Title

A Clinical Study to Evaluate Ospemifene in the Treatment of Vulvar and Vaginal Atrophy in Postmenopausal Women
Efficacy and Safety of Ospemifene in the Treatment of Vulvar and Vaginal Atrophy (VVA) in Postmenopausal Women: A 12-Week, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study Comparing Oral Ospemifene 30 and 60 Mg Daily Doses With Placebo
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    ospemifene ...
  • Study Participants

    826
The purpose of this study is to determine whether ospemifene is more effective than placebo in the treatment of vulvar and vaginal atrophy (VVA) in postmenopausal women.
Study Started
Jan 31
2006
Study Completion
Dec 31
2007
Results Posted
Jun 28
2013
Estimate
Last Update
Jun 28
2013
Estimate

Drug Ospemifene 30 mg

1 tablet (dose 30 mg/day) taken each morning with food for 12 weeks - from Visit 2 (Randomization, Day 1) to Visit 4 (Week 12).

Drug Ospemifene 60 mg

1 tablet (dose 60 mg/day) taken each morning with food for 12 weeks - from Visit 2 (Randomization, Day 1) to Visit 4 (Week 12).

Drug Placebo

1 tablet taken each morning with food for 12 weeks - from Visit 2 (Randomization, Day 1) to Visit 4 (Week 12).

Drug Nonhormonal vaginal lubricant

Subjects should apply the vaginal lubricant as needed and record the usage in the medication diary.

  • Other names: K-Y® Brand Jelly

Ospemifene 30 mg/day and nonhormonal vaginal lubricant Experimental

Subjects will receive a single dose (1 tablet) of ospemifene 30 mg each morning with food for 12 weeks. The vaginal lubricant (K-Y® Brand Jelly) should be applied as needed and its use should be recorded in the medication diary. The first dose of the study drug will be administered at the clinic at Visit 2.

Ospemifene 60 mg/day and nonhormonal vaginal lubricant Experimental

Subjects will receive a single dose (1 tablet) of ospemifene 60 mg each morning with food for 12 weeks. The vaginal lubricant (K-Y® Brand Jelly) should be applied as needed and its use should be recorded in the medication diary. The first dose of the study drug will be administered at the clinic at Visit 2.

Placebo tablets and nonhormonal vaginal lubricant Placebo Comparator

Subjects will receive a single dose (1 tablet) of placebo each morning with food for 12 weeks. The vaginal lubricant (K-Y® Brand Jelly) should be applied as needed and its use should be recorded in the medication diary. The first dose of the study drug will be administered at the clinic at Visit 2.

Criteria

Inclusion Criteria:

Naturally or surgically postmenopausal
Moderate or severe symptoms of vaginal atrophy (ie, vaginal dryness, irritation or itching, difficult or painful urination, pain or bleeding with intercourse)
Vaginal pH greater than 5.0
5% or fewer superficial cells in maturation index of vaginal smear

Exclusion Criteria:

Evidence of endometrial hyperplasia, endometrial cancer, or other abnormal endometrial pathology
Abnormal Pap smear
Uterine bleeding of unknown origin or uterine polyps
Current vaginal infection requiring medication

Summary

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Placebo Tablets and Nonhormonal Vaginal Lubricant

All Events

Event Type Organ System Event Term Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant Placebo Tablets and Nonhormonal Vaginal Lubricant

Mean Change From Baseline in the Most Bothersome Vulvar and Vaginal Atrophy (VVA) Symptom (MBS) of Vaginal Dryness

This outcome measure was analyzed using Cochran-Mantel-Haenszel (CMH) row mean scores test controlling for study center and uterine status. VVA Symptom Score: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-1.22
Units on a scale (Mean)
Standard Deviation: 0.929

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-1.26
Units on a scale (Mean)
Standard Deviation: 1.025

