SPIRIT EXTENSION: Efficacy and Safety Extension Study of Relugolix in Women With Endometriosis-Associated Pain

NCT ID: NCT03654274

Last Updated: 2023-08-08

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

802 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-05-22

Study Completion Date

2023-01-31

Brief Summary

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The purpose of this study is to evaluate the long-term efficacy and safety of relugolix 40 milligram (mg) once daily co-administered with low-dose estradiol (E2) and norethindrone acetate (NETA) for up to 104 weeks on endometriosis-associated pain in participants who previously completed a 24-week treatment period in one of the parent studies (MVT-601-3101 or MVT-601-3102).

Detailed Description

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This study is an international phase 3 open-label, single-arm, long-term efficacy and safety extension study that will enroll eligible participants who have completed their participation in one of the phase 3 randomized, double-blind, placebo-controlled parent studies, MVT-601-3101 (SPIRIT 1 - NCT03204318) or MVT-601-3102 (SPIRIT 2 - NCT03204331). All participants will receive relugolix 40 mg orally once daily co-administered with low-dose E2 (1.0 mg) and NETA (0.5 mg) for 80 weeks.

Approximately 800 women with endometriosis-associated pain will be enrolled, after having completed a 24-week treatment period in one of the parent studies. The objectives of the study are to evaluate long-term efficacy and safety through up to 104 weeks of treatment (including treatment during the parent study) of relugolix co-administered with low-dose E2/NETA.

Baseline procedures for this extension study will be performed on the same day as the Week 24 Visit of the parent study. This visit, referred to as the "Week 24/Baseline Visit, will be defined as the date of completion of the last Week 24 procedure in the parent study. Participants will have received their last dose of study drug in the parent study on the day prior to the Week 24/Baseline Visit and will receive their first dose of study drug for this extension study in the clinic after the participant is determined to be eligible for this extension study and has provided informed consent to participate. The administration of the first dose of study drug for MVT-601-3103 will define enrollment into this study. Study participants will then take the open-label study treatment orally, once daily for 80 weeks.

Conditions

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Endometriosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Open label extension
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Relugolix plus E2/NETA

Relugolix co-administered with E2/NETA for 80 weeks.

Group Type EXPERIMENTAL

Relugolix

Intervention Type DRUG

Relugolix 40-mg tablet administered orally once daily

Estradiol/norethindrone acetate

Intervention Type DRUG

Capsule containing co-formulated tablet of E2 (1.0 mg) and NETA (0.5 mg) administered orally once daily

Interventions

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Relugolix

Relugolix 40-mg tablet administered orally once daily

Intervention Type DRUG

Estradiol/norethindrone acetate

Capsule containing co-formulated tablet of E2 (1.0 mg) and NETA (0.5 mg) administered orally once daily

Intervention Type DRUG

Other Intervention Names

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TAK-385 MVT-601 E2/NETA low-dose hormonal add-back

Eligibility Criteria

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Inclusion Criteria

1. Completed 24 weeks of study drug treatment and study participation in either parent study, MVT-601-3101 or MVT-601-3102.
2. Is not expected to undergo gynecological surgery or other surgical procedures for treatment of endometriosis (including ablation, shaving, or excision) during the study, including during the Follow-Up Period, and the participant does not desire such treatment during this time frame.
3. Has agreed to continue to use only study-specified analgesic medications during the study and is not known to be intolerant to these.

