive IUD - Intrauterine Device- during menstruation .It will be inserted into uterus in similar procedure to non-hormonal IUD .Pelvic exam will be done, the vagina will hold open with speculum, grasping the cervix, measuring uterine length and proper insertion of IUD - Intrauterine Device by non-touch technic. Women will receive proper antibiotics after insertion.

Group B will receive combined oral contraceptive pills (Yasmin) which will be Monophasic pills have a constant dose of both estrogen and progestin in each of the hormonal active pills throughout the entire cycle . Yasmin (ethinyl estradiol 0.03 mg/ drospirenone 3 mg) tablets, it provides an oral contraceptive regimen, it will be used continuously for 6 months with stoppage after 3 months for withdrawal bleeding.

Both treatment arms (Metraplant E and Yasmin) will be followed up after 3 months and 6 month of patients' recruitment. Assessment of pain related symptoms will be done using visual analogue scale pain score, while assessment of menstrual improvement will be done using menstrual diary.

Conditions

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Adenomyosis

Keywords

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Adenomyosis Contraceptive pills Levonorgestrel-releasing Intrauterine System

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Group A-LNG

The Levonorgestrel releasing intrauterine device - IUD- will be Metraplant-E, which is used in this study for group A, is a modified Levonorgestrel-releasing intrauterine system from the old IUD "Metraplant", Metraplant-E design has a T-shaped frame containing Levonorgestrel and Ethylene Vinyl Acetate as well as Barium Sulphate to make it radio-opaque, All the "T" frame, the bulb of 20 mm length and sleeves contain: Ethylene Vinyl Acetate, Levonorgestrel and Barium Sulphate, ensure more exposure of the endometrial surface to the system and hence expect more endometrial suppression.

Group Type EXPERIMENTAL

Metraplant-E

Intervention Type DEVICE

Levonorgestrel-releasing Intrauterine System modified levonorgestrel-releasing intrauterine system from the old IUD "Metraplant", modified by Azzam 2013

Group B-COCs

Group B will receive combined oral contraceptive pills (Yasmin) COCs which will be Monophasic pills that have a constant dose of both estrogen and progestins in each of the hormonal active pills throughout the entire cycle . Yasmin (ethinyl estradiol 0.03 mg/ drospirenone 3 mg) tablets, provides an oral contraceptive regimen, it will be used continuously for 6 months with stoppage after 3 months for withdrawal bleeding.

Group Type EXPERIMENTAL

Yasmin

Intervention Type DRUG

(ethinyl estradiol 0.03 mg/ drospirenone 3 mg) tablets

Interventions

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Yasmin

(ethinyl estradiol 0.03 mg/ drospirenone 3 mg) tablets

Intervention Type DRUG

Metraplant-E

Levonorgestrel-releasing Intrauterine System modified levonorgestrel-releasing intrauterine system from the old IUD "Metraplant", modified by Azzam 2013

Intervention Type DEVICE

Other Intervention Names

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drospirenone and ethinyl estradiol tablets Metraplant-E- Levonorgestrel

Eligibility Criteria

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Inclusion Criteria

* Women patient aged 30-45 years
* Diagnosed adenomyosis by transvaginal ultrasound or MRI or 3D ultrasound
* Patient complains of heavy menstrual bleeding or dysmenorrhea or both
* Living in a nearby area to make follow-up reasonably possible
* Planning for birth spacing for at least 2 years.

Exclusion Criteria

* Pregnancy or seeking fertility
* Severe underlying comorbidities (hepatic, oncological)
* Pelvic inflammatory disease
* Other cervical or uterine pathologies
* Deep venous thromboembolism
* Hormonal therapy contraindications
* Endometriosis or fibroid
Minimum Eligible Age

30 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams Maternity Hospital

OTHER

Sponsor Role lead

Responsible Party

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Asmaa Mamdoh Mohamdy

Researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mohamed Es Abbas, Lecturer

Role: PRINCIPAL_INVESTIGATOR

Ain Shams University - Maternity Hospital

Karim Mo Labib, Lecturer

Role: PRINCIPAL_INVESTIGATOR

Ain Shams University - Maternity Hospital

Karim AH Labib, Assistant

Role: STUDY_CHAIR

Ain Shams University - Maternity Hospital

Locations

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Ain Shams University - Maternity Hospital

Cairo, Cairo Governorate, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Asmaa Ma Mohamdy, Bachelor

Role: CONTACT

Phone: +201008340829

Email: [email protected]

Mohamed Es Abbas, Lecturer

Role: CONTACT

Phone: +201007644642

Email: [email protected]

Facility Contacts

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Asmaa MA Mohamdy, Bachelors

Role: primary

References

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Benagiano, G.; Brosens, I.; Habiba, M.

Reference Type RESULT

Other Identifiers

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ASAD0316

Identifier Type: -

Identifier Source: org_study_id