Compare Two Copper IUDs: Mona Lisa NT Cu380 Mini and ParaGard

NCT ID: NCT03124160

Last Updated: 2024-09-25

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-26

Study Completion Date

2022-06-06

Brief Summary

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This will be a multi-site, participant-blinded, randomized clinical trial. The investigators will randomize 1000 eligible participants in a 4:1 ratio to two different copper IUDs: 800 to Mona Lisa NT Cu380 Mini and 200 to ParaGard.

Detailed Description

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The total duration of the study for each participant is expected to be approximately 39 months: including screening and enrollment (up to 30 days to meet enrollment criteria), 37 months of participation, and a post-removal follow up telephone call 17 days post-removal. After enrollment, subject visits occur at 6 weeks, 3 months, 6 months, 12 months, 24 months, with telephone calls at 9, 18, and 30 months and seen again at 37 months for their final visit. Subjects will use a home pregnancy test 17 days post-removal of the IUD or Exit Visit procedures, whichever occurs first, and called by the site for the result and for safety follow-up.

Subject recruitment is expected to begin Q2 (in the second quarter of) 2017 and is planned to continue through Q2 2018. However, if the enrollment rate declines, the enrollment period may be extended beyond this date. If this enrollment timeline is met, all subjects should finish active treatment by approximately the end of Q2 2021. The total duration of the study will be approximately 48 months for each study site including pre- and post- trial activities. The end of the study will occur when the last subject to be enrolled has completed her post-removal pregnancy test telephone call.

Total duration of the project is expected to be five years. Preliminary results of the study are expected to be available Q4 of 2019 based on the current study plan.

Conditions

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Healthy Women Female Contraception

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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Mona Lisa® NT Cu380 Mini

Mona Lisa® NT Cu380 Mini containing 380mm2 of copper surface inserted into the uterine cavity.

Group Type EXPERIMENTAL

Mona Lisa® NT Cu380 Mini

Intervention Type DRUG

copper intrauterine device

ParaGard® TCu380A

ParaGard® TCU380A containing 380mm2 of copper surface inserted into the uterine cavity.

Group Type ACTIVE_COMPARATOR

ParaGard® TCu380A

Intervention Type DRUG

copper intrauterine device

Interventions

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Mona Lisa® NT Cu380 Mini

copper intrauterine device

Intervention Type DRUG

ParaGard® TCu380A

copper intrauterine device

Intervention Type DRUG

Other Intervention Names

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NT380-Mini, NTCu380-Mini T380

Eligibility Criteria

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Inclusion Criteria

* 16-40 years

o 16 and 17 year olds, where permissible by state regulations and local Institutional Review Board (IRB) approval
* Sexually active, anticipating at least one act of vaginal intercourse per menstrual cycle with a male partner and at risk for pregnancy
* seeking contraception, and willing to use the study IUD as the only contraception method
* willing to be randomized to one of the two copper IUDs
* has an intact uterus and at least one ovary
* has a history of regular menstrual cycles; defined as occurring every 21-35 days when not using hormones, and with a variation of typical cycle length of no more than 5 days
* able and willing to provide written informed consent
* agrees to follow all study requirements
* not currently pregnant or at risk for luteal phase pregnancy based on history of unprotected intercourse

Exclusion Criteria

* abnormal Pap requiring treatment after enrollment
* known human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) infection
* intending to become pregnant in the 37 months after enrollment
* known infertility
* history of allergy or sensitivity to copper
* previous tubal sterilization
* has received an injectable contraceptive in the last 9 months and has not resumed regular menstrual cycles (as evidenced by 2 spontaneous menses)
* within 30 days of administration of mifepristone and/or misoprostol for medical abortion or for miscarriage management
* within 30 days of first, second, or third trimester abortion or miscarriage (note: potential abortion/miscarriage participants can be screened and return after 30 days for randomization and IUD insertion)
* within 30 days of delivery (for parous population)
* breastfeeding or recently breastfeeding women unless two consecutive normal menstrual periods have occurred after delivery and prior to enrollment.
* wants to use a copper IUD for emergency contraception
* has previously participated in the study
* participated in another clinical trial involving an investigational product within the last 30 days (before screening) or planning to participate in another clinical trial involving an intervention or treatment during this study
* not living in the catchment area of the study site or planning to move from the area within the year (unless known to be moving to the catchment area of another study site)
* known or suspected current alcohol or drug abuse
* planning to undergo major surgery during study participation
* current need for use of exogenous hormones or therapeutic anticoagulants (Note: subjects who start a therapeutic anticoagulant after enrolment will be allowed to continue in the study.)
* at high risk for sexually-transmitted infections or pelvic infection
* anticipated need for regular condom use (refer to Section 8.1).
* has any condition (social or medical) which in the opinion of the Investigator would make study participation unsafe or complicate data interpretation
* Reported medical contraindications (Medical Eligibility Criteria category 3 or 4)14 to copper IUDs, including:

* suspicious unexplained vaginal bleeding
* known cervical cancer
* known endometrial cancer
* known Wilson's disease
* Confirmed gestational trophoblastic disease with persistently elevated beta-hCG levels or malignant disease, with evidence or suspicion of intrauterine disease
* anatomic abnormalities with distorted uterine cavity
* current pelvic inflammatory disease (PID)
* pelvic tuberculosis
* immediately post-septic abortion or puerperal sepsis
* current known purulent cervicitis or chlamydial infection or gonorrhea; Note: to enroll, there must be no obvious signs of infection at the time of enrollment based on pelvic exam. If lab results come back for positive infection after enrollment, treatment should be provided but the IUD can be left in place.
* complicated solid organ transplantation
* systemic lupus erythematosus with severe thrombocytopenia
Minimum Eligible Age

16 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Premier Research

OTHER

Sponsor Role collaborator

FHI 360

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Diana Blithe

Role: STUDY_DIRECTOR

National Institute of Child Health & Human Development (NICHD)

David Hubacher

Role: STUDY_DIRECTOR

FHI 360

Locations

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Essential Access Health

Los Angeles, California, United States

Site Status

University of California, Davis

Sacramento, California, United States

Site Status

University of California, San Francisco

San Francisco, California, United States

Site Status

University of Colorado

Denver, Colorado, United States

Site Status

University of Hawaii

Honolulu, Hawaii, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Boston Medical Center Corporation

Boston, Massachusetts, United States

Site Status

Planned Parenthood League of Massachusetts

Boston, Massachusetts, United States

Site Status

Planned Parenthood of New York

New York, New York, United States

Site Status

Columbia University

New York, New York, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Eastern Virginia Medical School

Norfolk, Virginia, United States

Site Status

Countries

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United States

References

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Sivin I, Stern J. Long-acting, more effective copper T IUDs: a summary of U.S. experience, 1970-75. Stud Fam Plann. 1979 Oct;10(10):263-81. No abstract available.

Reference Type BACKGROUND
PMID: 516121 (View on PubMed)

Sivin I, Tatum HJ. Four years of experience with the TCu 380A intrauterine contraceptive device. Fertil Steril. 1981 Aug;36(2):159-63.

Reference Type BACKGROUND
PMID: 7262334 (View on PubMed)

Sivin I, Stern J, Coutinho E, Mattos CE, el Mahgoub S, Diaz S, Pavez M, Alvarez F, Brache V, Thevenin F, et al. Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/day (LNg 20) and the Copper T380 Ag IUDS. Contraception. 1991 Nov;44(5):473-80. doi: 10.1016/0010-7824(91)90149-a.

Reference Type BACKGROUND
PMID: 1797462 (View on PubMed)

The TCu380A, TCu220C, multiload 250 and Nova T IUDS at 3,5 and 7 years of use--results from three randomized multicentre trials. World Health Organization. Special Programme of Research, Development and Research Training in Human Reproduction: Task Force on the Safety and Efficacy of Fertility Regulating Methods. Contraception. 1990 Aug;42(2):141-58.

Reference Type BACKGROUND
PMID: 2085966 (View on PubMed)

Hubacher D. Copper intrauterine device use by nulliparous women: review of side effects. Contraception. 2007 Jun;75(6 Suppl):S8-11. doi: 10.1016/j.contraception.2006.12.005. Epub 2007 Feb 20.

Reference Type BACKGROUND
PMID: 17531622 (View on PubMed)

Abraham M, Zhao Q, Peipert JF. Young Age, Nulliparity, and Continuation of Long-Acting Reversible Contraceptive Methods. Obstet Gynecol. 2015 Oct;126(4):823-829. doi: 10.1097/AOG.0000000000001036.