Exclusion Criteria

1. Has had a surgical procedure for treatment for endometriosis at any time during the parent study (MVT-601-3101 or MVT-601-3102).
2. Has any chronic pain or frequently recurring pain condition, other than endometriosis, that is treated with opioids or requires analgesics for ≥ 7 days per month.
3. Has a Z-score \< -2.0 or has a ≥ 7% decrease in bone mineral density from the parent study Baseline at lumbar spine, total hip, or femoral neck based on the parent study Week 24 DXA assessment of bone mineral density.
4. Has any contraindication to treatment with low-dose E2 and NETA, including:

1. Known, suspected, or history of breast cancer;
2. Known or suspected estrogen-dependent neoplasia;
3. Active deep vein thrombosis or pulmonary embolism, or history of these conditions prior to the Week 24/Baseline visit;
4. History of or active arterial thromboembolic disease, including stroke and myocardial infarction;
5. Known anaphylactic reaction or angioedema or hypersensitivity to E2 or NETA;
6. Known protein C, protein S, or antithrombin deficiency, or other known thrombophilia disorders, including Factor V Leiden;
7. Migraine with aura;
8. History of porphyria.
5. Had any of the following clinical laboratory abnormalities at the parent study Week 20 visit or, if available, any subsequent visit in one of the parent studies (MVT-601-3101 or MVT-601-3102):

1. Alanine aminotransferase or aspartate aminotransferase \> 2.0 times the upper limit of normal (ULN); or
2. Bilirubin (total bilirubin) \> 1.5 x ULN (or \> 2.0 x ULN if secondary to Gilbert syndrome or pattern consistent with Gilbert syndrome).
Minimum Eligible Age