Placebo Tablets and Nonhormonal Vaginal Lubricant

-0.84
Units on a scale (Mean)
Standard Deviation: 0.996

Mean Change From Baseline in the MBS of Vaginal Pain Associated With Sexual Activity

This outcome measure was analyzed using CMH row mean scores test controlling for study center and uterine status. VVA Symptom Score: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-1.02
Units on a scale (Mean)
Standard Deviation: 1.132

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-1.19
Units on a scale (Mean)
Standard Deviation: 1.292

Placebo Tablets and Nonhormonal Vaginal Lubricant

-0.89
Units on a scale (Mean)
Standard Deviation: 1.115

Mean Change From Baseline in Vaginal pH

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-0.67
pH (Mean)
Standard Deviation: 1.054

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-1.01
pH (Mean)
Standard Deviation: 1.053

Placebo Tablets and Nonhormonal Vaginal Lubricant

-0.096
pH (Mean)
Standard Deviation: 0.8357

Mean Change From Baseline in Percentage of Parabasal Cells in Maturation Index of Vaginal Smear

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-21.9
percentage of parabasal cells (Mean)
Standard Deviation: 32.60

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-30.1
percentage of parabasal cells (Mean)
Standard Deviation: 37.93

Placebo Tablets and Nonhormonal Vaginal Lubricant

3.98
percentage of parabasal cells (Mean)
Standard Deviation: 35.205

Mean Change From Baseline in the Percentage of Superficial Cells in Maturation Index of Vaginal Smear

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

7.78
percentage of superficial cells (Mean)
Standard Deviation: 12.136

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

10.8
percentage of superficial cells (Mean)
Standard Deviation: 15.66

Placebo Tablets and Nonhormonal Vaginal Lubricant

2.18
percentage of superficial cells (Mean)
Standard Deviation: 8.393

Change From Baseline in Severity of VVA Symptoms

This outcome measure was analyzed using CMH row mean scores test controlling for study center and uterine status. VVA Symptom Score: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Difficult/painful urination

-0.17
Units on a scale (Mean)
Standard Deviation: 0.676

Vaginal bleeding associated with sexual activity

-0.26
Units on a scale (Mean)
Standard Deviation: 0.807

Vaginal dryness

-0.96
Units on a scale (Mean)
Standard Deviation: 1.018

Vaginal pain associated with sexual activity

-0.77
Units on a scale (Mean)
Standard Deviation: 1.200

Vulvar/vaginal itching or irritation

-0.4
Units on a scale (Mean)
Standard Deviation: 1.080

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Difficult/painful urination

-0.2
Units on a scale (Mean)
Standard Deviation: 0.673

Vaginal bleeding associated with sexual activity

-0.23
Units on a scale (Mean)
Standard Deviation: 0.707

Vaginal dryness

-1.17
Units on a scale (Mean)
Standard Deviation: 1.050

Vaginal pain associated with sexual activity

-0.87
Units on a scale (Mean)
Standard Deviation: 1.278

Vulvar/vaginal itching or irritation

-0.58
Units on a scale (Mean)
Standard Deviation: 0.982

Placebo Tablets and Nonhormonal Vaginal Lubricant

Difficult/painful urination

-0.097
Units on a scale (Mean)
Standard Deviation: 0.6745

Vaginal bleeding associated with sexual activity

-0.12
Units on a scale (Mean)
Standard Deviation: 0.667

Vaginal dryness

-0.63
Units on a scale (Mean)
Standard Deviation: 1.047

Vaginal pain associated with sexual activity

-0.57
Units on a scale (Mean)
Standard Deviation: 1.224

Vulvar/vaginal itching or irritation

-0.44
Units on a scale (Mean)
Standard Deviation: 0.948

Change From Baseline in Estradiol Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-1.44
pg/mL (Mean)
Standard Deviation: 19.01

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

1.02
pg/mL (Mean)
Standard Deviation: 12.74

Placebo Tablets and Nonhormonal Vaginal Lubricant

0.3
pg/mL (Mean)
Standard Deviation: 3.90

Change From Baseline in Urinary Symptoms

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Difficulty emptying bladder-Improved

