Safety/Efficacy Study Comparing the Misoprostol Vaginal Insert to Cervidil for Cervical Ripening and Induction of Labor - Full Text View

Purpose

The purpose of this study is to determine whether the misoprostol vaginal insert (50 mcg and 100 mcg) can safely and effectively speed time to vaginal delivery compared to Cervidil (R) in women who need to have their labor induced.

Condition	Intervention	Phase
Cervical Ripening Labor, Induced	Drug: Misoprostol vaginal insert 100 mcg Drug: Misoprostol vaginal insert 50 mcg Drug: Dinoprostone vaginal insert (Cervidil)	Phase III

MedlinePlus related topics:

Cesarean Section

Drug Information available for:

Misoprostol Alprostadil Dinoprostone

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Active Control, Parallel Assignment, Efficacy Study

Official Title:	A Multi-Center, Randomized, Double-Blind Phase III Study of the Efficacy and Safety of the Misoprostol Vaginal Insert Compared to Cervidil for Women Requiring Cervical Ripening and Induction of Labor (The MVP Study).

Further study details as provided by Cytokine PharmaSciences:

Primary Outcome Measures:

Time to vaginal delivery [ Time Frame: Following administration of study medication ]
Rate of Cesarean Section delivery [ Time Frame: Following administration of study medication ]

Secondary Outcome Measures:

Incidence of adverse events ( and comparison of overall safety [ Time Frame: Following administration of study medication ]
Need for oxytocin, duration of oxytocin use, total dose of oxytocin [ Time Frame: Pre-delivery ]
Successful cervical ripening using Modified Bishop's Score at 12 hours [ Time Frame: At 12 hours after study drug insertion ]
Time to onset of active labor [ Time Frame: From study drug insertion to onset active labor ]
Time to rupture of membranes [ Time Frame: Interval from study drug insertion to ROM ]
Duration of stay in labor and delivery suite [ Time Frame: While in the study ]
Duration of stay in hospital for mother and neonate [ Time Frame: While in the study ]

Enrollment:	1300
Study Start Date:	April 2006
Study Completion Date:	August 2007

Arms	Assigned Interventions
MVI 100: Experimental Misoprostol vaginal insert 100 mcg over 24h	Drug: Misoprostol vaginal insert 100 mcg
MVI 50: Experimental Misoprostol vaginal insert 50 mcg over 24h	Drug: Misoprostol vaginal insert 50 mcg
Cervidil 10 mg vaginal insert: Active Comparator Cervidil 10 mg over 24h	Drug: Dinoprostone vaginal insert (Cervidil)

Detailed Description:

Induction of labor is required in approximately 20% of pregnant women. Although contractions can be brought on by oxytocin ("pitocin"), some women need help in softening the cervix, or mouth of the womb (uterus), before oxytocin can be started. Prostaglandins have been shown to ripen, or soften, the cervix; at present, the only prostaglandin approved for marketing by FDA for this purpose is dinoprostone. Dinoprostone can be delivered in several ways; one method is to use a polymer vaginal insert that slowly releases the dinoprostone directly to the cervical tissues. This product is called Cervidil (R) and has been marketed for more than 10 years in the United States. Misoprostol is another form of prostaglandin that is approved for protecting the stomach and intestinal lining for patients taking NSAIDs. Misoprostol has also been used by many obstetricians for cervical ripening and inducing contractions, but, it is not approved by FDA for this purpose.

The same company that makes the Cervidil polymer insert has made an insert that will slowly release misoprostol. This study will determine whether this investigational insert containing misoprostol will decrease time to vaginal delivery compared to Cervidil. Two different doses of misoprostol will be tested (50 micrograms and 100 micrograms); each vaginal insert will gradually release a small, controlled amount of misoprostol over up to 24 hours.

Comparator: The Cervidil (R) vaginal insert containing dinoprostone will be the comparator in this study.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Pregnant women at least 36 weeks gestation requiring cervical ripening and induction of labor

Exclusion Criteria:

No uterine scar (no previous delivery by cesarean section)
No multiple gestation
No condition that disallows use of prostaglandins for induction of labor
No more than 3 previous vaginal births beyond 24 weeks gestation

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00308711

Show 52 Study Locations

Sponsors and Collaborators

Cytokine PharmaSciences

Investigators


Study Director:	Helen Colquhoun, MD	Unaffiliated

More Information

Publications:

Castaneda CS, Izquierdo Puente JC, Leon Ochoa RA, Plasse TF, Powers BL, Rayburn WF. Misoprostol dose selection in a controlled-release vaginal insert for induction of labor in nulliparous women. Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1071-5.

Rayburn WF, Powers BL, Plasse TF, Carr D, Di Spirito M. Pharmacokinetics of a controlled-release misoprostol vaginal insert at term. J Soc Gynecol Investig. 2006 Feb;13(2):112-7.

Ewert K, Powers B, Robertson S, Alfirevic Z. Controlled-release misoprostol vaginal insert in parous women for labor induction: a randomized controlled trial. Obstet Gynecol. 2006 Nov;108(5):1130-7.

Publications indexed to this study:

Wing DA; Misoprostol Vaginal Insert Consortium. Misoprostol vaginal insert compared with dinoprostone vaginal insert: a randomized controlled trial. Obstet Gynecol. 2008 Oct;112(4):801-12.

Study ID Numbers:	Miso-Obs-004
First Received:	March 27, 2006
Last Updated:	September 10, 2007
ClinicalTrials.gov Identifier:	NCT00308711
Health Authority:	United States: Food and Drug Administration

Keywords provided by Cytokine PharmaSciences:

Cervical ripening

Induction of labor

Dinoprostone vaginal insert

Cervidil

Misoprostol vaginal insert

Modified Bishop's Score

PGE2

PGE1

Uterine Hyperstimulation

Cesarean section

Study placed in the following topic categories:

Alprostadil

Dinoprostone

Misoprostol

Additional relevant MeSH terms:

Oxytocics

Therapeutic Uses

Anti-Ulcer Agents

Abortifacient Agents

Physiological Effects of Drugs

Gastrointestinal Agents

Reproductive Control Agents

Abortifacient Agents, Nonsteroidal

Pharmacologic Actions

ClinicalTrials.gov processed this record on November 20, 2008

Sponsored by:	Cytokine PharmaSciences
Information provided by:	Cytokine PharmaSciences
ClinicalTrials.gov Identifier:	NCT00308711