18 Years

Maximum Eligible Age

51 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Myovant Sciences GmbH

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Myovant Medical Monitor

Role: STUDY_DIRECTOR

Myovant Sciences

Locations

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Andalusia

Andalusia, Alabama, United States

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Scottsdale

Scottsdale, Arizona, United States

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Tucson

Tucson, Arizona, United States

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Tuscon

Tucson, Arizona, United States

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Canoga Park

Canoga Park, California, United States

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Los Angeles

Los Angeles, California, United States

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San Diego

San Diego, California, United States

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Greenwood Village

Greenwood Village, Colorado, United States

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Washington

Washington D.C., District of Columbia, United States

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Aventura

Aventura, Florida, United States

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Fort Myers

Fort Myers, Florida, United States

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Hialeah

Hialeah, Florida, United States

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Hialeah

Hialeah, Florida, United States

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Margate

Margate, Florida, United States

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Miami

Miami, Florida, United States

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Miami

Miami, Florida, United States

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Sarasota

Sarasota, Florida, United States

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Tampa

Tampa, Florida, United States

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Atlanta

Atlanta, Georgia, United States

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Atlanta

Atlanta, Georgia, United States

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Augusta

Augusta, Georgia, United States

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Norcross

Norcross, Georgia, United States

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Idaho Falls

Idaho Falls, Idaho, United States

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Oakbrook

Oakbrook Terrace, Illinois, United States

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Park Ridge

Park Ridge, Illinois, United States

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Shawnee

Shawnee Mission, Kansas, United States

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Marrero

Marrero, Louisiana, United States

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Towson

Towson, Maryland, United States

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Saginaw

Saginaw, Michigan, United States

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Jefferson City

Jefferson City, Missouri, United States

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St. Louis

St Louis, Missouri, United States

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Omaha

Omaha, Nebraska, United States

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Las Vegas

Las Vegas, Nevada, United States

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Durham

Durham, North Carolina, United States

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New Bern

New Bern, North Carolina, United States

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Winston Salem

Winston-Salem, North Carolina, United States

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Akron

Akron, Ohio, United States

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Columbus

Columbus, Ohio, United States

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Englewood

Englewood, Ohio, United States

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Hershey

Hershey, Pennsylvania, United States

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Columbia

Columbia, South Carolina, United States

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Chattanooga

Chattanooga, Tennessee, United States

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Memphis

Memphis, Tennessee, United States

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Beaumont

Beaumont, Texas, United States

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Corpus Christi

Corpus Christi, Texas, United States

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Dallas

Dallas, Texas, United States

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Fort Worth

Fort Worth, Texas, United States

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Houston

Houston, Texas, United States

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Houston

Houston, Texas, United States

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Irving

Irving, Texas, United States

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San Antonio

San Antonio, Texas, United States

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Sugar Land

Sugar Land, Texas, United States

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Webster

Webster, Texas, United States

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Salt Lake City

Salt Lake City, Utah, United States

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Salt Lake City

Salt Lake City, Utah, United States

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Salt Lake City

Salt Lake City, Utah, United States

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Norfolk

Norfolk, Virginia, United States

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Richmond

Richmond, Virginia, United States

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Virginia Beach

Virginia Beach, Virginia, United States

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Seattle

Seattle, Washington, United States

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Ciudad de Buenos Aires

Ciudad de Buenos Aires, Buenos Aires, Argentina

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San Isidro

San Isidro, Buenos Aires, Argentina

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Rosario

Rosario, Santa Fe Province, Argentina

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Cordoba

Córdoba, , Argentina

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Sydney

Sydney, New South Wales, Australia

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Wollongong

Wollongong, NS, Australia

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Taringa

Taringa, Queensland, Australia

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Adelaide

Adelaide, South Australia, Australia

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Nedlands

Nedlands, Western Australia, Australia

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Leuven

Leuven, Flemish Brabant, Belgium

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La Louvière

La Louvière, Hainaut, Belgium

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Gent

Ghent, Oost-vlaanderen, Belgium

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Brussels

Brussels, , Belgium

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Passo Fundo

Passo Fundo, Rio Grande do Sul, Brazil

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Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

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Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

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Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

