A Clinical Study to Evaluate the Safety and Efficacy of Elagolix in Participants With Moderate to Severe Endometriosis-Associated Pain

Sponsor
AbbVie (Industry)
Overall Status
Active, not recruiting
CT.gov ID
NCT03213457
Collaborator
(none)
681
197
3
66.8
3.5
0.1

Study Details

Study Description

Brief Summary

The objective of this study is to evaluate safety and efficacy of elagolix in the management of moderate to severe endometriosis-associated pain in adult premenopausal female participants including the safety and efficacy of elagolix in combination with concomitant hormonal add-back therapy.

Condition or Disease Intervention/Treatment Phase
  • Drug: Estradiol/Norethindrone Acetate
  • Drug: Placebo for Elagolix
  • Drug: Elagolix
  • Drug: Placebo for E2/NETA
Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
681 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Phase 3 Study to Evaluate the Safety and Efficacy of Elagolix in Combination With Estradiol/Norethindrone Acetate in Subjects With Moderate to Severe Endometriosis-Associated Pain
Actual Study Start Date :
Jul 7, 2017
Actual Primary Completion Date :
Mar 27, 2020
Anticipated Study Completion Date :
Jan 30, 2023

Arms and Interventions

Arm Intervention/Treatment
Placebo Comparator: Placebo

Placebo for elagolix administered twice daily (BID) plus placebo for estradiol/norethindrone acetate (E2/NETA) administered once daily (QD) for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.

Drug: Placebo for Elagolix
Tablet

Drug: Placebo for E2/NETA
Tablets

Experimental: Elagolix / Elagolix + E2/NETA

Elagolix 200 mg BID alone for the first 6 months of the 12-month placebo-controlled Treatment Period and elagolix 200 mg BID+E2/NETA 1 mg/0.5 mg QD for the second 6 months, followed by elagolix 200 mg BID+E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.

Drug: Estradiol/Norethindrone Acetate
Tablets
Other Names:
  • Activella
  • E2/NETA
  • Drug: Elagolix
    Tablet
    Other Names:
  • ABT-620
  • Elagolix Sodium
  • ORILISSA
  • Experimental: Elagolix + E2/NETA

    Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.

    Drug: Estradiol/Norethindrone Acetate
    Tablets
    Other Names:
  • Activella
  • E2/NETA
  • Drug: Elagolix
    Tablet
    Other Names:
  • ABT-620
  • Elagolix Sodium
  • ORILISSA
  • Outcome Measures

    Primary Outcome Measures

    1. Co-Primary Endpoint: Percentage of Participants With a Response for Dysmenorrhea (DYS) at Months 6 and 12 Based on Daily Assessment [Month 6, Month 12]

      Participants recorded rescue analgesic use for endometriosis-associated pain daily and DYS (pain during menstruation ) and its impact on daily activities each day of their period in an electronic diary (e-Diary). DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over 35 days prior to each visit. Response was defined as a reduction of -0.92 or more from baseline in DYS as well as no increase in rescue analgesic use for endometriosis-associated pain (defined as a < 15% increase in average rescue analgesic pill count and no additional analgesic).

    2. Co-Primary Endpoint: Percentage of Participants With a Response for Non-menstrual Pelvic Pain (NMPP) at Months 6 and 12 Based on Daily Assessment [Month 6, Month 12]

      Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit. Response was defined as a reduction of -0.55 or greater from baseline for NMPP as well as no increase in rescue analgesic use for endometriosis-associated pain (defined as a < 15% increase in average pill count of rescue analgesics and no additional analgesics).

    Secondary Outcome Measures

    1. Change From Baseline in DYS at Month 12 Based on Daily Assessment [Baseline, Month 12]

      Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.

    2. Change From Baseline in DYS at Month 6 Based on Daily Assessment [Baseline, Month 6]

      Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort Mild discomfort but I was easily able to do the things I usually do Moderate discomfort or pain that made it difficult to do some of the things I usually do Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.

    3. Change From Baseline in DYS at Month 3 Based on Daily Assessment [Baseline, Month 3]

      Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort Mild discomfort but I was easily able to do the things I usually do Moderate discomfort or pain that made it difficult to do some of the things I usually do Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.

    4. Change From Baseline in Non-menstrual Pelvic Pain (NMPP) at Month 12 Based on Daily Assessment [Baseline, Month 12]

      Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.

    5. Change From Baseline in NMPP at Month 6 Based on Daily Assessment [Baseline, Month 6]

      Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.

    6. Change From Baseline in NMPP at Month 3 Based on Daily Assessment [Baseline, Month 3]

      Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.

    7. Change From Baseline to Month 6 in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form 6a T-Score [Baseline, Month 6]

      The PROMIS Fatigue Short Form 6a is self-administered and composed of 6 questions to evaluate fatigue over the past 7 days. All questions employ the following five response options: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, and 5 = Always. The PROMIS Fatigue 6a score is calculated as a T-score, which is a standardized score with a mean of 50 (based on the average for the United States general population) and a standard deviation (SD) of 10. Higher scores indicate higher levels of fatigue. A decrease in score (negative change from baseline) indicates improvement in fatigue.

    8. Change From Baseline in Dyspareunia (DYSP) at Month 12 Based on Daily Assessment [Baseline, Month 12]

      Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.

    9. Change From Baseline in DYSP at Month 6 Based on Daily Assessment [Baseline, Month 6]

      Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.

    10. Change From Baseline in DYSP at Month 3 Based on Daily Assessment [Baseline, Month 3]

      Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.

    11. Change From Baseline to Month 12 in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form 6a T-Score [Baseline, Month 12]

      The PROMIS Fatigue Short Form 6a is self-administered and composed of 6 questions to evaluate fatigue over the past 7 days. All questions employ the following five response options: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, and 5 = Always. The PROMIS Fatigue 6a score is calculated as a T-score, which is a standardized score with a mean of 50 (based on the average for the United States general population) and a standard deviation (SD) of 10. Higher scores indicate higher levels of fatigue. A decrease in score (negative change from baseline) indicates improvement in fatigue.

    12. Change From Baseline in Endometriosis-Associated Pain Score at Month 12 Assessed With Numeric Rating Scale (NRS) [Baseline, Month 12]

      The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.

    13. Change From Baseline in Endometriosis-Associated Pain Score at Month 6 Assessed With NRS [Baseline, Month 6]

      The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.

