George Washington University School of Medicine, IntimMedicine Specialists, Washington, DC.
University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
Menopause. 2019 May;26(5):506-512. doi: 10.1097/GME.0000000000001271.
The aim of the study was to describe the effects of TX-001HR (17β-estradiol [E2] and natural progesterone [P4] in a single oral capsule) on menopause-specific quality of life in women with moderate to severe vasomotor symptoms (VMS).
The REPLENISH study (NCT01942668) was a phase 3, randomized, double-blind, placebo-controlled, multicenter trial which evaluated four E2/P4 doses in postmenopausal women with VMS and a uterus. Women with moderate to severe hot flushes (≥7/d or ≥50/wk) were included in a VMS substudy. Participants self-administered the Menopause-Specific Quality of Life (MENQOL) questionnaire. Baseline changes in MENQOL overall and domains were determined as well as correlations between changes in MENQOL scores and VMS frequency or severity.
In the VMS substudy, women treated with E2/P4 had significantly greater improvements from baseline in their MENQOL overall score at week 12, and months 6 and 12, compared with placebo (all, P < 0.05, except the lowest E2/P4 dose at months 6 and 12). Improvements from baseline for the MENQOL vasomotor domain score were significantly greater with TX-001HR doses versus placebo at all time points (all, P < 0.01). Changes in MENQOL vasomotor scores moderately correlated with changes in VMS frequency (r = 0.56, P < 0.0001) and severity (r = 0.55, P < 0.0001).
In the REPLENISH trial, women with moderate to severe VMS treated with most E2/P4 doses reported significant improvements in quality of life from baseline to 12 weeks compared with placebo, which were maintained up to 12 months. TX-001HR, if approved, may provide the first oral hormone therapy formulation in a single capsule containing E2 and P4 for the treatment of VMS in postmenopausal women with a uterus.
本研究旨在描述 TX-001HR(17β-雌二醇[E2]和天然孕酮[P4]的单一口服胶囊)对有中度至重度血管舒缩症状(VMS)的女性的绝经相关生活质量的影响。
REPLENISH 研究(NCT01942668)是一项 3 期、随机、双盲、安慰剂对照、多中心试验,评估了 4 种 E2/P4 剂量在有 VMS 和子宫的绝经后妇女中的应用。有中度至重度热潮红(≥7/天或≥50/周)的女性被纳入 VMS 子研究。参与者自行使用绝经相关生活质量(MENQOL)问卷。确定 MENQOL 总分及各领域的基线变化,以及 MENQOL 评分变化与 VMS 频率或严重程度之间的相关性。
在 VMS 子研究中,与安慰剂相比,E2/P4 治疗的女性在第 12 周、第 6 个月和第 12 个月时 MENQOL 总分的改善有显著意义(均 P<0.05,除了最低剂量在第 6 个月和第 12 个月)。与安慰剂相比,TX-001HR 剂量在所有时间点对 MENQOL 血管舒缩域评分的改善均有显著意义(均 P<0.01)。MENQOL 血管舒缩评分的变化与 VMS 频率(r=0.56,P<0.0001)和严重程度(r=0.55,P<0.0001)的变化中度相关。
在 REPLENISH 试验中,与安慰剂相比,有中度至重度 VMS 的女性在接受大多数 E2/P4 剂量治疗后,从基线到 12 周时生活质量有显著改善,并且在 12 个月时保持不变。如果 TX-001HR 获得批准,它可能会成为第一个在单一胶囊中含有 E2 和 P4 的口服激素治疗制剂,用于治疗有子宫的绝经后女性的 VMS。