A Study of Fezolinetant to Treat Hot Flashes in Women Going Through Menopause

Vasomotor Symptoms Clinical Trial

— Daylight  

Official title:

A Phase 3b, Randomized, Double-blind, Placebo-controlled, 24-week Study to Assess the Efficacy and Safety of Fezolinetant in Menopausal Women Suffering From Moderate to Severe Vasomotor Symptoms (Hot Flashes) and Considered Unsuitable for Hormone Replacement Therapy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05033886
• Other study ID #: 2693-CL-0312
• Secondary ID: 2021-001685-38
• Status: Completed
• Phase: Phase 3
• Start date: November 8, 2021
• Est. completion date: April 20, 2023

Study information

• Verified date: March 2024
• Source: Astellas Pharma Inc
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is for women in menopause who have moderate to severe hot flashes. It is for women who are unable to use hormone replacement therapy (HRT). Menopause, a normal part of life, is the time after a woman's last period. Hot flashes often occur during menopause. They can disrupt a woman's daily life.

The study medicines (also called investigational products, or IP) are tablets of fezolinetant or placebo. An investigational product means that the product is not yet licensed. In this study, a placebo is a dummy treatment that looks like fezolinetant but does not have any medicine in it. The study will compare fezolinetant with the placebo to learn if fezolinetant reduces the number and severity of hot flashes.

Women that want to take part in the study will be given an electronic handheld device with an app to track their hot flashes. Some women may be able to use the app on their own smartphone. In the last 10 days before their next clinic visit, the women will record information about their hot flashes. They can take part in the study if they have an average of 7 or more moderate to severe hot flashes each day. Women will be picked for 1 of 2 treatments (fezolinetant or placebo) by chance alone.

Women who take part in the study will take 2 tablets every day for 24 weeks. Treatment will be double-blinded. That means that the women in the study and the study doctors will not know who takes which of the study medicines (fezolinetant or placebo). The women will continue recording information about their hot flashes on the electronic device or their phone. They will also use another device to answer questions about how hot flashes affect their daily life.

During the study, the women will visit their study clinic several times for a check-up. This will happen during Weeks 2, 4, 8, 12, 16, 20, 24, and 27. Some women may be able to have home visits instead, from Week 2 to Week 20. At the check-up, they will be asked if they have any medical problems. Other checks will include vital signs (heart rate, temperature and blood pressure) and some blood samples taken for laboratory tests. At some check-ups, the women will have a physical exam. In Week 2 and Week 24, the women will have an ECG to check their heart rhythm. Women who have a uterus will also have a test called a transvaginal ultrasound. A probe is gently placed inside the vagina. Sound waves will create a picture of the organs in the pelvis. This will allow the study doctor to look more closely at the uterus and surrounding organs.

The last check-up (at Week 27) will be 3 weeks after they take their last tablets of study medicine (fezolinetant or placebo).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 453
• Est. completion date: April 20, 2023
• Est. primary completion date: March 27, 2023
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 40 Years to 65 Years

Eligibility

Inclusion Criteria :

• Participant must be seeking treatment or relief for vasomotor symptoms (VMS) associated with menopause and confirmed as menopausal per one of the following criteria at the screening visit:

• Spontaneous amenorrhea for >= 12 consecutive months

• Spontaneous amenorrhea for >= 6 months with biochemical criterion of menopause (follicle-stimulating hormone [FSH] > 40 IU/L)

• Had bilateral oophorectomy >= 6 weeks prior to the screening visit (with or without hysterectomy)

• Participant has VMS and is unsuitable to receive hormone replacement therapy (HRT) (HRT contraindicated, HRT caution, HRT stoppers and HRT averse participants).

• Participant has a minimum average of 7 moderate to severe hot flash's (HFs) (VMS) per day as recorded in the electronic diary during the last 10 days prior to randomization.

• Participant is in good general health as determined on the basis of medical history, general physical examination, laboratory and other medical assessments.

• Participant has a negative serology panel (including hepatitis B surface antigen, hepatitis C virus antibody and human immunodeficiency virus antibody screens).

• Had hysterectomy without oophorectomy and who meets the biochemical criterion of menopause (FSH > 40 IU/L).

Exclusion Criteria:

• Participant uses a prohibited therapy for VMS (e.g., prescription, over-the-counter or herbal) prior to screening and for the duration of treatment with investigational product (IP).

• Participant has known documented substance abuse or alcohol addiction within 6 months of screening.

• Participant has history of a malignant tumor within the last 5 years, except for basal cell carcinoma.

• Participant has endometrial thickness > 8 mm on the locally read screening transvaginal ultrasound (TVU) or any clinically significant findings that that would make the participant ineligible.