    14. Change From Baseline in Endometriosis-Associated Pain Score at Month 3 Assessed With NRS [Baseline, Month 3]

      The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 49 Years
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Participant is a premenopausal female 18 to 49 years of age (inclusive) at the time of Screening.

    • Participant has a documented surgical diagnosis (e.g., laparoscopy or laparotomy) of endometriosis established by visualization within 10 years prior to entry into Washout or Screening.

    • Participant must agree to use only protocol specified rescue analgesics during the Screening and Treatment Periods for endometriosis-associated pain.

    • Participant must have the following documented in the e-Diary during the last 35 days prior to Study Day 1:

    1. At least 2 days of "moderate" or "severe" dysmenorrhea (DYS) AND either

    2. At least 2 days of "moderate" or "severe" non-menstrual pelvic pain (NMPP) and an average NMPP score of at least 1.0, OR

    3. At least 4 days of "moderate" or "severe" NMPP and an average NMPP score of at least 0.5.

    Exclusion Criteria:
    • Participant has chronic pelvic pain that is not caused by endometriosis, that requires chronic analgesic therapy, which would interfere with the assessment of endometriosis-related pain.

    • Participant is using any systemic corticosteroids for over 14 days within 3 months prior to Screening or is likely to require treatment with systemic corticosteroids during the course of the study. Over-the-counter and prescription topical, inhaled or intranasal corticosteroids are allowed.

    • Participant has a history of any major depression or post-traumatic stress disorder (PTSD) within 2 years of the screening visit or other major psychiatric disorder at any time.

    • Participant has a history of suicide attempts or answered "yes" to questions 4 or 5 on the suicidal ideation portion of the Columbia-Suicide Severity Rating Scale (C-SSRS) within the last 1 year at Screening or prior to randomization on Day 1.

    • Participant has any history of osteoporosis or other metabolic bone disease or any condition that would interfere with obtaining adequate dual energy x-ray absorptiometry (DXA) measurements

    • Screening DXA results of the lumbar spine (L1-L4), femoral neck or total hip bone mineral density (BMD) corresponding to less than 2.0 or more standard deviations below normal.

    • Participant has either:

    1. a newly diagnosed, clinically significant medical condition that requires therapeutic intervention (e.g., new onset hypertension), that has not been stabilized 30 days prior to randomization on Day 1 OR

    2. a clinically significant medical condition that is anticipated to require intervention during the course of study participation (e.g., anticipated major elective surgery) OR

    3. an unstable medical condition that makes the subject an unsuitable candidate for the study in the opinion of the Investigator, (including, but not limited to, uncontrolled diabetes mellitus, uncontrolled hypertension, epilepsy requiring anti-epileptic medication, unstable angina, confirmed inflammatory bowel disease, hyperprolactinemia, clinically significant infection or injury).

