Assessment of the Transfer of Using Levonorgestrel Intrauterine System (LNG IUS) as a Contraceptive to Using it as Part of Hormone Replacement Therapy (HRT).

Sponsor
Bayer (Industry)
Overall Status
Completed
CT.gov ID
NCT00185458
Collaborator
(none)
394
12
1
96
32.8
0.3

Study Details

Study Description

Brief Summary

The study has been designed to look at the transfer from using LNG IUS for contraception only, in reproductive age to using it for endometrial protection in menopausal age. The main area of interest in the study is the pattern of any vaginal bleeding that occurs.

Condition or Disease Intervention/Treatment Phase
  • Drug: LNG IUS
Phase 3

Detailed Description

The study has previously been posted by Schering AG, Germany. Schering AG, Germany has been renamed to Bayer HealthCare AG, Germany. Bayer HealthCare AG, Germany is the sponsor of the trial.

Study Design

Study Type:
Interventional
Actual Enrollment :
394 participants
Allocation:
Non-Randomized
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A 60-month Non-comparative Study on Bleeding Profiles With Levonorgestrel Intrauterine System in Transition From Reproductive Age Contraception to Menopause Age Endometrial Protection During Estrogen Replacement Therapy.
Study Start Date :
May 1, 2000
Actual Primary Completion Date :
May 1, 2008
Actual Study Completion Date :
May 1, 2008

Arms and Interventions

Arm Intervention/Treatment
Experimental: LNG IUS

Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.

Drug: LNG IUS
LNG IUS (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) HRT Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by WHO guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.

Outcome Measures

Primary Outcome Measures

  1. Number of Bleeding Days [Last 90 days in Contraception Phase and first 360 days in Hormone-Replacement Therapy (HRT) Phase]

    Measured by using Subject Diaries (Subject Reported Data)

  2. Number of Spotting Days [Last 90 days in Contraception Phase and first 360 days in HRT Phase]

    Measured by using Subject Diaries (Subject Reported Data)

  3. Percentage of Participants With Successful Treatment [Last 90 days in Contraception Phase and first 360 days in HRT Phase]

    Definition of successful treatment: Completion of HRT phase, and Both, the number of bleeding days and the number of spotting days during HRT was equal to or less than during contraceptive phase, and The number of bleeding days and the number of spotting days could be calculated for at least 3 out of the first 4 reference periods in HRT

Secondary Outcome Measures

  1. Assessment of QOL as Measured by Women's Health Questionnaire [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Women's Health Questionnaire (Total Score). For the Total score, the minimum is 36 and maximum is 144. A higher score means the distress and dysfunction are less pronounced.

  2. Continuation Rates [At entry, at 2 years, at 4 years]

    Percentage of subjects continuing in the study at the given time points.

  3. Progestogenic Symptom 1: Headache (as Measured by a Visual Analogue Scale (VAS)) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  4. Progestogenic Symptom 2: Depressive Mood (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  5. Progestogenic Symptom 3: Acne or Greasy Skin (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  6. Progestogenic Symptom 4: Nausea (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  7. Progestogenic Symptom 5: Edema (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  8. Progestogenic Symptom 6: Decreased Libido (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  9. Climacteric Symptom 1: Hot Flushes (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  10. Climacteric Symptom 2: Sweating Episodes (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  11. Climacteric Symptom 3: Vaginal Dryness (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  12. Climacteric Symptom 4: Sleep Problems (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  13. Climacteric Symptom 5: Irritability (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  14. Climacteric Symptom 6: Breast Tension (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  15. Progestogenic Symptom 7: Hair Loss (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

  16. Progestogenic Symptom 8: Greasy Hair (as Measured by a VAS) [Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase]

    Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.

Eligibility Criteria

Criteria

Ages Eligible for Study:
46 Years to 51 Years
Sexes Eligible for Study:
Female
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Women with intact uterus, regular menstrual cycles and no previous or current climacteric symptoms.
Exclusion Criteria:
  • Pregnancy or lactation.

  • Previous pelvic infections.

  • Abnormal bleeding.

  • Abnormal uterine cavity.

  • Uterine polyps.