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Porto Alegre

Porto Alegre, São Paulo, Brazil

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São Bernardo do Campo

São Bernardo do Campo, São Paulo, Brazil

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São Paulo

São Paulo, São Paulo, Brazil

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Sao Paulo

São Paulo, São Paulo, Brazil

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São Paulo

São Paulo, São Paulo, Brazil

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Sao Paulo

São Paulo, , Brazil

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Sofia

Sofia, Sofia, Bulgaria

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Sofia

Sofia, Sofia, Bulgaria

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Sofia

Sofia, Sofia, Bulgaria

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Sofia

Sofia, Sofia, Bulgaria

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Blagoevgrad

Blagoevgrad, , Bulgaria

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Pleven

Pleven, , Bulgaria

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Stara Zagora

Stara Zagora, , Bulgaria

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Varna

Varna, , Bulgaria

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Red Deer

Red Deer, Alberta, Canada

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Waterloo

Waterloo, Ontario, Canada

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Victoriaville

Victoriaville, Quebec, Canada

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Santiago

Santiago, , Chile

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Santiago

Santiago, , Chile

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Santiago

Santiago, , Chile

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Tábor

Tábor, Jihormoravsky Kraj, Czechia

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Písek

Písek, Jihočeský kraj, Czechia

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Vodňany

Vodňany, Jihočeský kraj, Czechia

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Náchod

Náchod, Královéhradecký kraj, Czechia

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Praha 10

Prague, Prague, Czechia

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Praha 2

Prague, Prague, Czechia

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České Budějovice

České Budějovice, , Czechia

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Olomouc

Olomouc, , Czechia

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Praha 8 - Libeň

Praha 8 - Libeň, , Czechia

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Kuopio

Kuopio, Eastern Finland, Finland

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Helsinki

Helsinki, Southern Finland, Finland

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Oulu

Oulu, , Finland

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Tbilisi

Tbilisi, , Georgia

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Pécs

Pécs, Baranya, Hungary

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Békéscsaba

Békéscsaba, Bekes County, Hungary

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Gyula

Gyula, Bekes County, Hungary

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Kecskemét

Kecskemét, Bács-Kiskun county, Hungary

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Szeged

Szeged, Csongrád megye, Hungary

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Debrecen

Debrecen, Hajdú-Bihar, Hungary

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Debrecen

Debrecen, Hajdú-Bihar, Hungary

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Debrecen

Debrecen, Hajdú-Bihar, Hungary

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Nyíregyháza

Nyíregyháza, Szabolcs-Szatmár-Bereg, Hungary

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Monserrato

Monserrato, Cagliari, Italy

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Catanzaro

Catanzaro, , Italy

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Napoli

Napoli, , Italy

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Pavia

Pavia, , Italy

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Roma

Roma, , Italy

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Remuera

Remuera, Auckland, New Zealand

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Palmerston North

Palmerston North, Manawatu-Wanganui, New Zealand

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Christchurch

Christchurch, , New Zealand

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Skórzewo

Skórzewo, Greater Poland Voivodeship, Poland

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Lublin

Lublin, Lublin Voivodeship, Poland

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Lublin

Lublin, Lublin Voivodeship, Poland

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Lublin

Lublin, Lublin Voivodeship, Poland

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Lublin

Lublin, Lublin Voivodeship, Poland

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Warszawa

Warsaw, Masovian Voivodeship, Poland

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Warszawa

Warsaw, Masovian Voivodeship, Poland

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Warszawa

Warsaw, Masovian Voivodeship, Poland

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Białystok

Bialystok, Podlaskie Voivodeship, Poland

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Katowice

Katowice, Silesian Voivodeship, Poland

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Katowice

Katowice, Silesian Voivodeship, Poland

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Szczecin

Szczecin, West Pomeranian Voivodeship, Poland

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Łódź

Lodz, Łódź Voivodeship, Poland

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Almada

Almada, Lisbon District, Portugal

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Coimbra

Coimbra, , Portugal

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Covilhã

Covilha, , Portugal

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Porto

Porto, , Portugal

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Brasov

Brasov, , Romania

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Bucuresti

Bucharest, , Romania

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Bucuresti

Bucharest, , Romania

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Bucuresti

Bucharest, , Romania

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București

Bucharest, , Romania

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Port Elizabeth

Port Elizabeth, Eastern Cape, South Africa

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Centurion

Centurion, Gauteng, South Africa

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Roodepoort

Roodepoort, Gauteng, South Africa

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Durban

Durban, KwaZulu-Natal, South Africa

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Cape Town

Cape Town, Western Cape, South Africa

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Madrid

Madrid, , Spain

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Valencia

Valencia, , Spain

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Kyiv

Kyiv, Kiev City, Ukraine

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Kyiv

Kyiv, Kiev City, Ukraine

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Kyiv

Kyiv, Kyiv City, Ukraine

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Chernivtsi

Chernivtsi, , Ukraine

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Ivano-Frankivsk

Ivano-Frankivsk, , Ukraine

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Kharkiv

Kharkiv, , Ukraine

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Kiev

Kiev, , Ukraine

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Kiev

Kiev, , Ukraine

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Kyiv

Kyiv, , Ukraine

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Zaporizhzhya

Zaporizhzhya, , Ukraine

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Zaporizhzhya

Zaporizhzhya, , Ukraine

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Zaporizhzhya

Zaporizhzhya, , Ukraine

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Zaporizhzhya

Zaporizhzhya, , Ukraine

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Countries

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United States Argentina Australia Belgium Brazil Bulgaria Canada Chile Czechia Finland Georgia Hungary Italy New Zealand Poland Portugal Romania South Africa Spain Ukraine

References

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As-Sanie S, Abrao MS, Reznichenko G, Wilk K, Zhong Y, Perry J, Hunsche E, Soulban G, Becker CM. Impact of relugolix combination therapy on functioning and quality of life in women with endometriosis-associated pain. Fertil Steril. 2024 Oct;122(4):687-695. doi: 10.1016/j.fertnstert.2024.06.009. Epub 2024 Jun 19.

Reference Type DERIVED
PMID: 38906210 (View on PubMed)

Becker CM, Johnson NP, As-Sanie S, Arjona Ferreira JC, Abrao MS, Wilk K, Imm SJ, Mathur V, Perry JS, Wagman RB, Giudice LC. Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study. Hum Reprod. 2024 Mar 1;39(3):526-537. doi: 10.1093/humrep/dead263.

Reference Type DERIVED
PMID: 38243752 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2017-004066-10

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MVT-601-3103

Identifier Type: -

Identifier Source: org_study_id

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