    • Participant has any conditions contraindicated with use of E2/NETA.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Central Research Associates /ID# 163087 Birmingham Alabama United States 35205
    2 Alabama Clinical Therapeutics, LLC /ID# 145503 Birmingham Alabama United States 35235-3430
    3 Alabama Clinical Therapeutics, LLC /ID# 151468 Birmingham Alabama United States 35235-3430
    4 Southern Women's Specialists PC /ID# 148750 Fairhope Alabama United States 36532-3029
    5 Women's Health Alliance of Mobile /ID# 150083 Mobile Alabama United States 36604-1410
    6 University of South Alabama /ID# 148774 Mobile Alabama United States 36604-3302
    7 Mobile, Ob-Gyn, P.C. /ID# 145364 Mobile Alabama United States 36608
    8 Mesa Obstetricians and Gynecologists /ID# 147320 Mesa Arizona United States 85209
    9 Arizona Research Assoc /ID# 161703 Tucson Arizona United States 85712
    10 Eclipse Clinical Research /ID# 155600 Tucson Arizona United States 85745
    11 Unity Health- Searcy Medical Center /ID# 203674 Searcy Arkansas United States 72143-4802
    12 Core Healthcare Group /ID# 149321 Cerritos California United States 90703
    13 HRC Fertility /ID# 154143 Encino California United States 91436
    14 Glendale Adventist Medical Ctr /ID# 160530 Glendale California United States 91206
    15 HCP Clinical Research LLC /ID# 152045 Huntington Beach California United States 92646
    16 Alliance Research Centers /ID# 151240 Irvine California United States 92612-1245
    17 Long Beach Clinical Trial Serv /ID# 152428 Long Beach California United States 90806
    18 Olympia Clinical Trials /ID# 202325 Los Angeles California United States 90036-4667
    19 California Medical Research As /ID# 154746 Northridge California United States 91324
    20 Futura Research, Org /ID# 145406 Norwalk California United States 90650
    21 Huntington Medical Foundation /ID# 154750 Pasadena California United States 91105
    22 Northern California Research /ID# 159753 Sacramento California United States 95821-2640
    23 Precision Research Institute - San Diego /ID# 152557 San Diego California United States 92114-3643
    24 MD Strategies Research Centers /ID# 152429 San Diego California United States 92119
    25 Alta California Medical Group /ID# 155706 Simi Valley California United States 93065
    26 Downtown Womens Health Care /ID# 147955 Denver Colorado United States 80209
    27 Advanced Women's Health Institute /ID# 145396 Greenwood Village Colorado United States 80111
    28 Red Rocks OB/GYN /ID# 145325 Lakewood Colorado United States 80228-1810
    29 The Women's Health Group - Thornton /ID# 203707 Thornton Colorado United States 80229-4385
    30 James A. Simon, MD, PC /ID# 145480 Washington District of Columbia United States 20036
    31 Helix Biomedics, LLC /ID# 147108 Boynton Beach Florida United States 33436-6634
    32 Gulf Coast Research Group /ID# 162895 Brandon Florida United States 33510
    33 Olympian Clinical Research /ID# 148167 Clearwater Florida United States 33756
    34 Omega Research Maitland, LLC /ID# 145167 DeBary Florida United States 32713-2260
    35 KO Clinical Research, LLC /ID# 145410 Fort Lauderdale Florida United States 33316
    36 Clinical Physiology Associates /ID# 145237 Fort Myers Florida United States 33912
    37 Solutions Through Adv Rch /ID# 148768 Jacksonville Florida United States 32256
    38 Vida Clinical Research /ID# 150282 Kissimmee Florida United States 34741-2345
    39 Axcess Medical Center /ID# 148169 Loxahatchee Groves Florida United States 33470
    40 Precision Research Organization /ID# 145337 Miami Lakes Florida United States 33016-1501
    41 Ocean Blue Medical Research Center, Inc /ID# 145514 Miami Springs Florida United States 33166
    42 Genoma Research Group, Inc /ID# 152558 Miami Florida United States 33165
    43 Vista Health Research LLC - Miami /ID# 151455 Miami Florida United States 33176-1032
    44 Palmetto Professional Research /ID# 153838 Miami Florida United States 33186-1309
    45 Salom Tangir, LLC /ID# 148739 Miramar Florida United States 33027
    46 Suncoast Clinical Research /ID# 145484 New Port Richey Florida United States 34652
    47 Oncova Clinical Research, Inc. /ID# 148175 Saint Cloud Florida United States 34769
    48 Meridien Research - St Petersburg /ID# 145345 Saint Petersburg Florida United States 33709-3113
    49 Physician Care Clin. Res., LLC /ID# 145511 Sarasota Florida United States 34239
    50 Treasure Coast Research /ID# 148174 Stuart Florida United States 34996
    51 University of South Florida /ID# 145424 Tampa Florida United States 33612
    52 Stedman Clinical Trials /ID# 152554 Tampa Florida United States 33613
    53 Virtus Research Consultants, LLC /ID# 147101 Wellington Florida United States 33414
    54 Comprehensive Clinical Trials /ID# 145148 West Palm Beach Florida United States 33409
    55 Paramount Research Solutions /ID# 145226 Alpharetta Georgia United States 30005
    56 Paramount Research Solutions /ID# 149320 Alpharetta Georgia United States 30005
    57 Agile Clinical Research Trials /ID# 145494 Atlanta Georgia United States 30328-5532
    58 Atlanta Women's Research Inst /ID# 145543 Atlanta Georgia United States 30342
    59 Apogee Women's Health Inc. /ID# 145149 College Park Georgia United States 30349
    60 Columbus Regional Research Ins /ID# 159752 Columbus Georgia United States 31904
    61 Meridian Clinical Research, LLC /ID# 148176 Savannah Georgia United States 31406-2675
    62 Atlanta Gynecology Research Institute /ID# 149322 Suwanee Georgia United States 30024-7159
    63 Clinical Research Prime /ID# 161724 Idaho Falls Idaho United States 83404
    64 Womens Healthcare Assoc, DBA /ID# 148744 Idaho Falls Idaho United States 83404
    65 Advanced Clinical Research /ID# 147086 Meridian Idaho United States 83642
    66 Sonora Clinical Research /ID# 145541 Meridian Idaho United States 83646-1144
    67 Asr, Llc /Id# 161680 Nampa Idaho United States 83687
    68 Women's Health Practice, LLC /ID# 145517 Champaign Illinois United States 61820
    69 Affinity Clinical Research /ID# 151469 Oak Brook Illinois United States 60523
    70 Center for Women's Research, Inc /ID# 145486 Palos Heights Illinois United States 60463-1440
    71 The Advanced Gynecologic Surgery Institute - Park Ridge /ID# 151459 Park Ridge Illinois United States 60068
    72 American Health Network of Ind /ID# 167996 Avon Indiana United States 46123-7960
    73 Women's Health Advantage /ID# 145495 Fort Wayne Indiana United States 46825
    74 The Iowa Clinic /ID# 145409 West Des Moines Iowa United States 50266
    75 Womens & Family Care, LLC dba /ID# 145211 Shawnee Mission Kansas United States 66218
    76 PRN Professional Research Network of Kansas, LLC /ID# 151463 Wichita Kansas United States 67205
    77 Cypress Medical Research Ctr /ID# 147159 Wichita Kansas United States 67226
    78 University of Louisville /ID# 154751 Louisville Kentucky United States 40202
    79 Bluegrass Clinical Research /ID# 151209 Louisville Kentucky United States 40291-1988
    80 Clinical Trials Management, LLC - Covington /ID# 145220 Covington Louisiana United States 70433
    81 Clinical Trials Management, LLC - Covington /ID# 145520 Covington Louisiana United States 70433
    82 Horizon Research Group /ID# 148171 Eunice Louisiana United States 70535
    83 Praetorian Pharmaceutical Res /ID# 145405 Marrero Louisiana United States 70072
    84 Ochsner Baptist OB/GYN Clinic /ID# 147144 New Orleans Louisiana United States 70115
    85 Women Under Study, LLC /ID# 151216 New Orleans Louisiana United States 70125-1923
    86 Women's Health Clinic /ID# 155707 Shreveport Louisiana United States 71118-3133
    87 Omni Fertility and Laser Insti /ID# 145532 Shreveport Louisiana United States 71118
    88 Eastern Maine Medical Center /ID# 161681 Bangor Maine United States 04401
    89 Univ Maryland School Medicine /ID# 151739 Baltimore Maryland United States 21201
    90 Baltimore Suburban Health /ID# 147164 Baltimore Maryland United States 21208
    91 Continental Clinical Solutions /ID# 152041 Towson Maryland United States 21204
    92 NECCR Fall River LLC /ID# 145329 Fall River Massachusetts United States 02720-2972
    93 Genesis Clinical Research - Fall River /ID# 148573 Fall River Massachusetts United States 02723
    94 ClinSite, LLC /ID# 145314 Ann Arbor Michigan United States 48105
    95 Great Lakes Research Group, Inc. /ID# 145308 Bay City Michigan United States 48602
    96 Saginaw Valley Med Res Group /ID# 145527 Saginaw Michigan United States 48604
    97 Wayne State University Physician Group - Southfield /ID# 145431 Southfield Michigan United States 48034
