Title

Topical DHEA Against Vaginal Atrophy
Topical DHEA Against Vaginal Atrophy (3-Month Placebo-Controlled Double-Blind Randomized Phase III Study)
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    218
The purpose of this study is to determine the dose-response of vaginal mucosa parameters to the local action of DHEA (Dehydroepiandrosterone) in postmenopausal women suffering from vaginal atrophy.
Study Started
Jun 30
2007
Primary Completion
May 31
2008
Study Completion
Oct 31
2008
Results Posted
Apr 28
2017
Last Update
Aug 29
2017

Drug Placebo

Placebo vaginal suppository containing 0.0% (0 mg) DHEA; daily dosing with one suppository for 12 weeks.

  • Other names: Prasterone, Dehydroepiandrosterone

Drug DHEA (0.25%)

Vaginal suppository containing 0.25% (3.25 mg) DHEA; daily dosing with one suppository for 12 weeks.

  • Other names: Prasterone, Dehydroepiandrosterone

Drug DHEA (0.5%)

Vaginal suppository containing 0.5% (6.5 mg) DHEA; daily dosing with one suppository for 12 weeks.

  • Other names: Prasterone, Dehydroepiandrosterone

Drug DHEA (1.0%)

Vaginal suppository containing 1.0% (13 mg) DHEA; daily dosing with one suppository for 12 weeks.

  • Other names: Prasterone, Dehydroepiandrosterone

Placebo Placebo Comparator

0.25% DHEA Experimental

0.5% DHEA Experimental

1.0% DHEA Experimental

Criteria

Inclusion Criteria:

Postmenopausal women (non hysterectomized or hysterectomized)
Women between 40 and 75 years of age
Willing to participate in the study and sign an informed consent
Women having a low maturation index (no greater part of guidance than 5% of superficial cells on vaginal smear)
Women having a vaginal pH above 5
Women who have self-identified at least one moderate to severe symptoms of vulvovaginal atrophy

Exclusion Criteria:

Undiagnosed abnormal genital bleeding
Hypertension equal to or above 160/95 mm Hg or not controlled by standard therapy
The administration of any investigational drug within 30 days of screening visit
Endometrial hyperplasia at biopsy performed at screening or endometrial cancer
Use of estrogens/progestins products (vaginal, oral, pellet, transdermal, etc) in the 4 weeks to 6 months (depending on the product used) prior study entry

Summary

Placebo

0.25% DHEA

0.50% DHEA

1.00% DHEA

All Events

Event Type Organ System Event Term Placebo 0.25% DHEA 0.50% DHEA 1.00% DHEA

Co-primary Endpoint: Change From Baseline to Week 12 of Vaginal Cell Maturation (Percentage of Parabasal Cells)

The percentage of parabasal cells was determined from the vaginal smears collected during the study. A 100-cell count was performed by a central laboratory to classify cells as parabasal (P) (including basal), intermediate (I), and superficial (S) squamous cell types. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

46.7
percentage of parabasal cells (Mean)
Standard Error: 8.64

Change from Baseline

1.1
percentage of parabasal cells (Mean)
Standard Error: 3.62

Week 12

47.8
percentage of parabasal cells (Mean)
Standard Error: 7.52

0.25% DHEA

Baseline

65.5
percentage of parabasal cells (Mean)
Standard Error: 6.92

Change from Baseline

-48.6
percentage of parabasal cells (Mean)
Standard Error: 6.78

Week 12

16.9
percentage of parabasal cells (Mean)
Standard Error: 3.66

0.50% DHEA

Baseline

53.4
percentage of parabasal cells (Mean)
Standard Error: 7.49

Change from Baseline

-42.4
percentage of parabasal cells (Mean)
Standard Error: 7.36

Week 12

11.0
percentage of parabasal cells (Mean)
Standard Error: 3.43

1.00% DHEA

Baseline

61.8
percentage of parabasal cells (Mean)
Standard Error: 6.88

Change from Baseline

-54.9
percentage of parabasal cells (Mean)
Standard Error: 6.60

Week 12

6.9
percentage of parabasal cells (Mean)
Standard Error: 1.77

Co-primary Endpoint: Change From Baseline to Week 12 of Vaginal Cell Maturation (Percentage of Superficial Cells)

The percentage of superficial cells was determined from the vaginal smears collected during the study. A 100-cell count was performed by a central laboratory to classify cells as parabasal (P) (including basal), intermediate (I), and superficial (S) squamous cell types. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

