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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT00962585
Registration number
NCT00962585
Ethics application status
Date submitted
19/08/2009
Date registered
20/08/2009
Date last updated
8/04/2014
Titles & IDs
Public title
Efficacy and Safety of S-equol on Vasomotor Symptoms in Menopausal Patients
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Scientific title
Randomized, Double Blind, Multicenter, Placebo Controlled, Proof of Concept Trial to Assess the Efficacy and Safety of 4 Weeks Treatment With AUS-131 (S-equol) on Vasomotor Symptoms in Menopausal Patients
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Secondary ID [1]
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AUS-CT03
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Menopause
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Placebo
Treatment: Drugs - S-equol
Placebo Comparator: Placebo - Placebo
Experimental: S-equol 10 mg BID - S-equol 20 mg total daily dose
Experimental: S-equol 50 mg BID - S-equol 100 mg total daily dose
Experimental: S-equol 150 mg BID - S-equol 300 mg total daily dose
Treatment: Drugs: Placebo
Treatment: Drugs: S-equol
Eligible patients meeting all study entry criteria were randomly assigned to receive one of the following active treatments for 4 weeks:
S-equol 10 mg BID (20 mg total daily dose)
S-equol 50 mg BID (100 mg total daily dose)
S-equol 150 mg BID (300 mg total daily dose)
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Mean Change in Frequency of Moderate to Severe Vasomotor Symptoms (MSVS) Baseline at Week 4 (2-week Period)
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Assessment method [1]
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The primary efficacy endpoint for this study was the change from Baseline (Day 0) in the frequency of MSVS (difference between Baseline [2-week run-in period] and Week 4), where the baseline MSVS frequency was captured over 14 ± 2 day period. Moderate is defined as "sensation of heat with sweating, able to continue activity"; severe is defined as "sensation of heat with sweating, causing cessation of activity". Patients used the take-home daily diary to record MSVS information during the run-in period and treatment period and analyses were performed as specified.
Treatment group differences are estimated using least squares (LS) means and 95% confidence intervals based on the mean square error from the ANCOVA. LSMeans refer to overall adjusted mean frequency of MSVS.
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Timepoint [1]
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4 weeks from Baseline (2-week run-in period)
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Secondary outcome [1]
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Mean Change in Frequency of MSVS From Baseline at Week 4 (1-week Period)
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Assessment method [1]
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Change from Baseline in the frequency of MSVS (difference between Baseline [period following first 7 days of 2-week run-in period] and period following first 7 days of 2-week Week 4 period), where the Baseline MSVS frequency was captured at visit 3 (Day 0), in the period following the first 7 days, as per CRF. Note: this endpoint is identical to the primary endpoint, however, instead of a 14 ± 2 day period, the period following the first 7 days was used, at Baseline and visit 3.
Treatment group differences are estimated using least squares (LS) means and 95% confidence intervals based on the mean square error from the ANCOVA. LSMeans refer to overall adjusted mean frequency of MSVS.
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Timepoint [1]
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4 weeks from Baseline (period following first 7 days of 2-week run-in period)
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Secondary outcome [2]
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Change From Baseline (Day 0) in the Frequency of MSVS at Week 1 and Week 2
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Assessment method [2]
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The frequency of MSVS per week, at each of the protocol visits, was calculated as follows, for each patient: [# of Moderate+Severe hot flushes)/(Current protocol visit date-Previous protocol visit date (days)] * 7.
The ANCOVA procedure tested the following hypotheses:
H0: µ1 = µp versus HA: µ1 ? µp, where µ1 and µp denote the mean frequency of MSVS, adjusted for Baseline MSVS values, in the treatment and placebo groups, respectively.
LSMeans refer to the overall adjusted mean frequecy of MSVS.
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Timepoint [2]
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1 and 2 weeks from Baseline (Day 0)
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Secondary outcome [3]
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Change From Baseline (Day 0) in the Severity of VMS as Recorded in the Patient Diary at Week 1, Week 2, and Week 4
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Assessment method [3]
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The severity of vasomotor symptoms per week at each of the protocol visits was calculated for each patient as follows: [(Sum of scores of Mild, Moderate, Severe hot flushes)/(Current protocol visit date - Previous protocol visit date (days)] * 7, where severity of vasomotor symptoms were scored as: 1 = mild, 2 = moderate and 3 = severe. Higher values represented worse severity.