    98 Prism Research /ID# 159751 Saint Paul Minnesota United States 55114
    99 Womens Clinic of Lincoln, P.C. /ID# 145366 Lincoln Nebraska United States 68510
    100 Accent Clinical Trials /ID# 147109 Las Vegas Nevada United States 89106-4017
    101 Office of Edmond E. Pack, MD /ID# 148747 Las Vegas Nevada United States 89113
    102 R. Garn Mabey Jr, MD Chartered /ID# 145361 Las Vegas Nevada United States 89128
    103 Jersey Shore University Medical Center /ID# 148756 Neptune New Jersey United States 07753-4859
    104 Rutgers Robert Wood Johnson /ID# 152858 New Brunswick New Jersey United States 08901
    105 St. Joseph's Regional Medical /ID# 157759 Totowa New Jersey United States 07512
    106 Albuquerque Clinical Trials, Inc /ID# 154747 Albuquerque New Mexico United States 87102
    107 Bosque Women's Care /ID# 147084 Albuquerque New Mexico United States 87109
    108 SUNY Downstate Medical Center /ID# 148749 Brooklyn New York United States 11203
    109 Scott Research Inc. /ID# 161704 Laurelton New York United States 11413
    110 Manhattan Medical Research /ID# 145175 New York New York United States 10016-6023
    111 Columbia Univ Medical Center /ID# 145334 New York New York United States 10032-3725
    112 Hamburg Regional Gynecology Gr /ID# 161705 Orchard Park New York United States 14127
    113 OB.GYN Associates of WNY /ID# 161665 West Seneca New York United States 14224
    114 PMG Research of Charlotte /ID# 145432 Charlotte North Carolina United States 28209
    115 DJL Clinical Research, PLLC /ID# 154679 Charlotte North Carolina United States 28210-8508
    116 Carolina Women's Research and Wellness Center /ID# 145356 Durham North Carolina United States 27713
    117 Unified Women's Clinical Research-Greensboro /ID# 155543 Greensboro North Carolina United States 27408
    118 Pinewest Ob-Gyn, Inc. /ID# 151743 High Point North Carolina United States 27262
    119 Eastern Carolina Women's Centr /ID# 145386 New Bern North Carolina United States 28562
    120 Unified Women's Clinical Resea /ID# 145353 Raleigh North Carolina United States 27607
    121 PMG Research of Wilmington /ID# 152555 Wilmington North Carolina United States 28401-6638
    122 Trinity Health Center Town /ID# 147102 Minot North Dakota United States 58701
    123 Clinical Inquest Center Ltd /ID# 147107 Beavercreek Ohio United States 45431-2573
    124 CTI Clinical Research Center /ID# 145428 Cincinnati Ohio United States 45212
    125 The Christ Hospital /ID# 149244 Cincinnati Ohio United States 45219
    126 University of Cincinnati /ID# 145496 Cincinnati Ohio United States 45267-0585
    127 Univ Hosp Cleveland /ID# 148741 Cleveland Ohio United States 44106
    128 The Ohio State University /ID# 145444 Columbus Ohio United States 43210-1257
    129 Aventiv Research, Inc. /ID# 145492 Columbus Ohio United States 43213
    130 Aventiv Research, Inc. /ID# 162896 Columbus Ohio United States 43213
    131 Wright State University & CTRA /ID# 145512 Fairborn Ohio United States 45324
    132 University of Toledo /ID# 145403 Toledo Ohio United States 43614
    133 Oregon Health and Science University /ID# 155705 Portland Oregon United States 97239
    134 Main Line Fertility Center /ID# 150099 Bryn Mawr Pennsylvania United States 19010
    135 OB/GYN Associates of Erie /ID# 157935 Erie Pennsylvania United States 16507-1423
    136 Penn State University and Milton S. Hershey Medical Center /ID# 145231 Hershey Pennsylvania United States 17033
    137 University of Pennsylvania /ID# 145470 Philadelphia Pennsylvania United States 19104-5502
    138 Drexel Univ College of Med /ID# 149789 Philadelphia Pennsylvania United States 19129
    139 Frontier Clinical Research /ID# 162091 Smithfield Pennsylvania United States 15478
    140 Vista Clinical Research /ID# 148767 Columbia South Carolina United States 29201
    141 University Medical Group /ID# 148777 Greenville South Carolina United States 29605
    142 Venus Gynecology, LLC /ID# 145336 Myrtle Beach South Carolina United States 29572
    143 James T. Martin, Jr., MD., Obs /ID# 148755 North Charleston South Carolina United States 29406
    144 Palmetto Clinical Research /ID# 150992 Summerville South Carolina United States 29485-7539
    145 Brown Clinic, PLLP /ID# 154372 Watertown South Dakota United States 57201
    146 Holston Medical Group /ID# 145449 Bristol Tennessee United States 37620-7346
    147 Chattanooga Medical Research /ID# 145184 Chattanooga Tennessee United States 37404
    148 WR-ClinSearch /ID# 145205 Chattanooga Tennessee United States 37421-1605
    149 The Jackson Clinic, PA /ID# 145303 Jackson Tennessee United States 38305
    150 Research Memphis Associates, LLC /ID# 150100 Memphis Tennessee United States 38119-3895
    151 Access Clinical Trials, Inc. /ID# 145224 Nashville Tennessee United States 37203
    152 Lotus Gynecology /ID# 148479 Austin Texas United States 78703-1448
    153 AA (Austin Area) ObGyn PLLC /ID# 205696 Austin Texas United States 78758-5653
    154 Sirius Clinical Research, LLC /ID# 154749 Austin Texas United States 78759
    155 Gadolin Research, LLC /ID# 201383 Beaumont Texas United States 77702-1100
    156 Center for Assisted Reprod. /ID# 154748 Bedford Texas United States 76022
    157 Texas Health Presbyterian Hosp /ID# 150098 Dallas Texas United States 75231
    158 UT Southwestern Medical Center /ID# 145201 Dallas Texas United States 75390-7208
    159 Baylor Scott & White /ID# 170430 Fort Worth Texas United States 76104-4110
    160 Signature Gyn Services /ID# 145534 Fort Worth Texas United States 76104
    161 Willowbend Health and Wellness - Frisco /ID# 145245 Frisco Texas United States 75035
    162 Next Innovative Clinical Research /ID# 203863 Houston Texas United States 77004-6031
    163 Advances in Health, Inc. /ID# 145425 Houston Texas United States 77030
    164 Houston Methodist Hospital /ID# 170586 Houston Texas United States 77030
    165 Precision Research Institute - Houston /ID# 154370 Houston Texas United States 77036
    166 The Woman's Hospital of Texas /ID# 145316 Houston Texas United States 77054
    167 Centex Studies, Inc /ID# 148776 Houston Texas United States 77058-2705
    168 FMC Science /ID# 150981 Lampasas Texas United States 76550
    169 Clinical Trials of Texas, Inc /ID# 147100 San Antonio Texas United States 78229
    170 VIP Trials /ID# 151745 San Antonio Texas United States 78230
    171 Discovery Clinical Trials-San Antonio /ID# 145363 San Antonio Texas United States 78258
    172 Houston Ctr for Clin Research /ID# 148799 Sugar Land Texas United States 77479
    173 Center of Reproductive Medicin /ID# 145467 Webster Texas United States 77598
    174 Corner Canyon Obstetrics and G /ID# 145519 Draper Utah United States 84020
    175 Tanner Clinic /ID# 148786 Layton Utah United States 84041
    176 Revere Health /ID# 145540 Pleasant Grove Utah United States 84062
    177 Southampton Women's Health /ID# 151691 Franklin Virginia United States 23851
    178 Health Research of Hampton Roads, Inc. (HRHR) /ID# 156477 Newport News Virginia United States 23606
    179 Clinical Research Partners, LL /ID# 145392 North Chesterfield Virginia United States 23235-4722
    180 Clinical Research Partners, LL /ID# 145416 North Chesterfield Virginia United States 23235-4722
    181 Clinical Trials Virginia, Inc. /ID# 145430 Richmond Virginia United States 23225
    182 Alliance Womens Health /ID# 148770 Richmond Virginia United States 23226-1930
    183 Tidewater Clinical Research /ID# 145397 Virginia Beach Virginia United States 23456
    184 Clinical Research Adv, Inc. /ID# 149257 Puyallup Washington United States 98372
    185 Virginia Mason Medical Center /ID# 145387 Seattle Washington United States 98101
    186 Seattle Women's Health, Research, Gynecology /ID# 145341 Seattle Washington United States 98105
    187 North Spokane Women's Health /ID# 145382 Spokane Washington United States 99207
    188 Madigan Army Medical Center /ID# 145186 Tacoma Washington United States 98431
    189 Strand Clinic /ID# 152582 St. John's Newfoundland and Labrador Canada A1A 4Y3
    190 The Ottawa Hospital /ID# 148927 Ottawa Ontario Canada K1H 8L6
    191 Medicor Research Inc /ID# 151453 Sudbury Ontario Canada P3E 5M4
    192 Mount Sinai Hosp.-Toronto /ID# 148972 Toronto Ontario Canada M5G 1X5
    193 Victory Reproductive Care /ID# 149016 Windsor Ontario Canada N8W 5R7
    194 Puerto Rico Medical Research /ID# 152040 Ponce Puerto Rico 00717
    195 Clinical Research Puerto Rico /ID# 149018 San Juan Puerto Rico 00909
    196 Rodriguez-Ginorio, San Juan /ID# 145545 San Juan Puerto Rico 00917
    197 School of Medicine University of Puerto Rico-Medical Science Campus /ID# 145546 San Juan Puerto Rico 00935

