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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01963403
Other study ID # UCD IRB Protocol Number 478388
Secondary ID MISP 50618
Status Terminated
Phase Phase 4
First received October 10, 2013
Last updated October 24, 2016
Start date December 2013
Est. completion date September 2015

Study information

Verified date October 2016
Source University of California, Davis
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

This double-blinded, placebo-controlled, randomized trial will compare the effects of the use of a combined oral contraceptive pill to a placebo pill for women who are experiencing irregular and/or heavy bleeding associated with the use of an etonogestrel (ETG) implant.

The hypothesis of the study is:

- Use of combined oral contraceptive will significantly improve bleeding patterns for users of ETG implant

- Continuation rate of ETG implant users will be increased by use of combined oral contraceptive in women desiring ETG implant removal because of the undesirable bleeding

- Adverse events will be uncommon and acceptable to women who use a combined oral contraceptive with the ETG implant


Description:

Women who are experiencing irregular and/or heavy bleeding associated with the use of an etonogestrel (ETG) implant will be recruited for this study. Women who have bothersome bleeding will be randomized to use either a combined oral contraceptive pill or a placebo pill.

Participants will take one pill every day and record their bleeding patterns on a daily diary.

Participants will have one screening/enrollment visit, two in-person follow up visits, and one telephone follow up contact. Subjects will be enrolled for a total of 84 days (three months).

Participants will be assigned to a treatment group at her screening/enrollment visit. Her first follow up visit will occur 22-28 days after her enrollment. Participants can choose to:

- Continue use of assigned treatment medication

- Discontinue use of assigned treatment medication, but use an open-label combined oral contraceptive pill

- Discontinue the use of assigned treatment medication, decline use of an open-label combined oral contraceptive pill

- Discontinue use of ETG implant.

Participants who choose to continue use of ETG implant will have a follow up telephone contact 50-56 days after her enrollment visit. A final in-person visit will occur 78-84 days after enrollment. Bleeding patterns will be assessed by daily bleeding diaries completed by the participant.


Recruitment information / eligibility

Status Terminated
Enrollment 26
Est. completion date September 2015
Est. primary completion date July 2015
Accepts healthy volunteers No
Gender Female
Age group 14 Years and older
Eligibility Inclusion Criteria:

- Women who have an ETG implant in place

- Women who subjectively experience the side effect of an undesirable bleeding profile such as bleeding irregularity or heavy flow after ETG implant was placed and who desire intervention for this side effect by either treatment of bleeding or removal of the implant

- Age 14 years an older, inclusive

Exclusion Criteria:

- Irregular or heavy bleeding from an etiology other than ETG use (e.g. fibroids, cervical polyp, or other organic cause of bleeding)

- Has attempted prescription treatment for menstrual side effects while using ETG implant

- Has one or more of the conditions considered Category 3 (risks outweigh benefits) or Category 4 (unacceptable health risk) for estrogen-containing oral contraceptives by the Center for Disease Control Medical Eligibility Criteria for Contraceptive Use:

- Current or history of heart or vascular diseases, including deep venous thrombosis, pulmonary embolism, known thrombogenic mutations, peripartum cardiomyopathy, and complicated valvular heart disease

- Hypertension, even if adequately controlled

- Diabetes with vascular involvement

- Headaches with focal aura, or migraines in women age 35 and older even without focal aura

- Major surgery with prolonged immobilization

- Breast cancer (current or past)

- Severe (decompensated) cirrhosis

- Acute or flare viral hepatitis

- Breastfeeding less than 1 month postpartum

- Post-partum less than 3 weeks

- 35 years of age and older and smoking

- Multiple risk factors for arterial cardiovascular disease

- Systemic Lupus Erythematosus with positive or unknown antiphospholipid antibodies

- Current symptomatic gallbladder disease or history of cholestasis related to past combined oral contraceptive use

- On certain anticonvulsants (phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine, lamotrigine)

- On Ritonavir-boosted protease inhibitors for antiretroviral therapy

- Issues or concerns, in the judgment of the investigator, that may compromise the safety of the subject, impact the subject's adherence to the protocol requirements, or confound the reliability of the data acquired in this study

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
EE 30mcg/LNG 150mcg
1 pill per day; daily during study participation (up to 84 days)
Placebo
1 pill per day; daily during study participation (up to 84 days)

Locations

Country Name City State
United States University of California, Davis Department of Obstetrics and Gynecology Sacramento California
United States Washington University School of Medicine, Department of Obstetrics and Gynecology St. Louis Missouri

Sponsors (2)

Lead Sponsor Collaborator
University of California, Davis Washington University School of Medicine

Country where clinical trial is conducted

United States, 

References & Publications (1)

Hou MY, McNicholas C, Creinin MD. Combined oral contraceptive treatment for bleeding complaints with the etonogestrel contraceptive implant: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2016 Oct;21(5):361-6. doi: 10.1080/13625187.20 — View Citation

Outcome

Type Measure Description Time frame Safety issue
Other Treatment Success or Failure Treatment success will be measured by desire to continue treatment because the initial treatment made the bleeding better.
Partial failure of the study treatment will be measured by the desire to continue treatment because the initial treatment did not work
Complete failure of treatment will be measured by the desire to:
discontinue treatment because it did not work; no further treatment requested
ETG implant removal
Desire to use non-study treatment
Evaluated at follow up visits at 1 month and, if subject continues after 1st month, again at 3 months No
Other Bleeding patterns Bleeding improvement in women who received placebo but opted for open-label treatment after first cycle
Bleeding improvement over the 84 days of study participation
Bleeding patterns in placebo vs. combined oral contraceptive users
Evaluated at follow up visits at 1 month and, if subject continues after 1st month, again at 3 months No
Primary Bleeding Improvement Bleeding improvement will be measured by participant response to the question of whether she feels her bleeding is improved and she is satisfied with the treatment. Bleeding improvement will be evaluated during first cycle of study treatment (28 days) No
Secondary Adverse Events Participants will be evaluated for adverse events while using a combined oral contraceptive with ETG implant. Adverse events will be evaluated at each contact (visits at 1 and 3 months, phone contact at 2 months) with the participant Yes
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