LSMeans refer to the overall adjusted mean severity of VMS.
Hot Flush Classification: Mild: sensation of heat without sweating; Moderate: sensation of heat with sweating, able to continue activity; Severe: sensation of heat with sweating, causing cessation of activity.
Patients recorded the number of hot flushes (day and night) in their diaries related to the severity (mild/moderate/severe).
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Timepoint [3]
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1, 2, and 4 weeks from Baseline (Day 0)
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Secondary outcome [4]
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Change From Baseline (Day 0) in Vaginal pH at Week 2 and Week 4
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Assessment method [4]
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The pH scale measures how acidic or basic a substance is. The pH scale ranges from 0 to 14. A pH of 7 is neutral. A pH less than 7 is acidic. A pH greater than 7 is basic. The pH scale is logarithmic and as a result, each whole pH value below 7 is ten times more acidic than the next higher value.
Normal vaginal pH is 3.8 to 4.5, slightly acidic.
The LSMeans refer to overall adjusted mean pH.
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Timepoint [4]
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2 and 4 weeks from Baseline (Day 0)
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Secondary outcome [5]
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Change From Baseline in Vaginal Maturation Index at Week 2 and Week 4
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Assessment method [5]
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The Vaginal Maturation Index was calculated by examining the maturation of the vaginal epithelium as adjudged by the cell types exfoliated. Parabasal cells are the least mature cells, intermediate cells display mild maturation, and superficial cells display the most maturity. The cell count is expressed as a percentage. The Vaginal Maturation Index was calculated as: 0.2*(parabasal cells, %)+0.6*(intermediate cells, %)+1.0*(superficial cells, %). This method is described in Menopause 2005;12(6):708-15.
The index serves as an objective means of evaluating hormonal secretion or response; lower values indicate more immature cells on the surface (atrophy), while higher values indicate more mature epithelium.
The LSMeans refer to overall adjusted mean percent of cells counted.
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Timepoint [5]
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2 and 4 weeks from Baseline (Day 0)
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Secondary outcome [6]
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Change From Baseline in Estradiol Concentration at Weeks 2 and 4
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Assessment method [6]
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The LSMeans refer to overall adjusted mean estradiol concentration.
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Timepoint [6]
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2 and 4 weeks from Baseline (Day 0)
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Secondary outcome [7]
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Change From Baseline in Progesterone Concentration at Week 2 and Week 4
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Assessment method [7]
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No repeated measures ANCOVA results are presented for change from Baseline in progesterone concentrations since the model did not converge.
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Timepoint [7]
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2 and 4 weeks from Baseline (Day 0)
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Secondary outcome [8]
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Mean Change in the Menopause Rating Scale Total Score From Baseline at Week 4
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Assessment method [8]
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MRS consists of 11 menopause symptoms. The scoring scheme is simple, i.e., the score increases point by point with increasing severity of subjectively perceived symptoms in each of the 11 items (severity 0 [no complaints] 4 scoring points [extremely severe symptoms]). The respondent provides her personal perception by checking one of 5 possible boxes of "severity" for each of the items. The composite score (total score) is the sum of the 11 item scores, which can range from 0 (no symptoms) to 44 (extremely severe symptoms). Low total scores represent less severe menopause symptoms while higher scores represent more severe symptoms.
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Timepoint [8]
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4 weeks from Baseline (Day 0)
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Secondary outcome [9]
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Mean Precentage Change in the Menopause Rating Scale Total Score From Baseline at Week 4
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Assessment method [9]
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Percentage change from Baseline at Week 4 = (Week 4 value - Day 0 value)/(Day 0 value) x 100. Note: MRS consists of 11 symptoms, where each symptom is assigned a score from 0 to 4 (0 = 'None' and 4 = 'Extremely severe').
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Timepoint [9]
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4 weeks from Baseline (Day 0)
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Eligibility
Key inclusion criteria
- 12 months of spontaneous amenorrhea, or 6 months of spontaneous amenorrhea with serum
follicle stimulating hormone (FSH) concentrations > 40 mIU/mL, or 6 weeks postsurgical
bilateral oophorectomy with or without hysterectomy, or hysterectomy with 2 (measured
14 days apart) serum FSH concentrations > 40 mIU/mL.