    Sponsors and Collaborators

    • AbbVie

    Investigators

    • Study Director: AbbVie Inc., AbbVie

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    AbbVie
    ClinicalTrials.gov Identifier:
    NCT03213457
    Other Study ID Numbers:
    • M14-702
    First Posted:
    Jul 11, 2017
    Last Update Posted:
    Feb 16, 2022
    Last Verified:
    Feb 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Keywords provided by AbbVie
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details A total of 681 participants were randomized at 138 sites in 2 countries (United States [including Puerto Rico] and Canada).
    Pre-assignment Detail Participants were randomly assigned on Study Day 1 in a 4:1:2 ratio as follows: elagolix 200 mg twice daily (BID) plus estradiol/norethindrone acetate (E2/NETA) 1 mg/0.5 mg once daily (QD) elagolix 200 mg BID placebo Data are presented for the 12-month placebo-controlled Treatment Period (data cutoff date of 12-May-2020).
    Arm/Group Title Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID alone for the first 6 months of the 12-month placebo-controlled Treatment Period and elagolix 200 mg BID+E2/NETA 1 mg/0.5 mg QD for the second 6 months, followed by elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Period Title: Overall Study
    STARTED 194 98 389
    Randomized and Treated 193 97 389
    COMPLETED 106 59 215
    NOT COMPLETED 88 39 174

    Baseline Characteristics

    Arm/Group Title Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA Total
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID alone for the first 6 months of the 12-month placebo-controlled Treatment Period and elagolix 200 mg BID+E2/NETA 1 mg/0.5 mg QD for the second 6 months, followed by elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Total of all reporting groups
    Overall Participants 193 97 389 679
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    33.1
    (6.72)
    32.5
    (6.44)
    32.3
    (6.74)
    32.5
    (6.69)
    Sex/Gender, Customized (Count of Participants)
    Female
    193
    100%
    97
    100%
    389
    100%
    679
    100%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    37
    19.2%
    11
    11.3%
    58
    14.9%
    106
    15.6%
    Not Hispanic or Latino
    156
    80.8%
    86
    88.7%
    331
    85.1%
    573
    84.4%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    1
    0.5%
    0
    0%
    1
    0.3%
    2
    0.3%
    Asian
    0
    0%
    0
    0%
    4
    1%
    4
    0.6%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    1
    0.3%
    1
    0.1%
    Black or African American
    31
    16.1%
    19
    19.6%
    49
    12.6%
    99
    14.6%
    White
    159
    82.4%
    74
    76.3%
    328
    84.3%
    561
    82.6%
    More than one race
    2
    1%
    4
    4.1%
    6
    1.5%
    12
    1.8%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%

