Evaluation of a Subcutaneous Progestogen Implants in the Medical Management of Painful Endometriosis (END-IMPACT)
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|ClinicalTrials.gov Identifier: NCT02669238|
Recruitment Status : Terminated (insufficient recruitment)
First Posted : February 1, 2016
Last Update Posted : March 4, 2020
Endometriosis is a chronic relapsing disease characterized by the presence and proliferation of endometrial glands and stroma outside the uterus. This is a serious disease, widespread, difficult to live with for the patients, but also difficult to treat for practitioners who take care of these patients. It affects 1.6% of the general population, but its incidence is 10 times higher (up 40%) in patients with infertility. It occurs mainly by complex chronic pelvic pain and a negative influence on fertility.
It is a disease whose complexity can be explained to four levels. Firstly, through its extremely polymorphic character with intraperitoneal superficial forms, ovarian forms and deep sub-peritoneal forms.
Secondly by the plurality of the main symptoms which are individually non-specific and the frequency and / or intensity is not correlated with the severity of the disease. This non-specificity of symptoms partially explains the long lead misdiagnosis, which vary by 5 to 11 years.
Thirdly, by its prevalence which seems very high and largely underestimated. If its precise estimate in the general population is so complicated, it seems very high in many studies of patients supported surgically for gynecological reasons. These very large prevalence figures are observed when some consultations support the hypothesis of a widespread and probably insufficiently evaluated disease.
Lately by its management, insufficiently amended, for which there is currently only a few scientifically supported recommendations.
Chronic pain caused by the disease associated with altered sexuality to a loss of fertility significantly impacts the quality of life of patients.
|Condition or disease||Intervention/treatment||Phase|
|Endometriosis||Device: Nexplanon® Drug: Minidril®/Leeloo®||Phase 2 Phase 3|
Investigators propose a randomized trial comparing two medical alternatives: a continuous monophasic type of estrogen-progestin oral treatment of second generation versus the establishment of an etonogestrel contraceptive implant type.
Are excluded from this study certain absolute surgical indications. Patients, by consenting to participate in the study, choose a medical care, which means not to be operated immediately. They are clearly informed about the various possible treatment alternatives. The benefits and risks of surgery and medical treatment they are explicitly presented. At any time during the study, patients who wish may discuss again a surgical treatment with their physician and stop the study drug if the decision of an intervention is taken.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||2 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Supportive Care|
|Official Title:||Evaluation of a Subcutaneous Progestogen Implants in the Medical Management of Painful Endometriosis|
|Actual Study Start Date :||May 25, 2018|
|Actual Primary Completion Date :||October 10, 2019|
|Actual Study Completion Date :||October 10, 2019|
Subcutaneous insertion of an progestative implant containing 68mg of etonogestrel
Subcutaneous implant (Nexplanon®) containing etonogestrel 68 mg
Active Comparator: Oral treatment
Continuous oral administration of second generation monophasic oestro-progestative (ethinyl-oestradiol)
continuous per os administration of oestroprogestative treatment. 1 pill a day First line: Minidril® (Levonogestrel 0.15 mg / Ethinylestradiol 0.03 mg) Second line: Leeloo® (Levonogestrel 0.1 mg / Ethinylestradiol 0.02 mg)
- Global satisfaction [ Time Frame: 6th month of treatment ]Global satisfaction evaluated by the SATMED-Q® satisfaction score at 6th month.
- Pain evaluation [ Time Frame: 6th and 12th month ]Pain evaluation from analogical visual scale
- Daily life impact [ Time Frame: 6th and 12th month ]Evaluation of daily life impact of endometriosis with Endometriosis Health Profile - 30 (EHP-30)
- Sex life impact [ Time Frame: 6th and 12th month ]Evaluation of sexual life impact of endometriosis with Female Sexual Function Index (FSFI)
- Evaluation of dysmenorrhea, dyspareunia and pelvic pain [ Time Frame: 6th and 12th month ]Evaluation of frequency and intensity of dysmenorrhea, dyspareunia and pelvic pain with Biberoglu scale
- Quality of life score [ Time Frame: 6th and 12th month ]Evaluation of quality of life impact of endometriosis with SF36 scale
- Number of lesions [ Time Frame: Day 1 and 12th month ]The number, size, localisation and activity of the lesions is evaluated by Resonance Magnetic Image
- size of lesions [ Time Frame: Day 1 and 12th month ]Size of the lesions (mm) is evaluated by Resonance Magnetic Image
- Localisation of lesions [ Time Frame: Day 1 and 12th month ]Localisations of the lesions is evaluated by Resonance Magnetic Image
- Incidence of treatment-emergent adverse events (safety and tolerability) [ Time Frame: 3rd, 6th, 9th and 12th month ]percentage of clinical and biological adverse effects
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02669238
|CHU de La Réunion|
|Saint-Denis, Saint Denis, Réunion, 97400|
|Principal Investigator:||Anca BIRSAN, MD|