  • Genital cancer.

  • Liver diseases.

  • Alcoholism or drug abuse.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Gent Belgium 9000
2 HUY Belgium 4500
3 Espoo Finland 02100
4 Turku Finland 20100
5 Turku Finland 20520
6 Heerlen Netherlands 6419 PC
7 Venlo Netherlands 5912 BL
8 Zaandam Netherlands 1502 DV
9 Zwijndrecht Netherlands 3331 LZ
10 Cambridge Cambridgeshire United Kingdom CB23 2TN
11 Poole Dorset United Kingdom BH15 2JB
12 Newcastle upon Tyne United Kingdom NE4 6BE

Sponsors and Collaborators

  • Bayer

Investigators

  • Study Director: Bayer Study Director, Bayer

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Bayer
ClinicalTrials.gov Identifier:
NCT00185458
Other Study ID Numbers:
  • 90660
  • 300400
First Posted:
Sep 16, 2005
Last Update Posted:
Nov 27, 2013
Last Verified:
Nov 1, 2013

Study Results

Participant Flow

Recruitment Details Only the subjects who reached menopause within max. of 4 years of the contraception phase were eligible for the Hormone-Replacement Therapy (HRT) phase. 58 subjects discontinued the study during the contraception phase before starting the HRT, and 168 subjects who started treatment did not reach menopause.
Pre-assignment Detail 489 subjects were screened: 394 subjects started treatment and 95 subjects failed screening. Intent-to-treat (ITT) population included all subjects (N=394) who had the LNG IUS inserted, or for whom the insertion was attempted. 322 subjects without major protocol deviations were included in the Per protocol set (PPS).
Arm/Group Title LNG IUS
Arm/Group Description Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.
Period Title: Contraception Phase
STARTED 394
COMPLETED 336
NOT COMPLETED 58
Period Title: Contraception Phase
STARTED 168
COMPLETED 141
NOT COMPLETED 27

Baseline Characteristics

Arm/Group Title LNG IUS
Arm/Group Description Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.
Overall Participants 394
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
47.8
(1.42)
Sex: Female, Male (Count of Participants)
Female
394
100%
Male
0
0%

Outcome Measures

1. Primary Outcome
Title Number of Bleeding Days
Description Measured by using Subject Diaries (Subject Reported Data)
Time Frame Last 90 days in Contraception Phase and first 360 days in Hormone-Replacement Therapy (HRT) Phase

Outcome Measure Data

Analysis Population Description
Intention to treat population (ITT); all subjects with adequate bleeding diary data. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Reference Period -1 (Contraception Phase) Reference Period 1 (HRT Phase) Reference Period 2 (HRT Phase) Reference Period 3 (HRT Phase) Reference Period 4 (HRT Phase)
Arm/Group Description Patient assessment within the last 90-days before starting the HRT Patient assessment within the first 90-days of the HRT phase Patient assessment within day 91 to 180 of the HRT phase Patient assessment within day 181 to 270 of the HRT phase Patient assessment within day 271 to 360 of the HRT phase
Measure Participants 165 154 151 141 132
Median (Inter-Quartile Range) [Bleeding days]
0
0
0
0
0
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase)
Comments Time effect tested with Friedman's two-way analysis of variance (ANOVA). The null-hypothesis is that the means are equal at the reference period tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.128
Comments
Method Friedman's two-way ANOVA
Comments
2. Primary Outcome
Title Number of Spotting Days
Description Measured by using Subject Diaries (Subject Reported Data)
Time Frame Last 90 days in Contraception Phase and first 360 days in HRT Phase