    Outcome Measures

    1. Primary Outcome
    Title Co-Primary Endpoint: Percentage of Participants With a Response for Dysmenorrhea (DYS) at Months 6 and 12 Based on Daily Assessment
    Description Participants recorded rescue analgesic use for endometriosis-associated pain daily and DYS (pain during menstruation ) and its impact on daily activities each day of their period in an electronic diary (e-Diary). DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over 35 days prior to each visit. Response was defined as a reduction of -0.92 or more from baseline in DYS as well as no increase in rescue analgesic use for endometriosis-associated pain (defined as a < 15% increase in average rescue analgesic pill count and no additional analgesic).
    Time Frame Month 6, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment at given time point. Last observation carried forward. Per protocol, the primary comparison for the co-primary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 190 384
    Month 6
    23.7
    12.3%
    62.8
    64.7%
    Month 12
    29.1
    15.1%
    63.8
    65.8%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Month 6
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P-value for test of difference is from a logistic regression model including treatment as the main effect and baseline value as a covariate.
    Method Regression, Logistic
    Comments
    Method of Estimation Estimation Parameter Odds Ratio (OR)
    Estimated Value 5.51
    Confidence Interval (2-Sided) 95%
    3.711 to 8.176
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Month 12
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P-value for test of difference is from a logistic regression model including treatment as the main effect and baseline value as a covariate.
    Method Regression, Logistic
    Comments
    Method of Estimation Estimation Parameter Odds Ratio (OR)
    Estimated Value 4.33
    Confidence Interval (2-Sided) 95%
    2.968 to 6.331
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Primary Outcome
    Title Co-Primary Endpoint: Percentage of Participants With a Response for Non-menstrual Pelvic Pain (NMPP) at Months 6 and 12 Based on Daily Assessment
    Description Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit. Response was defined as a reduction of -0.55 or greater from baseline for NMPP as well as no increase in rescue analgesic use for endometriosis-associated pain (defined as a < 15% increase in average pill count of rescue analgesics and no additional analgesics).
    Time Frame Month 6, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment at given time point. Last observation carried forward. Per protocol, the primary comparison for the co-primary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 190 384
    Month 6
    36.8
    19.1%
    51.3
    52.9%
    Month 12
    42.3
    21.9%
    54.3
    56%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Month 6
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P-value for test of difference is from a logistic regression model including treatment as the main effect and baseline value as a covariate.
    Method Regression, Logistic
    Comments
    Method of Estimation Estimation Parameter Odds Ratio (OR)
    Estimated Value 1.82
    Confidence Interval (2-Sided) 95%
    1.275 to 2.605
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Month 12
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.007
    Comments P-value for test of difference is from a logistic regression model including treatment as the main effect and baseline value as a covariate.
    Method Regression, Logistic
    Comments
    Method of Estimation Estimation Parameter Odds Ratio (OR)
    Estimated Value 1.63
    Confidence Interval (2-Sided) 95%
    1.146 to 2.326
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    3. Secondary Outcome
    Title Change From Baseline in DYS at Month 12 Based on Daily Assessment
    Description Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 111 216
    Least Squares Mean (Standard Error) [score on a scale]
    -0.73
    (0.077)
    -1.73
    (0.055)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method mixed model repeated measures (MMRM)
    Comments
    Method of Estimation Estimation Parameter Least Squares (LS) Mean of Difference
    Estimated Value -0.99
    Confidence Interval (2-Sided) 95%
    -1.180 to -0.809
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.094
    Estimation Comments
    4. Secondary Outcome
    Title Change From Baseline in DYS at Month 6 Based on Daily Assessment
    Description Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort Mild discomfort but I was easily able to do the things I usually do Moderate discomfort or pain that made it difficult to do some of the things I usually do Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 6

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 138 286
    Least Squares Mean (Standard Error) [score on a scale]
    -0.62
    (0.072)
    -1.64
    (0.050)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -1.02
    Confidence Interval (2-Sided) 95%
    -1.190 to -0.845
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.088
    Estimation Comments
    5. Secondary Outcome
    Title Change From Baseline in DYS at Month 3 Based on Daily Assessment
    Description Participants assessed DYS (pain during menstruation) and its impact on their daily activities each day of their period in an e-Diary. DYS was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort Mild discomfort but I was easily able to do the things I usually do Moderate discomfort or pain that made it difficult to do some of the things I usually do Severe pain that made it difficult to do the things I usually do. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 3

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 170 335
    Least Squares Mean (Standard Error) [score on a scale]
    -0.56
    (0.069)
    -1.54
    (0.049)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.99
    Confidence Interval (2-Sided) 95%
    -1.156 to -0.823
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.085
    Estimation Comments
    6. Secondary Outcome
    Title Change From Baseline in Non-menstrual Pelvic Pain (NMPP) at Month 12 Based on Daily Assessment
    Description Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 111 216
    Least Squares Mean (Standard Error) [score on a scale]
    -0.64
    (0.060)
    -0.86
    (0.042)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.002
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.22
    Confidence Interval (2-Sided) 95%
    -0.367 to -0.080
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.073
    Estimation Comments
    7. Secondary Outcome
    Title Change From Baseline in NMPP at Month 6 Based on Daily Assessment
    Description Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 6

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 138 286
    Least Squares Mean (Standard Error) [score on a scale]
    -0.57
    (0.051)
    -0.78
    (0.036)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.21
    Confidence Interval (2-Sided) 95%
    -0.329 to -0.085
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.062
    Estimation Comments
    8. Secondary Outcome
    Title Change From Baseline in NMPP at Month 3 Based on Daily Assessment
    Description Participants recorded rescue analgesic medication for endometriosis-associated pain and assessed NMPP and its impact on their daily activities each day in an e-Diary was measured by the 4-point Endometriosis Daily Pain Impact Diary according to the following: 0: No discomfort 1: Mild discomfort but I was easily able to do the things I usually do 2: Moderate discomfort or pain that made it difficult to do some of the things I usually do 3: Severe pain that made it difficult to do the things I usually do. Pain scores and analgesic use were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 3

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 170 335
    Least Squares Mean (Standard Error) [score on a scale]
    -0.49
    (0.046)
    -0.65
    (0.032)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.004
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.16
    Confidence Interval (2-Sided) 95%
    -0.270 to -0.050
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.056
    Estimation Comments
    9. Secondary Outcome
    Title Change From Baseline to Month 6 in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form 6a T-Score
    Description The PROMIS Fatigue Short Form 6a is self-administered and composed of 6 questions to evaluate fatigue over the past 7 days. All questions employ the following five response options: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, and 5 = Always. The PROMIS Fatigue 6a score is calculated as a T-score, which is a standardized score with a mean of 50 (based on the average for the United States general population) and a standard deviation (SD) of 10. Higher scores indicate higher levels of fatigue. A decrease in score (negative change from baseline) indicates improvement in fatigue.
    Time Frame Baseline, Month 6