0.6
percentage of superficial cells (Mean)
Standard Error: 0.2

Change from Baseline

-0.1
percentage of superficial cells (Mean)
Standard Error: 0.23

Week 12

0.5
percentage of superficial cells (Mean)
Standard Error: 0.19

0.25% DHEA

Baseline

0.4
percentage of superficial cells (Mean)
Standard Error: 0.15

Change from Baseline

5.3
percentage of superficial cells (Mean)
Standard Error: 1.39

Week 12

5.7
percentage of superficial cells (Mean)
Standard Error: 1.33

0.50% DHEA

Baseline

0.4
percentage of superficial cells (Mean)
Standard Error: 0.11

Change from Baseline

4.8
percentage of superficial cells (Mean)
Standard Error: 1.20

Week 12

5.2
percentage of superficial cells (Mean)
Standard Error: 1.19

1.00% DHEA

Baseline

0.4
percentage of superficial cells (Mean)
Standard Error: 0.16

Change from Baseline

6.1
percentage of superficial cells (Mean)
Standard Error: 1.54

Week 12

6.5
percentage of superficial cells (Mean)
Standard Error: 1.53

Co-primary Endpoint: Change From Baseline to Week 12 of Vaginal pH.

A pH strip was applied directly to the lateral wall of the vagina using forceps. The change in color of the pH indicator strip was compared to the color chart for pH evaluation. The corresponding pH value (with one decimal) was recorded. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

6.5
pH (Mean)
Standard Error: 0.13

Change from Baseline

-0.5
pH (Mean)
Standard Error: 0.16

Week 12

6.0
pH (Mean)
Standard Error: 0.22

0.25% DHEA

Baseline

6.6
pH (Mean)
Standard Error: 0.10

Change from Baseline

-1.1
pH (Mean)
Standard Error: 0.16

Week 12

5.5
pH (Mean)
Standard Error: 0.19

0.50% DHEA

Baseline

6.6
pH (Mean)
Standard Error: 0.09

Change from Baseline

-1.5
pH (Mean)
Standard Error: 0.18

Week 12

5.2
pH (Mean)
Standard Error: 0.17

1.00% DHEA

Baseline

6.5
pH (Mean)
Standard Error: 0.11

Change from Baseline

-1.4
pH (Mean)
Standard Error: 0.15

Week 12

5.1
pH (Mean)
Standard Error: 0.12

Co-primary Endpoint: Change From Baseline to Week 12 of Self-assessment of the Most Bothersome Symptom Dyspareunia

The severity of dyspareunia was evaluated by a questionnaire. The severity of dyspareunia recorded as none, mild, moderate or severe was analyzed using the score values of 0, 1, 2 or 3, respectively. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

2.8
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-0.4
units on a scale (Mean)
Standard Error: 0.16

Week 12

2.3
units on a scale (Mean)
Standard Error: 0.18

0.25% DHEA

Baseline

2.8
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-1.3
units on a scale (Mean)
Standard Error: 0.20

Week 12

1.4
units on a scale (Mean)
Standard Error: 0.22

0.50% DHEA

Baseline

2.7
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-1.6
units on a scale (Mean)
Standard Error: 0.21

Week 12

1.1
units on a scale (Mean)
Standard Error: 0.22

1.00% DHEA

Baseline

2.6
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-1.4
units on a scale (Mean)
Standard Error: 0.18

Week 12

1.2
units on a scale (Mean)
Standard Error: 0.20

Change From Baseline to Week 12 of Vaginal Secretions

To evaluate the aspect of the vaginal mucosa and the local tolerance to DHEA suppository, the vaginal secretions (one of the four main signs of vaginal atrophy) evaluated by the physician/gynecologist as corresponding to none, mild, moderate, or severe atrophy were analyzed using the score values of 1, 2, 3 and 4, respectively. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-0.4
units on a scale (Mean)
Standard Error: 0.10

Week 12

2.7
units on a scale (Mean)
Standard Error: 0.12

0.25% DHEA

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-1.2
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.9
units on a scale (Mean)
Standard Error: 0.10

0.50% DHEA

Baseline

3.2
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-1.4
units on a scale (Mean)
Standard Error: 0.13