Outcome Measure Data

Analysis Population Description
ITT; all subjects with adequate bleeding diary data. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Reference Period -1 (Contraception Phase) Reference Period 1 (HRT Phase) Reference Period 2 (HRT Phase) Reference Period 3 (HRT Phase) Reference Period 4 (HRT Phase)
Arm/Group Description Patient assessment within the last 90-days before starting the HRT Patient assessment within the first 90-days of the HRT phase Patient assessment within day 91 to 180 of the HRT phase Patient assessment within day 181 to 270 of the HRT phase Patient assessment within day 271 to 360 of the HRT phase
Measure Participants 165 154 151 141 132
Median (Inter-Quartile Range) [Spotting days]
4
4
2
1
0
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase)
Comments Time effect tested with Friedman's two-way analysis of variance (ANOVA). The null-hypothesis is that the means are equal at the reference period tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.296
Comments
Method Friedman's two-way ANOVA
Comments
3. Primary Outcome
Title Percentage of Participants With Successful Treatment
Description Definition of successful treatment: Completion of HRT phase, and Both, the number of bleeding days and the number of spotting days during HRT was equal to or less than during contraceptive phase, and The number of bleeding days and the number of spotting days could be calculated for at least 3 out of the first 4 reference periods in HRT
Time Frame Last 90 days in Contraception Phase and first 360 days in HRT Phase

Outcome Measure Data

Analysis Population Description
ITT; all subjects eligible for the HRT
Arm/Group Title LNG IUS
Arm/Group Description Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.
Measure Participants 168
Number [Percentage of participants with success]
31
7.9%
4. Secondary Outcome
Title Assessment of QOL as Measured by Women's Health Questionnaire
Description Women's Health Questionnaire (Total Score). For the Total score, the minimum is 36 and maximum is 144. A higher score means the distress and dysfunction are less pronounced.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 165 148 141
Mean (Standard Deviation) [score on a scale]
104.1
(17.75)
114.4
(16.64)
112.9
(16.32)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
5. Secondary Outcome
Title Continuation Rates
Description Percentage of subjects continuing in the study at the given time points.
Time Frame At entry, at 2 years, at 4 years

Outcome Measure Data

Analysis Population Description
ITT. Kaplan-Meier estimator given.
Arm/Group Title LNG IUS
Arm/Group Description Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.
Measure Participants 394
At Entry
100.0
25.4%
At 2 Years
72.3
18.4%
At 4 Years
23.6
6%
6. Secondary Outcome
Title Progestogenic Symptom 1: Headache (as Measured by a Visual Analogue Scale (VAS))
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 147 139
Mean (Standard Deviation) [score on a scale]
23.9
(23.98)
19.1
(22.57)
18.2
(23.00)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.027
Comments
Method Friedman's two-way ANOVA
Comments
7. Secondary Outcome
Title Progestogenic Symptom 2: Depressive Mood (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 139
Mean (Standard Deviation) [score on a scale]
22.3
(25.69)
11.8
(17.31)
14.6
(22.10)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
8. Secondary Outcome
Title Progestogenic Symptom 3: Acne or Greasy Skin (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 147 139
Mean (Standard Deviation) [score on a scale]
8.9
(14.02)
7.3
(15.38)
7.6
(15.41)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
9. Secondary Outcome
Title Progestogenic Symptom 4: Nausea (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 147 139
Mean (Standard Deviation) [score on a scale]
7.5
(13.57)
5.3
(11.96)
6.7
(15.32)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
10. Secondary Outcome
Title Progestogenic Symptom 5: Edema (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 147 139
Mean (Standard Deviation) [score on a scale]
15.7
(20.30)
12.3
(18.93)
11.7
(17.65)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.054
Comments
Method Friedman's two-way ANOVA
Comments
11. Secondary Outcome
Title Progestogenic Symptom 6: Decreased Libido (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 166 144 135
Mean (Standard Deviation) [score on a scale]
24.9
(26.29)
15.6
(22.06)
17.5
(21.13)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
12. Secondary Outcome
Title Climacteric Symptom 1: Hot Flushes (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
39.9
(30.21)
9.4
(14.88)
11.3
(18.65)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
13. Secondary Outcome
Title Climacteric Symptom 2: Sweating Episodes (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
43.0
(29.40)
14.0
(19.95)
17.0
(21.97)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
14. Secondary Outcome
Title Climacteric Symptom 3: Vaginal Dryness (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
22.8
(27.96)
13.1
(20.93)
16.7
(23.00)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
15. Secondary Outcome
Title Climacteric Symptom 4: Sleep Problems (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
39.4
(29.71)
17.1
(21.34)
19.9
(23.93)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
16. Secondary Outcome
Title Climacteric Symptom 5: Irritability (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
33.1
(27.40)
17.2
(19.47)
19.4
(20.26)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments
17. Secondary Outcome
Title Climacteric Symptom 6: Breast Tension (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 167 147 138
Mean (Standard Deviation) [score on a scale]
15.5
(22.16)
13.5
(20.39)
13.0
(19.42)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.175
Comments
Method Friedman's two-way ANOVA
Comments
18. Secondary Outcome
Title Progestogenic Symptom 7: Hair Loss (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 147 139
Mean (Standard Deviation) [score on a scale]
10.0
(15.14)
9.3
(16.69)
9.0
(13.63)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.062
Comments
Method Friedman's two-way ANOVA
Comments
19. Secondary Outcome
Title Progestogenic Symptom 8: Greasy Hair (as Measured by a VAS)
Description Higher value means the symptom is more pronounced. Minimum is 0, maximum is 100.
Time Frame Last measurement before start of HRT phase, 6 months after start of HRT phase, 12 month after start of HRT phase