Reference Type BACKGROUND
PMID: 26348177 (View on PubMed)

Benacerraf BR, Shipp TD, Lyons JG, Bromley B. Width of the normal uterine cavity in premenopausal women and effect of parity. Obstet Gynecol. 2010 Aug;116(2 Pt 1):305-310. doi: 10.1097/AOG.0b013e3181e6cc10.

Reference Type BACKGROUND
PMID: 20664389 (View on PubMed)

Koch P, Reinhardt P, Soyka E. Intrauterine contraception using the Copper Mini-Gravigard 7 IUD: summary of 328 case histories. Contracept Deliv Syst. 1981 Apr;2(1):171-6.

Reference Type BACKGROUND
PMID: 12336868 (View on PubMed)

Petersen KR, Brooks L, Jacobsen N, Skoby SO. Clinical performance of intrauterine devices in nulligravidae: is the length of the endometrial cavity of significance? Acta Eur Fertil. 1991 Jul-Aug;22(4):225-8.

Reference Type BACKGROUND
PMID: 1844327 (View on PubMed)

Otero-Flores JB, Guerrero-Carreno FJ, Vazquez-Estrada LA. A comparative randomized study of three different IUDs in nulliparous Mexican women. Contraception. 2003 Apr;67(4):273-6. doi: 10.1016/s0010-7824(02)00519-x.

Reference Type BACKGROUND
PMID: 12684147 (View on PubMed)

Ott MA, Sucato GS; Committee on Adolescence. Contraception for adolescents. Pediatrics. 2014 Oct;134(4):e1257-81. doi: 10.1542/peds.2014-2300.

Reference Type BACKGROUND
PMID: 25266435 (View on PubMed)

Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and Gynecologists. Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2012 Oct;120(4):983-8. doi: 10.1097/AOG.0b013e3182723b7d.

Reference Type BACKGROUND
PMID: 22996129 (View on PubMed)

Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep. 2016 Jul 29;65(3):1-103. doi: 10.15585/mmwr.rr6503a1.

Reference Type BACKGROUND
PMID: 27467196 (View on PubMed)

Heinemann K, Reed S, Moehner S, Minh TD. Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European Active Surveillance Study on Intrauterine Devices. Contraception. 2015 Apr;91(4):274-9. doi: 10.1016/j.contraception.2015.01.007. Epub 2015 Jan 16.

Reference Type BACKGROUND
PMID: 25601352 (View on PubMed)

Farley TM, Rosenberg MJ, Rowe PJ, Chen JH, Meirik O. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet. 1992 Mar 28;339(8796):785-8. doi: 10.1016/0140-6736(92)91904-m.

Reference Type BACKGROUND
PMID: 1347812 (View on PubMed)

Schreiber CA, Nanda K, Hubacher D, Turok DK, Jensen JT, Creinin MD, White KO, Dayananda I, Teal SB, Chen PL, Chen BA, Goldberg AB, Kerns JL, Dart C, Nelson AL, Thomas MA, Archer DF, Brown JE, Castano PM, Burke AE, Kaneshiro B, Blithe DL. Contraceptive Efficacy and Comparative Side Effects of a Mini Copper Intrauterine Device. NEJM Evid. 2025 Aug;4(8):EVIDoa2400480. doi: 10.1056/EVIDoa2400480. Epub 2025 Jul 22.

Reference Type DERIVED
PMID: 40693846 (View on PubMed)

Hubacher D, Schreiber CA, Turok DK, Jensen JT, Creinin MD, Nanda K, White KO, Dayananda I, Teal SB, Chen PL, Chen BA, Goldberg AB, Kerns JL, Dart C, Nelson AL, Thomas MA, Archer DF, Brown JE, Castano PM, Burke AE, Kaneshiro B, Blithe DL. Continuation rates of two different-sized copper intrauterine devices among nulliparous women: Interim 12-month results of a single-blind, randomised, multicentre trial. EClinicalMedicine. 2022 Jul 16;51:101554. doi: 10.1016/j.eclinm.2022.101554. eCollection 2022 Sep.

Reference Type DERIVED
PMID: 35865736 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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Other Identifiers

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CCN016

Identifier Type: -

Identifier Source: org_study_id

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