Constantine G, Graham S, Portman D J, Rosen R C, Kingsberg S A
EndoRheum Consultants , Media, PA.
Climacteric. 2015 Apr;18(2):226-32. doi: 10.3109/13697137.2014.954996. Epub 2014 Sep 25.
Ospemifene is a non-estrogen, tissue selective estrogen receptor agonist/antagonist, or selective estrogen receptor modulator, recently approved for the treatment of dyspareunia, a symptom of vulvar and vaginal atrophy (VVA), due to menopause. Postmenopausal dyspareunia is often associated with female sexual dysfunction (FSD). In this report, we present data that demonstrate the effect of ospemifene 60 mg/day on FSD assessed by the Female Sexual Function Index (FSFI), a widely used tool with six domains (Arousal, Desire, Orgasm, Lubrication, Satisfaction, and Pain).
A phase-3, randomized, double-blind, 12-week trial (n = 919) compared the efficacy and safety of oral ospemifene 60 mg/day vs. placebo in postmenopausal women with VVA in two strata based on self-reported, most bothersome symptom of either dyspareunia or dryness. Primary data were published previously. We report herein pre-specified secondary efficacy endpoints analyses, including changes from baseline to Weeks 4 and 12 for FSFI total and domain scores as well as serum hormone levels.
Ospemifene 60 mg/day demonstrated a significantly greater FSFI total score improvement vs. placebo at Week 4 (p < 0.001). Improvement in FSFI scores continued to Week 12 (p < 0.001). At Week 4, the FSFI domains of Sexual Pain, Arousal, and Desire were significantly improved with ospemifene vs. placebo; at Week 12, improvements in all domains were significant (p < 0.05). Changes in serum hormones were minor and uncorrelated with changes in sexual functioning.
In a large, randomized, double-blind, placebo-controlled trial, ospemifene 60 mg/day significantly improved FSD in women with VVA. Consistent effects across FSFI domains were observed.
奥培米芬是一种非雌激素、组织选择性雌激素受体激动剂/拮抗剂,即选择性雌激素受体调节剂,最近被批准用于治疗绝经引起的性交困难,这是外阴和阴道萎缩(VVA)的一种症状。绝经后性交困难常与女性性功能障碍(FSD)相关。在本报告中,我们展示了数据,证明每日60毫克奥培米芬对通过女性性功能指数(FSFI)评估的FSD的影响,FSFI是一种广泛使用的工具,有六个领域(性欲、性唤起、性高潮、润滑、满意度和疼痛)。
一项3期、随机、双盲、12周试验(n = 919),根据自我报告的最困扰症状为性交困难或阴道干涩,将患有VVA的绝经后女性分为两个亚组,比较每日口服60毫克奥培米芬与安慰剂的疗效和安全性。主要数据已在之前发表。我们在此报告预先指定的次要疗效终点分析,包括从基线到第4周和第12周FSFI总分和各领域得分以及血清激素水平的变化。
在第4周时,每日60毫克奥培米芬与安慰剂相比,FSFI总分改善显著更大(p < 0.001)。FSFI得分的改善持续到第12周(p < 0.001)。在第4周时,奥培米芬与安慰剂相比,性疼痛、性唤起和性欲等FSFI领域有显著改善;在第12周时,所有领域的改善均显著(p < 0.05)。血清激素变化较小,且与性功能变化无关。
在一项大型、随机、双盲、安慰剂对照试验中,每日60毫克奥培米芬显著改善了患有VVA女性的FSD。在FSFI各领域观察到了一致的效果。