Outcome Measure Data

Analysis Population Description
ITT. Only the subjects that were eligible for the HRT are included. Due to dropouts and missing data the number of subjects do not necessarily sum up to 168, the number of subjects of the ITT, who qualified for the HRT phase.
Arm/Group Title Last Measurement Before Start of HRT Phase 6 Months After Start of HRT Phase 12 Months After Start of HRT Phase
Arm/Group Description Patient assessment at the end of contraception phase Patient assessment about day 180 of the HRT phase Patient assessment about day 360 of the HRT phase
Measure Participants 168 146 139
Mean (Standard Deviation) [score on a scale]
14.0
(20.60)
11.5
(18.85)
11.1
(18.93)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Reference Period -1 (Contraception Phase), Reference Period 1 (HRT Phase), Reference Period 2 (HRT Phase)
Comments This is a Friedman's two-way analysis of variance (ANOVA) to test the time effect within the treatment group. The null-hypothesis is that the means are equal at the time points tested.
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.001
Comments
Method Friedman's two-way ANOVA
Comments

Adverse Events

Time Frame The data covers the entire treatment period (contraception phase + HRT phase).
Adverse Event Reporting Description
Arm/Group Title LNG IUS
Arm/Group Description Levonorgestrel Intrauterine System (LNG IUS) (initial in vitro release 20 µg/24h) intrauterine for minimum of 9 months and maximum of 60 months - 2 phases: a) Contraception Phase b) Hormone-Replacement Therapy (HRT) Phase. For outcome measures (vaginal bleeding variables), five 90-day Reference Periods were defined, which were used for comparison during statistical analysis: Reference Period -1 in Contraception Phase; Reference Periods 1-4 in HRT Phase. 90-day reference periods for analyzing vaginal bleeding data are defined by World Health Organization (WHO) guideline. Reference Period -1 is the last 90-day reference period that the subject had before starting the HRT. Reference Period 1 covers the first 90-days of the HRT phase, Reference Period 2 covers days 91 to 180, Reference Period 3 days 181 to 270, and Reference Period 4 days 271 to 360 of the HRT phase.
All Cause Mortality
LNG IUS
Affected / at Risk (%) # Events
Total / (NaN)
Serious Adverse Events
LNG IUS
Affected / at Risk (%) # Events
Total 25/394 (6.3%)
Cardiac disorders
Palpitations 1/394 (0.3%)
Gastrointestinal disorders
Abdominal pain 1/394 (0.3%)
Crohn's disease 1/394 (0.3%)
Ileus 1/394 (0.3%)
Volvulus 1/394 (0.3%)
Hepatobiliary disorders
Cholelithiasis 1/394 (0.3%)
Infections and infestations
Bronchitis 1/394 (0.3%)
Pneumonia 1/394 (0.3%)
Injury, poisoning and procedural complications
Muscle rupture 1/394 (0.3%)
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion 1/394 (0.3%)
Periarthritis 1/394 (0.3%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer 4/394 (1%)
Uterine leiomyoma 2/394 (0.5%)
Nervous system disorders
Cerebrovascular accident 1/394 (0.3%)
