Control of Bleeding on Nexplanon in Latinx Patients

NCT ID: NCT05116371

Last Updated: 2021-11-11

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

Total Enrollment

144 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-12-01

Study Completion Date

2024-12-01

Brief Summary

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In this study, researchers want to find out more about how the Etonogestrel (ENG) contraceptive implant device (also known as Nexplanon) changes people's periods. Study subjects will self select into an exposure group- starting combined hormonal contraceptive pills (COC) on the same day as Nexplanon placement or a "delayed initiation" of COC when/if bleeding concerns develop. Patients will be followed for 12 months.

Detailed Description

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The study will be conducted at University of Arizona. Investigators will recruit people seeking Nexplanon placement and willing to enroll. We aim to enroll 144 patients.

Visit 1:

All patients ages 14-24 presenting for contraception services will be screened for potential inclusion. A trained research assistant will conduct a brief patient-centered contraceptive counseling session focusing on patient preferences.

If interested in participating, the patient will be given a card to present to their clinician. During the visit, patient and provider will discuss further method selection including risks, benefits, and alternatives. The clinician will assess for contraindications per the CDC MEC for use of COC or the implant. Screening for pregnancy, sexually transmitted infections, and cervical cancer screening will follow as clinically indicated. If pregnancy test is negative and clinician can be reasonably certain that patient is not pregnant using the CDC Selected Practice Recommendations, the ENG implant will be placed.

After a clinician encounter, the research assistant will consent those interested in participating. Patients will be assigned a unique identification number once they self-select into their exposure group of choice:

1. ENG implant with initiation of concurrent COC use for bleeding control at time of insertion
2. ENG implant alone with option for "delayed initiation" of COC if bleeding concerns develop

Enrolled patients will complete Demographic Questionnaire and Bleeding Preference Questionnaire.

Enrolled patients in exposure group 1 will receive 6 months COC pills (150 mcg levonorgestrel/30 mcg ethinyl estradiol) and condoms for the first week of back-up method. After 6 months, they will be offered a prescription to continue COC pills. Patients in exposure group 2 will be receive handouts describing how to contact the research team should bleeding concerns develop. A telehealth or in-person visit will be arranged with the research clinicians, during which the patient may opt to start COC pills. A 6 month supply will be provided.

Follow-Up:

Follow-up contact will be weekly for the first 6 months. There will also be 9 and 12 month contact.

Each contact will be a brief text-message survey inquiring about bleeding patterns, pill usage and side effects. The ENG implant will be removed upon request at any time during the study.

Study participation will be completed after the 12 month follow-up survey.

No blood draws will occur during this study.

There is little data available on the adverse effects of ENG implant use and combined COC. This is a common clinical practice to combine use for bothersome bleeding and this study will collect long-term data regarding this practice.

Conditions

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Contraception

Keywords

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etonogestrel implant; irregular bleeding

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1: Same day initiation option

1\) ENG implant with initiation of concurrent COC use for bleeding control at time of insertion

150 mcg levonorgestrel/30 mcg ethinyl estradiol

Intervention Type DRUG

concurrent use of COC with Nexplanon

Group 2: Delayed initiation option

2\) ENG implant alone with option for "delayed initiation" of COC if bleeding concerns develop

150 mcg levonorgestrel/30 mcg ethinyl estradiol

Intervention Type DRUG

concurrent use of COC with Nexplanon

Interventions

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150 mcg levonorgestrel/30 mcg ethinyl estradiol

concurrent use of COC with Nexplanon

Intervention Type DRUG

Other Intervention Names

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combined oral contraceptive (COC)

Eligibility Criteria

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Inclusion Criteria

Fluent in English or Spanish Access to a cellular phone with text messaging and internet capabilities Capable of and willing to receive cellular phone text message Interest in preventing pregnancy for at least 12 months with the ENG implant Interest in use of COC pills with concurrent with ENG implant use Negative urine pregnancy test

Exclusion Criteria

Contraindication to COC pills or ENG implant as determined by the Centers for Disease Control Medical Eligibility Criteria for Contraceptive Use (CDC MEC) Less than 4 weeks postpartum
Minimum Eligible Age

14 Years

Maximum Eligible Age

24 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Organon

INDUSTRY

Sponsor Role collaborator

University of Arizona

OTHER

Sponsor Role lead

Responsible Party

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Holly Bullock

Assistant Professor, Department of OBGYN

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Holly Bullock, MD, MPH

Role: CONTACT

Phone: 520-626-6591

Email: [email protected]

Shamam Hashim, BS

Role: CONTACT

Phone: 520-626-6591

Email: [email protected]

Other Identifiers

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IRB 2104687928

Identifier Type: -

Identifier Source: org_study_id