Trial Outcomes & Findings for The Menopause Transition: Estrogen Variability, Stress Reactivity and Mood (NCT NCT03003949)

NCT ID: NCT03003949

Last Updated: 2021-03-26

Results Overview

The State-Trait anxiety inventory is consists of 20 questions on a 4-point force-choice Likert-type response scales (scores 0 - 3). The 20 questions are summed together for final score. The score can range from 0 to 60 with higher scores representing higher levels of anxiety. Change over time is defined as the difference in the least square means between timepoints and 95% confidence interval limits.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

82 participants

Primary outcome timeframe

Baseline (Week 8), Weeks 16, 20 and 24

Results posted on

2021-03-26

Participant Flow

Participant milestones

Participant milestones
Measure
Placebo Patch and Placebo Capsule
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Overall Study
STARTED
40
42
Overall Study
Week 8
40
42
Overall Study
Week 16
38
35
Overall Study
Week 20
35
33
Overall Study
Week 24
35
32
Overall Study
COMPLETED
35
32
Overall Study
NOT COMPLETED
5
10

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The Menopause Transition: Estrogen Variability, Stress Reactivity and Mood

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo Patch and Placebo Capsule
n=40 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=42 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Total
n=82 Participants
Total of all reporting groups
Age, Continuous
50.40 years
STANDARD_DEVIATION 2.52 • n=99 Participants
49.39 years
STANDARD_DEVIATION 3.04 • n=107 Participants
49.88 years
STANDARD_DEVIATION 2.83 • n=206 Participants
Sex: Female, Male
Female
40 Participants
n=99 Participants
42 Participants
n=107 Participants
82 Participants
n=206 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=99 Participants
3 Participants
n=107 Participants
6 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
37 Participants
n=99 Participants
39 Participants
n=107 Participants
76 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
2 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
6 Participants
n=99 Participants
9 Participants
n=107 Participants
15 Participants
n=206 Participants
Race (NIH/OMB)
White
34 Participants
n=99 Participants
30 Participants
n=107 Participants
64 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
40 Participants
n=99 Participants
42 Participants
n=107 Participants
82 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Baseline (Week 8), Weeks 16, 20 and 24

The State-Trait anxiety inventory is consists of 20 questions on a 4-point force-choice Likert-type response scales (scores 0 - 3). The 20 questions are summed together for final score. The score can range from 0 to 60 with higher scores representing higher levels of anxiety. Change over time is defined as the difference in the least square means between timepoints and 95% confidence interval limits.

Outcome measures

Outcome measures
Measure
Placebo Patch and Placebo Capsule
n=40 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=42 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Change Over Time in the Anxiety Score From State-Trait Anxiety Inventory
Baseline (Week 8) to Week 16
2.74 score on a scale
Interval -4.08 to 9.57
-0.89 score on a scale
Interval -6.47 to 4.67
Change Over Time in the Anxiety Score From State-Trait Anxiety Inventory
Week 16 to Week 20
-3.50 score on a scale
Interval -10.56 to 3.56
0.19 score on a scale
Interval -5.75 to 6.12
Change Over Time in the Anxiety Score From State-Trait Anxiety Inventory
Week 20 to Week 24
3.63 score on a scale
Interval -3.57 to 10.83
3.75 score on a scale
Interval -2.24 to 9.73

PRIMARY outcome

Timeframe: Baseline (Week 8), Weeks 16, 20 and 24

Anhedonia will be assessed using SHAPS scores which range from 14-56, with higher scores corresponding to higher levels of anhedonia. Change over time is defined as the difference in least square means between time points and 95% confidence interval limits.