Transient ischaemic attack 1/394 (0.3%)
Renal and urinary disorders
Bladder prolapse 1/394 (0.3%)
Reproductive system and breast disorders
Colpocele 1/394 (0.3%)
Cystocele 1/394 (0.3%)
Ovarian cyst 1/394 (0.3%)
Surgical and medical procedures
Cholecystectomy 1/394 (0.3%)
Jejunectomy 1/394 (0.3%)
Scar excision 1/394 (0.3%)
Splenectomy 1/394 (0.3%)
Thyroidectomy 1/394 (0.3%)
Varicose vein operation 1/394 (0.3%)
Vascular disorders
Venous thrombosis limb 1/394 (0.3%)
Other (Not Including Serious) Adverse Events
LNG IUS
Affected / at Risk (%) # Events
Total 357/394 (90.6%)
Cardiac disorders
Palpitations 12/394 (3%)
Gastrointestinal disorders
Abdominal pain 30/394 (7.6%)
Abdominal pain lower 16/394 (4.1%)
Abdominal distension 12/394 (3%)
Nausea 9/394 (2.3%)
General disorders
Fatigue 14/394 (3.6%)
Infections and infestations
Influenza 43/394 (10.9%)
Vaginal candidiasis 29/394 (7.4%)
Cystitis 26/394 (6.6%)
Nasopharyngitis 24/394 (6.1%)
Bronchitis 20/394 (5.1%)
Sinusitis 19/394 (4.8%)
Vaginitis bacterial 15/394 (3.8%)
Vaginal infection 14/394 (3.6%)
Upper respiratory tract infection 13/394 (3.3%)
Urinary tract infection 11/394 (2.8%)
Vulvovaginal mycotic infection 11/394 (2.8%)
Acute sinusitis 8/394 (2%)
Respiratory tract infection 8/394 (2%)
Tooth infection 8/394 (2%)
Injury, poisoning and procedural complications
Procedural pain 117/394 (29.7%)
Investigations
Smear cervix normal 31/394 (7.9%)
Weight increased 17/394 (4.3%)
Musculoskeletal and connective tissue disorders
Back pain 47/394 (11.9%)
Pain in extremity 23/394 (5.8%)
Arthralgia 20/394 (5.1%)
Musculoskeletal pain 11/394 (2.8%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Uterine leiomyoma 26/394 (6.6%)
Nervous system disorders
Headache 59/394 (15%)
Migraine 13/394 (3.3%)
Dizziness 10/394 (2.5%)
Psychiatric disorders
Depression 19/394 (4.8%)
Sleep disorder 18/394 (4.6%)
Insomnia 9/394 (2.3%)
Reproductive system and breast disorders
Menopausal symptoms 31/394 (7.9%)
Ovarian cyst 31/394 (7.9%)
Breast pain 28/394 (7.1%)
Breast tenderness 27/394 (6.9%)
Genital haemorrhage 19/394 (4.8%)
Vaginal discharge 14/394 (3.6%)
Metrorrhagia 12/394 (3%)
Cervical polyp 9/394 (2.3%)
Breast cyst 8/394 (2%)
Vulvovaginal pruritus 8/394 (2%)
Respiratory, thoracic and mediastinal disorders
Cough 12/394 (3%)
Skin and subcutaneous tissue disorders
Night sweats 29/394 (7.4%)
Hyperhidrosis 27/394 (6.9%)
Acne 8/394 (2%)
Vascular disorders
Hypertension 23/394 (5.8%)
Hot flush 14/394 (3.6%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

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

The investigators agree to allow the sponsor to review any manuscripts and to negotiate the times and forums of their publication.

Results Point of Contact

Name/Title Therapeutic Area Head
Organization BAYER
Phone
Email clinical-trials-contact@bayerhealthcare.com
Responsible Party:
Bayer
ClinicalTrials.gov Identifier:
NCT00185458
Other Study ID Numbers:
  • 90660
  • 300400
First Posted:
Sep 16, 2005
Last Update Posted:
Nov 27, 2013
Last Verified:
Nov 1, 2013