• Participant has history of severe allergy, hypersensitivity or intolerance to the IP and/or any of its excipients.

• Participant has a history of seizures or other convulsive disorders unless well controlled.

• Participant has a medical condition or chronic disease (including history of neurological [including cognitive], renal, cardiovascular, gastrointestinal, pulmonary [e.g., moderate asthma], endocrine or gynecological disease) or malignancy that could confound interpretation of the study outcome.

• Participant has any of the following: active liver disease, jaundice, elevated liver aminotransferases at screening (alanine aminotransferase [ALT] or aspartate aminotransferase [AST]), elevated total bilirubin (TBL) or direct bilirubin (DBL) > 1.5 × upper limit of normal (ULN), elevated International Normalized Ratio (INR) > 1.5 (unless participant is receiving anticoagulant therapy) or elevated alkaline phosphatase (ALP). Participants with mildly elevated ALT or AST up to 1.5 × ULN can be enrolled if TBL and DBL are normal. Participants with mildly elevated ALP (up to 1.5 × ULN) can be enrolled if cholestatic liver disease is excluded and no cause other than fatty liver is diagnosed. Participants with Gilbert's syndrome with elevated TBL may be enrolled as long as DBL, hemoglobin and reticulocytes are normal.

• Participant has creatinine > 1.5 × ULN or estimated glomerular filtration rate using the Modification of Diet in Renal Disease formula <= 59 mL/min per 1.73 m^2 at the screening visit.

• Participant has a history of suicide attempt or suicidal behavior within the last 12 months.

• Participant has participated in another interventional study within the last 30 days prior to screening and for the duration of the study.

• Participant who has been previously enrolled in a clinical study with fezolinetant.

• Participant is unable or unwilling to complete the study procedures.

• Participant has any condition makes the participant unsuitable for study participation.

Related Conditions & MeSH terms

• Hot Flashes
• Vasomotor Symptoms

Intervention

Drug:
• fezolinetant
oral
• placebo
oral

Locations

Country	Name	City	State
Belgium	Site BE32005	Tienen	Vlaams Brabant
Canada	Site CA15008	Brampton	Ontario
Canada	Site CA15010	London	Ontario
Canada	Site CA15012	Montreal	Quebec
Canada	Site CA15002	Quebec
Canada	Site CA15007	Quebec
Canada	Site CA15009	Quebec
Canada	Site CA15014	Quebec City	Quebec
Canada	Site CA15011	Saint Charles Borromeee	Quebec
Canada	Site CA15003	Sarnia	Ontario
Canada	Site CA15001	Sherbrooke	Quebec
Canada	Site CA15005	Victoriaville	Quebec
Czechia	Site CZ42008	Brno
Czechia	Site CZ42010	Ceske Budejovice
Czechia	Site CZ42005	Cheb
Czechia	Site CZ42009	Hradec Kralove
Czechia	Site CZ42011	Nachod
Czechia	Site CZ42003	Olomouc
Czechia	Site CZ42004	Pisek
Czechia	Site CZ42006	Praha 2
Czechia	Site CZ42007	Tabor 3	Jihocesky
Czechia	Site CZ42002	Vodnany	Jihocesky
Denmark	Site DK45005	Arhus C
Denmark	Site DK45003	Gandrup	Nordjylland
Denmark	Site DK45002	Odense	Syddanmark
Denmark	Site DK45004	Vejle	Syddanmark
Finland	Site FI35801	Kuopio
Finland	Site FI35803	Oulu
France	Site FR33003	La Rochelle
France	Site FR33001	Nantes
Germany	Site DE49004	Hamburg
Germany	Site DE49005	Hamburg
Germany	Site DE49002	Leipzig
Germany	Site DE49008	Muechen
Germany	Site DE49006	Schwerin
Hungary	Site HU36002	Debrecen
Hungary	Site HU36004	Kecskemet
Hungary	Site HU36001	Szekesfeherver
Italy	Site IT39002	Bologna
Italy	Site IT39006	Pavia
Netherlands	Site NL31001	Beek	Limburg
Netherlands	Site NL31004	Rotterdam
Norway	Site NO47001	Hamar
Poland	Site PL48003	Bialystok
Poland	Site PL48013	Bydgoszcz
Poland	Site PL48004	Katowice
Poland	Site PL48006	Katowice
Poland	Site PL48011	Katowice
Poland	Site PL48007	Lublin
Poland	Site PL48009	Siedice
Poland	Site PL48017	Skierniewice
Poland	Site PL48012	Skorzewo
Poland	Site PL48001	Szczecin	Zachodniopomorskie
Poland	Site PL48010	Zamosc
Spain	Site ES34002	Alcobendas
Spain	Site ES34005	Centellas
Spain	Site ES34003	Leganes
Spain	Site ES34001	Madrid
Sweden	Site SE46004	Qerebro
Sweden	Site SE46003	Stockholm
Sweden	Site SE46002	Uppsala
Turkey	Site TR90001	Ankara	Mamak
Turkey	Site TR90008	Izmir
Turkey	Site TR90002	Konak	Izmir
United Kingdom	Site GB44007	Corby	Northamptonshire
United Kingdom	Site GB44002	Coventry
United Kingdom	Site GB44006	Northwood
United Kingdom	Site GB44003	Orpington
United Kingdom	Site GB44004	Shipley	Yorkshire

Sponsors (1)

Lead Sponsor	Collaborator
Astellas Pharma Global Development, Inc.