Outcome measures

Outcome measures
Measure
Placebo Patch and Placebo Capsule
n=40 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=42 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Change Over Time in Anhedonia Score From Snaith-Hamilton Pleasure Scale
Baseline (Week 8) to Week 16
-0.01 score on a scale
Interval -1.04 to 1.03
-0.63 score on a scale
Interval -1.71 to 0.46
Change Over Time in Anhedonia Score From Snaith-Hamilton Pleasure Scale
Week 16 to Week 20
0.12 score on a scale
Interval -0.87 to 1.27
0.88 score on a scale
Interval -0.27 to 2.03
Change Over Time in Anhedonia Score From Snaith-Hamilton Pleasure Scale
Week 20 to Week 24
0.29 score on a scale
Interval -0.79 to 1.38
-0.07 score on a scale
Interval -1.22 to 1.08

SECONDARY outcome

Timeframe: Baseline (Week 8), Weeks 16, 20 and 24

Population: Data reported for all samples collected.

The stress biomarker cortisol (µg/dL) assessed at rest and in response to the Trier Social Stress test (AUC with respect to ground) at baseline (Week 8) and again post-randomization at weeks 16, 20 and 24. Blood serum samples for measuring cortisol are taken at immediately before the Trier Social Stress test and at 10, 20, 30, and 45 minutes post test. Change over time is defined as the difference in least square means between timepoints and with 95% confidence interval limits.

Outcome measures

Outcome measures
Measure
Placebo Patch and Placebo Capsule
n=31 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=33 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Change Over Time in AUC Cortisol Stress Response
Week 20 to Week 24
53.40 µg/dL
Interval -239.71 to 346.51
88.80 µg/dL
Interval -429.4 to 606.9
Change Over Time in AUC Cortisol Stress Response
Baseline (Week 8) to Week 16
33.77 µg/dL
Interval -160.13 to 229.67
245.50 µg/dL
Interval -102.6 to 593.6
Change Over Time in AUC Cortisol Stress Response
Week 16 to Week 20
-7.30 µg/dL
Interval -253.61 to 239.02
-244.20 µg/dL
Interval -711.3 to 222.8

SECONDARY outcome

Timeframe: up to 24 weeks

Population: Data reported from tasks completed.

Changes in threat bias scores assessed using Dot Probe task during labs at weeks 8, 16, 20 and 24. The bias measurement protocol consists of 144 trials (48 threat congruent, 48 threat incongruent, 48 neutral presentations). Participants indicate the probe letter via button press. Angry face location, probe location, probe type and actor are all fully counterbalanced in presentation. The threat bias score equals the mean of reaction time on threat congruent from threat incongruent trials. A threat bias scores \>0 indicate a bias towards threat, whereas scores \<0 mean that the participant is slower to respond to threatening stimuli than neutral stimuli. Reaction times were measured in milliseconds. Change over time is defined as the difference in least square means between timepoints with 95% confidence interval limits.

Outcome measures

Outcome measures
Measure
Placebo Patch and Placebo Capsule
n=34 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=41 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Change Over Time in Threat Bias Score From Dot Probe Task
Week 16 to Week 20
-2.49 milliseconds
Interval -19.75 to 14.78
-3.81 milliseconds
Interval -15.79 to 8.16
Change Over Time in Threat Bias Score From Dot Probe Task
Baseline (Week 8) to Week 16
-5.23 milliseconds
Interval -21.51 to 11.06
-3.75 milliseconds
Interval -14.95 to 7.45
Change Over Time in Threat Bias Score From Dot Probe Task
Week 20 to Week 24
-0.92 milliseconds
Interval -18.31 to 16.47
7.25 milliseconds
Interval -4.67 to 19.17

SECONDARY outcome

Timeframe: up to 24 weeks

Population: Data reported from tasks completed.

Effort Expenditure for Rewards Task (EEfRT) measures approach motivation that indexes the willingness to expend effort to obtain monetary rewards under varying conditions of reward probability and magnitude. On each trial, participants choose between an "easy task" and a "hard task" and are presented with information about the probability of winning (i.e., 12%, 50%, or 88%), and the magnitude of the potential reward if they complete the button-press task successfully (range: $1.24 - $4.12). Completion of the easy task requires 30 button presses in 7 seconds using the dominant index finger, whereas completion of the hard task requires 100 presses with the non-dominant "pinky" finger in 21 seconds. The percent of hard task choices is the dependent measure. Change over time is defined as the difference in least square means between time points with 95% confidence interval limits.