25.0
Participants

Difficulty emptying bladder-Worsened

14.0
Participants

Frequent urination-Improved

49.0
Participants

Frequent urination-Worsened

24.0
Participants

Pain in lower abdominal/genital area-Improved

37.0
Participants

Pain in lower abdominal or genital area-Worsened

17.0
Participants

Small amount of urine leakage-Improved

59.0
Participants

Small amount of urine leakage-Worsened

30.0
Participants

Urine leakage (feeling of urgency)-Improved

52.0
Participants

Urine leakage (feeling of urgency)-Worsened

24.0
Participants

Urine leakage with physical exertion-Improved

50.0
Participants

Urine leakage with physical exertion-Worsened

24.0
Participants

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Difficulty emptying bladder-Improved

26.0
Participants

Difficulty emptying bladder-Worsened

11.0
Participants

Frequent urination-Improved

63.0
Participants

Frequent urination-Worsened

25.0
Participants

Pain in lower abdominal/genital area-Improved

41.0
Participants

Pain in lower abdominal or genital area-Worsened

13.0
Participants

Small amount of urine leakage-Improved

55.0
Participants

Small amount of urine leakage-Worsened

32.0
Participants

Urine leakage (feeling of urgency)-Improved

53.0
Participants

Urine leakage (feeling of urgency)-Worsened

26.0
Participants

Urine leakage with physical exertion-Improved

56.0
Participants

Urine leakage with physical exertion-Worsened

23.0
Participants

Placebo Tablets and Nonhormonal Vaginal Lubricant

Difficulty emptying bladder-Improved

24.0
Participants

Difficulty emptying bladder-Worsened

15.0
Participants

Frequent urination-Improved

60.0
Participants

Frequent urination-Worsened

22.0
Participants

Pain in lower abdominal/genital area-Improved

37.0
Participants

Pain in lower abdominal or genital area-Worsened

16.0
Participants

Small amount of urine leakage-Improved

58.0
Participants

Small amount of urine leakage-Worsened

27.0
Participants

Urine leakage (feeling of urgency)-Improved

57.0
Participants

Urine leakage (feeling of urgency)-Worsened

32.0
Participants

Urine leakage with physical exertion-Improved

47.0
Participants

Urine leakage with physical exertion-Worsened

27.0
Participants

Change From Baseline in Follicle Stimulating Hormone Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-5.93
IU/L (Mean)
Standard Deviation: 12.49

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-8.71
IU/L (Mean)
Standard Deviation: 13.61

Placebo Tablets and Nonhormonal Vaginal Lubricant

-1.33
IU/L (Mean)
Standard Deviation: 10.87

Change From Baseline in Luteinizing Hormone Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

-2.85
IU/L (Mean)
Standard Deviation: 6.07

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-3.73
IU/L (Mean)
Standard Deviation: 5.83

Placebo Tablets and Nonhormonal Vaginal Lubricant

0.41
IU/L (Mean)
Standard Deviation: 7.25

Change From Baseline in Sex Hormone Binding Globulin Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

11.1
nmol/L (Mean)
Standard Deviation: 16.46

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

22.8
nmol/L (Mean)
Standard Deviation: 22.06

Placebo Tablets and Nonhormonal Vaginal Lubricant

-2.17
nmol/L (Mean)
Standard Deviation: 12.02

Change From Baseline in Testosterone (Free) Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

0.002
ng/dL (Mean)
Standard Deviation: 0.51

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

-0.031
ng/dL (Mean)
Standard Deviation: 0.15

Placebo Tablets and Nonhormonal Vaginal Lubricant

-0.008
ng/dL (Mean)
Standard Deviation: 0.13

Change From Baseline in Testosterone (Total) Levels

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

1.55
ng/dL (Mean)
Standard Deviation: 18.82

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

1.92
ng/dL (Mean)
Standard Deviation: 5.56

Placebo Tablets and Nonhormonal Vaginal Lubricant

-0.059
ng/dL (Mean)
Standard Deviation: 6.07

Change From Baseline in Visual Evaluation of the Vagina

Exam Rating Scale: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Friability