Countries where clinical trial is conducted

Belgium,  Canada,  Czechia,  Denmark,  Finland,  France,  Germany,  Hungary,  Italy,  Netherlands,  Norway,  Poland,  Spain,  Sweden,  Turkey,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Mean change in the frequency of moderate to severe VMS from baseline at week 24	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, week 24
Secondary	Mean change in the severity of moderate to severe VMS from baseline at week 24	Severity of moderate to severe VMS per day is calculated as follows: [(number of moderate Hot Flashes (HFs) × 2) + (number of severe HFs/day × 3)]/number of daily moderate/severe HFs. Moderate VMS is defined as sensation of heat with sweating but able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, causing cessation of activity. Severity is zero for participants that have had no moderate or severe VMS. Higher score indicates greater severity. A negative change indicates a reduction/improvement.	Baseline, week 24
Secondary	Mean change in the patient-reported sleep disturbance by the Patient-reported Outcomes Measurement Information System Sleep Disturbance - Short Form 8b (PROMIS SD SF 8b total score) from baseline at week 24	The PROMIS SD SF 8b assesses self reported sleep disturbance over the past 7 days and includes perceptions of restless sleep; satisfaction with sleep; refreshing sleep; difficulties sleeping, getting to sleep or staying asleep; amount of sleep; and sleep quality. Because it assesses the participants experience of sleep disturbance, the measure does not focus on specific sleep-disorder symptoms or ask participants to report objective measures of sleep (e.g., total amount of sleep, time to fall asleep and amount of wakefulness during sleep). Responses to each of the 8 items range from 1 (no disturbed sleep) to 5 (disturbed sleep), and the range of possible summed raw scores is 8 to 40. Higher scores on the PROMIS SD SF 8b indicate more of the disturbed sleep. A negative value indicates a better outcome.	Baseline, week 24
Secondary	Mean change in the frequency of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16 and 20	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, weeks 1, 4, 8, 12, 16 and 20
Secondary	Mean change in severity of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16 and 20	Severity of moderate to severe VMS per day is calculated as follows: [(number of moderate HFs × 2) + (number of severe HFs/day × 3)]/number of daily moderate/severe HFs. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, causing cessation of activity. Severity is zero for participants that have had no moderate or severe VMS. Higher score indicates greater severity. A negative change indicates a reduction/improvement.	Baseline, weeks 1, 4, 8, 12, 16 and 20
Secondary	Mean percent change in the frequency of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16, 20 and 24	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, weeks 1, 4, 8, 12, 16, 20 and 24
Secondary	Number of participants with percent reduction of >/= 50% in the frequency of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16, 20 and 24	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, weeks 1, 4, 8, 12, 16, 20 and 24
Secondary	Number of participants with percent reduction of >/= 75% in the frequency of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16, 20 and 24	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, weeks 1, 4, 8, 12, 16, 20 and 24
Secondary	Number of participants with percent reduction at 100% in the frequency of moderate to severe VMS from baseline at weeks 1, 4, 8, 12, 16, 20 and 24	The frequency of moderate to severe VMS is the number of moderate to severe VMS per 24 hours. A daily frequency per week is derived by taking the mean of the data over 7 days. Moderate VMS is defined as sensation of heat with sweating/dampness but is able to continue activity. Severe VMS is defined as sensation of intense heat with sweating, caused disruption of activity.	Baseline, weeks 1, 4, 8, 12, 16, 20 and 24
Secondary	Number of participants with Treatment Emergent Adverse Events (TEAEs)	An AE is any untoward medical occurrence in a participant administered a study drug, which does not necessarily have to have a causal relationship with this treatment. An AE can be any unfavorable & unintended sign, symptom, or disease temporally associated with the use of medicinal product (MP) whether considered related to MP. A TEAE was defined as an AE observed after starting administration of study intervention and up to 21 days after the last dose of study intervention.	From first dose to week 27

External Links

•   Link to plain language summary of the study on the Trial Results Summaries website.
•   Link to results and other applicable study documents on the Astellas Clinical Trials website.