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Observed cases. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 146 302
    Least Squares Mean (Standard Error) [T-score]
    -4.71
    (0.739)
    -7.22
    (0.514)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.005
    Comments P-value for test of difference at each post-baseline time point is from an ANCOVA model with treatment as the main effect and baseline as a covariate.
    Method ANCOVA
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -2.51
    Confidence Interval (2-Sided) 95%
    -4.283 to -0.746
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.900
    Estimation Comments
    10. Secondary Outcome
    Title Change From Baseline in Dyspareunia (DYSP) at Month 12 Based on Daily Assessment
    Description Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.
    Time Frame Baseline, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 84 147
    Least Squares Mean (Standard Error) [score on a scale]
    -0.60
    (0.079)
    -0.70
    (0.058)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.284
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.11
    Confidence Interval (2-Sided) 95%
    -0.298 to 0.088
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.098
    Estimation Comments
    11. Secondary Outcome
    Title Change From Baseline in DYSP at Month 6 Based on Daily Assessment
    Description Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.
    Time Frame Baseline, Month 6

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 96 209
    Least Squares Mean (Standard Error) [score on a scale]
    -0.54
    (0.076)
    -0.63
    (0.053)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.286
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.10
    Confidence Interval (2-Sided) 95%
    -0.279 to 0.083
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.092
    Estimation Comments
    12. Secondary Outcome
    Title Change From Baseline in DYSP at Month 3 Based on Daily Assessment
    Description Participants assessed DYSP each day in an e-Diary according to the following response options: 0: None; No discomfort during sexual intercourse 1: Mild; Able to tolerate the discomfort during sexual intercourse 2: Moderate; Intercourse was interrupted due to pain 3: Severe; Avoided intercourse because of pain Not applicable; I was not sexually active for reasons other than endometriosis or did not have sexual intercourse. Pain scores were averaged over the 35 days prior to each visit. Responses of "Not Applicable" were excluded.
    Time Frame Baseline, Month 3

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 119 257
    Least Squares Mean (Standard Error) [score on a scale]
    -0.40
    (0.064)
    -0.62
    (0.045)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.005
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -0.22
    Confidence Interval (2-Sided) 95%
    -0.375 to -0.066
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.079
    Estimation Comments
    13. Secondary Outcome
    Title Change From Baseline to Month 12 in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form 6a T-Score
    Description The PROMIS Fatigue Short Form 6a is self-administered and composed of 6 questions to evaluate fatigue over the past 7 days. All questions employ the following five response options: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, and 5 = Always. The PROMIS Fatigue 6a score is calculated as a T-score, which is a standardized score with a mean of 50 (based on the average for the United States general population) and a standard deviation (SD) of 10. Higher scores indicate higher levels of fatigue. A decrease in score (negative change from baseline) indicates improvement in fatigue.
    Time Frame Baseline, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Observed cases. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 108 220
    Least Squares Mean (Standard Error) [T-score]
    -6.43
    (0.949)
    -8.92
    (0.665)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.032
    Comments P-value for test of difference at each post-baseline time point is from an ANCOVA model with treatment as the main effect and baseline as a covariate.
    Method ANCOVA
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -2.49
    Confidence Interval (2-Sided) 95%
    -4.773 to -0.216
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 1.158
    Estimation Comments
    14. Secondary Outcome
    Title Change From Baseline in Endometriosis-Associated Pain Score at Month 12 Assessed With Numeric Rating Scale (NRS)
    Description The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 12

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 102 202
    Least Squares Mean (Standard Error) [score on a scale]
    -3.25
    (0.263)
    -4.39
    (0.186)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -1.14
    Confidence Interval (2-Sided) 95%
    -1.774 to -0.508
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.322
    Estimation Comments
    15. Secondary Outcome
    Title Change From Baseline in Endometriosis-Associated Pain Score at Month 6 Assessed With NRS
    Description The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 6

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period.
    Measure Participants 130 269
    Least Squares Mean (Standard Error) [score on a scale]
    -2.74
    (0.248)
    -4.12
    (0.174)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -1.38
    Confidence Interval (2-Sided) 95%
    -1.978 to -0.788
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.303
    Estimation Comments
    16. Secondary Outcome
    Title Change From Baseline in Endometriosis-Associated Pain Score at Month 3 Assessed With NRS
    Description The NRS measured endometriosis-associated pain with and without menstruation on an 11-point scale from 0 = no pain to 10 = worst pain ever. Site staff administered the Overall Endometriosis-Associated Pain questionnaire assessing pain over a 7-day recall period, and recorded the participant's response electronically via a tablet at the time of visit. Pain scores were averaged over the 35 days prior to each visit.
    Time Frame Baseline, Month 3

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set: all randomized participants who received at least 1 dose of study drug. Participants with an assessment. Mixed-effects model repeated measures (MMRM) analysis. Per protocol, the primary comparison for the secondary endpoints was between the elagolix plus E2/NETA and placebo arms only.
    Arm/Group Title Placebo Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA 1 mg/0.5 mg QD for the remaining 36 months of the Treatment Period. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period, followed by elagolix 200 mg BID plus E2/NETA [1 mg/0.5 mg] QD for the remaining 36 months of the Treatment Period.
    Measure Participants 156 304
    Least Squares Mean (Standard Error) [score on a scale]
    -2.33
    (0.225)
    -3.79
    (0.161)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Elagolix + E2/NETA
    Comments Ranked secondary endpoints were tested following a fixed-sequence testing procedure. Testing began with testing each of the co-primary endpoints using alpha of 0.05 (2-sided) for elagolix plus E2/NETA compared to placebo. If both co-primary endpoints achieved statistical significance with elagolix plus E2/NETA as compared to placebo, continued testing was performed for the ranked secondary endpoints following a fixed-sequence testing procedure in the order of endpoints presented.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.001
    Comments P value for the test of the difference is from an MMRM with the fixed categorical effects of treatment, visit, and treatment-by-visit interaction, and the continuous fixed covariate of baseline pain score, and random effect for participant.
    Method MMRM
    Comments
    Method of Estimation Estimation Parameter LS Mean of Difference
    Estimated Value -1.46
    Confidence Interval (2-Sided) 95%
    -2.002 to -0.915
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.276
    Estimation Comments