Week 12

1.8
units on a scale (Mean)
Standard Error: 0.12

1.00% DHEA

Baseline

3.0
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-1.4
units on a scale (Mean)
Standard Error: 0.11

Week 12

1.5
units on a scale (Mean)
Standard Error: 0.09

Change From Baseline to Week 12 of Vaginal Epithelial Integrity

To evaluate the aspect of the vaginal mucosa and the local tolerance to DHEA suppository, the vaginal epithelial integrity (one of the four main signs of vaginal atrophy) evaluated by the physician/gynecologist as corresponding to none, mild, moderate, or severe atrophy was analyzed using the score values of 1, 2, 3 and 4, respectively. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

2.8
units on a scale (Mean)
Standard Error: 0.13

Change from Baseline

-0.4
units on a scale (Mean)
Standard Error: 0.12

Week 12

2.4
units on a scale (Mean)
Standard Error: 0.13

0.25% DHEA

Baseline

2.7
units on a scale (Mean)
Standard Error: 0.12

Change from Baseline

-1.0
units on a scale (Mean)
Standard Error: 0.14

Week 12

1.7
units on a scale (Mean)
Standard Error: 0.11

0.50% DHEA

Baseline

2.8
units on a scale (Mean)
Standard Error: 0.11

Change from Baseline

-1.3
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.5
units on a scale (Mean)
Standard Error: 0.10

1.00% DHEA

Baseline

2.7
units on a scale (Mean)
Standard Error: 0.11

Change from Baseline

-1.3
units on a scale (Mean)
Standard Error: 0.11

Week 12

1.4
units on a scale (Mean)
Standard Error: 0.09

Change From Baseline to Week 12 of Vaginal Epithelial Surface Thickness

To evaluate the aspect of the vaginal mucosa and the local tolerance to DHEA suppository, the vaginal epithelial surface thickness(one of the four main signs of vaginal atrophy) evaluated by the physician/gynecologist as corresponding to none, mild, moderate, or severe atrophy was analyzed using the score values of 1, 2, 3 and 4, respectively. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

3.0
units on a scale (Mean)
Standard Error: 0.10

Change from Baseline

-0.4
units on a scale (Mean)
Standard Error: 0.10

Week 12

2.6
units on a scale (Mean)
Standard Error: 0.12

0.25% DHEA

Baseline

2.9
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-1.0
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.9
units on a scale (Mean)
Standard Error: 0.11

0.50% DHEA

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-1.3
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.8
units on a scale (Mean)
Standard Error: 0.11

1.00% DHEA

Baseline

3.0
units on a scale (Mean)
Standard Error: 0.08

Change from Baseline

-1.4
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.6
units on a scale (Mean)
Standard Error: 0.10

Change From Baseline to Week 12 of Vaginal Color

To evaluate the aspect of the vaginal mucosa and the local tolerance to DHEA suppository, the vaginal color (one of the four main signs of vaginal atrophy) evaluated by the physician/gynecologist as corresponding to none, mild, moderate, or severe atrophy was analyzed using the score values of 1, 2, 3 and 4, respectively. Data obtained at Baseline and Week 12 as well as the change from Baseline to Week 12 are presented.

Placebo

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-0.5
units on a scale (Mean)
Standard Error: 0.11

Week 12

2.7
units on a scale (Mean)
Standard Error: 0.11

0.25% DHEA

Baseline

3.0
units on a scale (Mean)
Standard Error: 0.10

Change from Baseline

-1.0
units on a scale (Mean)
Standard Error: 0.13

Week 12

2.0
units on a scale (Mean)
Standard Error: 0.12

0.50% DHEA

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.09

Change from Baseline

-1.3
units on a scale (Mean)
Standard Error: 0.14

Week 12

1.8
units on a scale (Mean)
Standard Error: 0.11

1.00% DHEA

Baseline

3.1
units on a scale (Mean)
Standard Error: 0.07

Change from Baseline

-1.5
units on a scale (Mean)
Standard Error: 0.12

Week 12

1.6
units on a scale (Mean)
Standard Error: 0.10

Total

217
Participants

Age, Continuous

58.65
years (Mean)
Standard Deviation: 5.50

Race/Ethnicity, Customized

Sex/Gender, Customized

Overall Study

Placebo

0.25% DHEA

0.50% DHEA

1.00% DHEA

Drop/Withdrawal Reasons

Placebo

0.25% DHEA

0.50% DHEA

1.00% DHEA