-0.57
Units on a scale (Mean)
Standard Deviation: 0.922

Pallor

-0.75
Units on a scale (Mean)
Standard Deviation: 0.914

Petechiae

-0.5
Units on a scale (Mean)
Standard Deviation: 0.829

Vaginal dryness in mucosa

-1.05
Units on a scale (Mean)
Standard Deviation: 0.959

Vaginal redness in mucosa

-0.44
Units on a scale (Mean)
Standard Deviation: 0.811

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Friability

-0.71
Units on a scale (Mean)
Standard Deviation: 0.911

Pallor

-0.93
Units on a scale (Mean)
Standard Deviation: 0.930

Petechiae

-0.6
Units on a scale (Mean)
Standard Deviation: 0.848

Vaginal dryness in mucosa

-1.22
Units on a scale (Mean)
Standard Deviation: 0.981

Vaginal redness in mucosa

-0.6
Units on a scale (Mean)
Standard Deviation: 0.924

Placebo Tablets and Nonhormonal Vaginal Lubricant

Friability

-0.16
Units on a scale (Mean)
Standard Deviation: 0.818

Pallor

-0.3
Units on a scale (Mean)
Standard Deviation: 0.940

Petechiae

-0.037
Units on a scale (Mean)
Standard Deviation: 0.8080

Vaginal dryness in mucosa

-0.48
Units on a scale (Mean)
Standard Deviation: 0.911

Vaginal redness in mucosa

-0.23
Units on a scale (Mean)
Standard Deviation: 0.792

Total

826
Participants

Age Continuous

58.6
Years (Mean)
Standard Deviation: 6.23

Body Mass Index (BMI)

26.2
kg/m^2 (Mean)
Standard Deviation: 4.43

Height

162.1
cm (Mean)
Standard Deviation: 6.62

No. of Days with Hot Flashes (/month)

19.6
Days (Mean)
Standard Deviation: 11.41

No. of Vaginal Births

1.68
Vaginal births per participant (Mean)
Standard Deviation: 1.480

Number (No.) of Pregnancies

2.46
Pregnancies per participant (Mean)
Standard Deviation: 1.675

Percentage of Parabasal Cells at Screening

39.3
Percentage of Parabasal Cells (Mean)
Standard Deviation: 38.28

Percentage of Superficial Cells at Screening

1.07
Percentage of Superficial Cells (Mean)
Standard Deviation: 2.989

Vaginal pH at Screening

6.35
Vaginal pH (Mean)
Standard Deviation: 0.743

Weight

68.9
kg (Mean)
Standard Deviation: 12.68

Currently Experiencing Hot Flashes?

Intact Cervix?

Intact Uterus?

MBS-Difficult/Painful Urination at Randomization

MBS-Vaginal and/or Vulvar Irritation or Itching at Randomization

MBS-Vaginal Bleeding with Sexual Activity at Randomization

MBS-Vaginal Dryness at Randomization

MBS-Vaginal Pain with Sexual Activity at Randomization

Most Bothersome Vulvar and Vaginal Atrophy (VVA) Symptom (MBS) by Severity (Overall [Composite])

No. of Urinary Tract Infections in Past 6 Months

Previous Hormone Treatment

Race/Ethnicity, Customized

Sex: Female, Male

Overall Study

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Placebo Tablets and Nonhormonal Vaginal Lubricant

Drop/Withdrawal Reasons

Ospemifene 30 mg/Day and Nonhormonal Vaginal Lubricant

Ospemifene 60 mg/Day and Nonhormonal Vaginal Lubricant

Placebo Tablets and Nonhormonal Vaginal Lubricant