    Adverse Events

    Time Frame All-cause mortality: from randomization through the end of the Treatment Period (Month 12). Adverse Events (AEs): From first dose of study drug through the end of the Treatment Period (Month 12).
    Adverse Event Reporting Description Treatment emergent AEs (TEAEs) during the 12-Month Placebo-Controlled Treatment Period are presented, and are defined as those that occurred no more than 30 days after the last dose of study drug for participants who discontinued prematurely or until the first dose of the study drug in the Open-Label Treatment.
    Arm/Group Title Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA
    Arm/Group Description Placebo for the 12-month placebo-controlled Treatment Period. Elagolix 200 mg BID alone for the first 6 months of the 12-month placebo-controlled Treatment Period and elagolix 200 mg BID+E2/NETA 1 mg/0.5 mg QD for the second 6 months. Elagolix 200 mg BID + E2/NETA 1 mg/0.5 mg QD for the 12-month placebo-controlled Treatment Period.
    All Cause Mortality
    Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/194 (0%) 0/98 (0%) 0/389 (0%)
    Serious Adverse Events
    Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 8/193 (4.1%) 2/97 (2.1%) 13/389 (3.3%)
    Cardiac disorders
    SINUS NODE DYSFUNCTION 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Ear and labyrinth disorders
    VESTIBULAR DISORDER 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Endocrine disorders
    PITUITARY APOPLEXY 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Gastrointestinal disorders
    PANCREATITIS 1/193 (0.5%) 1 0/97 (0%) 0 0/389 (0%) 0
    PNEUMOPERITONEUM 0/193 (0%) 0 1/97 (1%) 1 0/389 (0%) 0
    UMBILICAL HERNIA 1/193 (0.5%) 1 0/97 (0%) 0 0/389 (0%) 0
    Hepatobiliary disorders
    BILIARY COLIC 1/193 (0.5%) 1 0/97 (0%) 0 0/389 (0%) 0
    CHOLECYSTITIS CHRONIC 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Infections and infestations
    ABSCESS INTESTINAL 0/193 (0%) 0 1/97 (1%) 1 0/389 (0%) 0
    URINARY TRACT INFECTION 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Metabolism and nutrition disorders
    DIABETIC KETOACIDOSIS 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Musculoskeletal and connective tissue disorders
    SPONDYLOLISTHESIS 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    PITUITARY TUMOUR 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Nervous system disorders
    MIGRAINE 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    TRANSIENT ISCHAEMIC ATTACK 1/193 (0.5%) 1 0/97 (0%) 0 0/389 (0%) 0
    VESTIBULAR MIGRAINE 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Pregnancy, puerperium and perinatal conditions
    ABORTION SPONTANEOUS 1/193 (0.5%) 1 0/97 (0%) 0 1/389 (0.3%) 1
    ECTOPIC PREGNANCY 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Psychiatric disorders
    ANXIETY 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    PANIC ATTACK 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    SUICIDE ATTEMPT 0/193 (0%) 0 0/97 (0%) 0 1/389 (0.3%) 1
    Reproductive system and breast disorders
    ENDOMETRIOSIS 2/193 (1%) 2 1/97 (1%) 1 0/389 (0%) 0
    Surgical and medical procedures
    ABORTION INDUCED 1/193 (0.5%) 1 0/97 (0%) 0 1/389 (0.3%) 1
    Other (Not Including Serious) Adverse Events
    Placebo Elagolix / Elagolix + E2/NETA Elagolix + E2/NETA
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 72/193 (37.3%) 73/97 (75.3%) 209/389 (53.7%)
    Gastrointestinal disorders
    NAUSEA 12/193 (6.2%) 12 17/97 (17.5%) 20 51/389 (13.1%) 55
    General disorders
    FATIGUE 7/193 (3.6%) 7 5/97 (5.2%) 5 17/389 (4.4%) 17
    Infections and infestations
    GASTROENTERITIS VIRAL 2/193 (1%) 2 5/97 (5.2%) 5 9/389 (2.3%) 9
    NASOPHARYNGITIS 6/193 (3.1%) 10 5/97 (5.2%) 5 21/389 (5.4%) 24
    SINUSITIS 13/193 (6.7%) 14 10/97 (10.3%) 10 32/389 (8.2%) 34
    UPPER RESPIRATORY TRACT INFECTION 7/193 (3.6%) 7 7/97 (7.2%) 8 17/389 (4.4%) 18
    URINARY TRACT INFECTION 9/193 (4.7%) 10 9/97 (9.3%) 10 15/389 (3.9%) 15
    Metabolism and nutrition disorders
    VITAMIN D DEFICIENCY 10/193 (5.2%) 10 2/97 (2.1%) 2 7/389 (1.8%) 7
    Musculoskeletal and connective tissue disorders
    ARTHRALGIA 4/193 (2.1%) 4 6/97 (6.2%) 6 14/389 (3.6%) 16
    BACK PAIN 3/193 (1.6%) 3 1/97 (1%) 1 22/389 (5.7%) 22
    Nervous system disorders
    HEADACHE 10/193 (5.2%) 10 13/97 (13.4%) 13 45/389 (11.6%) 46
    Psychiatric disorders
    INSOMNIA 1/193 (0.5%) 1 9/97 (9.3%) 9 13/389 (3.3%) 15
    MOOD SWINGS 2/193 (1%) 2 4/97 (4.1%) 4 21/389 (5.4%) 21
    Reproductive system and breast disorders
    METRORRHAGIA 2/193 (1%) 2 8/97 (8.2%) 8 17/389 (4.4%) 19
    Skin and subcutaneous tissue disorders
    ACNE 7/193 (3.6%) 7 5/97 (5.2%) 5 17/389 (4.4%) 17
    NIGHT SWEATS 6/193 (3.1%) 6 13/97 (13.4%) 14 24/389 (6.2%) 24
    Vascular disorders
    HOT FLUSH 14/193 (7.3%) 15 43/97 (44.3%) 44 69/389 (17.7%) 74

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    AbbVie requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. AbbVie requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if AbbVie needs to secure patent or proprietary protection.

    Results Point of Contact

    Name/Title Global Medical Services
    Organization AbbVie
    Phone 800-633-9110
    Email abbvieclinicaltrials@abbvie.com
    Responsible Party:
    AbbVie
    ClinicalTrials.gov Identifier:
    NCT03213457
    Other Study ID Numbers:
    • M14-702
    First Posted:
    Jul 11, 2017
    Last Update Posted:
    Feb 16, 2022
    Last Verified:
    Feb 1, 2022