- Is likely to experience at least 50 moderate to severe vasomotor symptoms ([MSVS] hot
flushes and nocturnal sweating) per week while not receiving estrogen replacement
therapy based on history of menopause, in the judgment of the investigator.
- Documented experiencing at least 50 MSVS per week during the 14 day baseline period
before the Randomization Visit (Visit 3), based on the patient diary entries
(calculated mean MSVS/week for the 14 day baseline period).
- If = 40 years of age, has a documented negative mammogram and a normal clinical breast
examination with no findings indicative of breast malignancy.
- Has a body mass index (BMI) < 35.0 kg/m2.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Has a known history of allergic reaction or clinically significant intolerance to
ingredients of the study drug.
- Received any of the following:oral or dermal estrogen/progestin or selective estrogen
receptor modulator (SERM) containing drug product therapy within 8 weeks before
Screening, injectable or implantable estrogen/progestin therapy within 3 months before
Screening, hormone releasing intrauterine device
- Had unexplained or otherwise abnormal vaginal bleeding within 6 months before
Screening.
- Has a history of, or currently has, any of the following conditions: thrombophlebitis,
thromboembolic disease, estrogen dependent neoplasia, or carcinoma of the breast.
- Has a history of any untreated or uncontrolled endocrine disorders (e.g.,
hyperparathyroidism, uncontrolled hyperthyroidism).
- Has any clinically significant unstable cardiac, respiratory, neurological,
immunological, hematological, hepatic, renal, endocrine, or gastric disease or any
other condition that, in the opinion of the investigator, could compromise the
patient's welfare, ability to communicate with the study staff, or otherwise
contraindicate study participation.
- Has clinically significant depression or severe psychiatric disturbances.
- Has active liver disease with aspartate aminotransferase (AST) > 3 times the upper
limit of normal (ULN), alanine aminotransferase (ALT) > 3 times ULN, unexplained
alkaline phosphatase > 3 times ULN, total bilirubin > 2 times ULN, renal insufficiency
with creatinine > 1.7 mg/dL, or clinically significant abnormal hemoglobin, white
blood cell count, or platelet count.
- Has an endometrial thickness = 4 mm.
- Has a history indicative of endometrial hyperplasia or cancer.
- Shows presence of any manifest premalignant or malignant disease except treated skin
cancers (except melanoma).
- Has known or suspected history of alcoholism or drug abuse or misuse within the past 5
years.
- Has resting systolic blood pressure (BP) > 160 mmHg or < 90 mmHg, or diastolic BP > 90
mmHg or < 60 mmHg at Screening.
- Has a history of smoking more than 5 cigarettes daily within the year before
Screening.
- Has tested positive on the urine drug screen. Patients who test positive at Screening
and can produce documentation from their physician for the medication that caused the
positive test may be considered for study enrollment at the discretion of the
investigator.
- Has significant difficulties swallowing capsules or is unable to tolerate oral
medication.
- Has participated in another clinical trial or received any investigational drug or
device or investigational therapy within 30 days before Screening.
- Has a disorder that affects gastrointestinal absorption.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/06/2010
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/11/2011
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Sample size
Target
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Accrual to date
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Final
169
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
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Recruitment hospital [1]
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Sydney Centre for Reproductive Health Research - Ashfield
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Recruitment hospital [2]
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Royal Hospital for Women - Randwick
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Recruitment hospital [3]
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Women's Health Center, Royal Adelaide Hospital - Adelaide
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Recruitment hospital [4]
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Emeritus Research - Malvern East
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Recruitment postcode(s) [1]
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2131 - Ashfield
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Recruitment postcode(s) [2]
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2031 - Randwick
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Recruitment postcode(s) [3]
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5000 - Adelaide
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Recruitment postcode(s) [4]
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3144 - Malvern East
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Kentucky
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Country [2]
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United States of America
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State/province [2]
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Ohio
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Country [3]
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United States of America
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State/province [3]
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South Carolina
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Country [4]
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United States of America
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State/province [4]
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Utah
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Ausio Pharmaceuticals, LLC
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the safety and effectiveness of S-equol in menopausal
patients with hot flushes and night sweats.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT00962585
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Michael A Thomas, MD
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Address
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University of Cincinnati
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT00962585
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