Outcome measures

Outcome measures
Measure
Placebo Patch and Placebo Capsule
n=38 Participants
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=36 Participants
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Change Over Time in Percent of "Hard Task" Choice in EEfRT
Baseline (Week 8) to Week 16
-0.0044 percentage of "hard task" choices
Interval -0.1306 to 0.1219
0.0086 percentage of "hard task" choices
Interval -0.087 to 0.1042
Change Over Time in Percent of "Hard Task" Choice in EEfRT
Week 16 to Week 20
0.0019 percentage of "hard task" choices
Interval -0.1309 to 0.1347
0.0289 percentage of "hard task" choices
Interval -0.072 to 0.1298
Change Over Time in Percent of "Hard Task" Choice in EEfRT
Week 20 to Week 24
-0.0045 percentage of "hard task" choices
Interval -0.1392 to 0.1303
0.0200 percentage of "hard task" choices
Interval -0.0885 to 0.1286

Adverse Events

Placebo Patch and Placebo Capsule

Serious events: 0 serious events
Other events: 39 other events
Deaths: 0 deaths

Estradiol Patch and Progesterone Capsule

Serious events: 0 serious events
Other events: 39 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Placebo Patch and Placebo Capsule
n=40 participants at risk
Placebo patches worn for 16 weeks. On the 9th week of patch, oral placebo capsule taken daily for 12 days. Following the 16 weeks of patch use oral placebo capsule taken daily for 12 days. Placebo Patch: Matching placebo patches to be worn every day for 16 weeks (patch changed every 7 days). Placebo Oral Capsule: Matching placebo capsules will be administered orally every day for 12 days during the 9th week of randomization and again following randomization at the 17th week.
Estradiol Patch and Progesterone Capsule
n=42 participants at risk
Estradiol patches worn for 16 weeks. On the 9th week of patch, oral progesterone capsule taken daily for 12 days. Following the 16 weeks of estradiol patch use oral progesterone capsule taken daily for 12 days. Estradiol Patch, 0.1 Mg/24 Hours Weekly Transdermal Film, Extended Release: Transdermal Estradiol worn daily for 16 weeks (patch changed every 7 days). Progesterone Capsule: Micronized progesterone (200 mg) will be administered every day for 12 days during the 9th week of randomization and again following randomization at the 17th week
Reproductive system and breast disorders
Breast tenderness
27.5%
11/40 • Number of events 16 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
71.4%
30/42 • Number of events 91 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Reproductive system and breast disorders
Profuse menstrual bleeding
2.5%
1/40 • Number of events 1 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
23.8%
10/42 • Number of events 13 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Reproductive system and breast disorders
Prolonged menstrual bleeding
0.00%
0/40 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
11.9%
5/42 • Number of events 5 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Nervous system disorders
Headache (Non-Migraine)
72.5%
29/40 • Number of events 75 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
64.3%
27/42 • Number of events 63 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Nervous system disorders
Migraine
12.5%
5/40 • Number of events 8 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
7.1%
3/42 • Number of events 4 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Psychiatric disorders
Negative Mood Change
42.5%
17/40 • Number of events 37 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
40.5%
17/42 • Number of events 27 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
42.5%
17/40 • Number of events 29 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
28.6%
12/42 • Number of events 20 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Gastrointestinal disorders
Nausea
30.0%
12/40 • Number of events 14 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
35.7%
15/42 • Number of events 24 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Skin and subcutaneous tissue disorders
Skin irritation (at patch site)
45.0%
18/40 • Number of events 36 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
78.6%
33/42 • Number of events 96 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Cardiac disorders
Hypertension
7.5%
3/40 • Number of events 4 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
19.0%
8/42 • Number of events 10 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
Metabolism and nutrition disorders
Weight gain
10.0%
4/40 • Number of events 7 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
0.00%
0/42 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
General disorders
Lightheadedness
5.0%
2/40 • Number of events 2 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.
4.8%
2/42 • Number of events 2 • From Baseline (Week 8) through study Week 24, an approximate total of 16 weeks.

Additional Information

Susan Girdler, PhD

University of North Carolina at Chapel Hill

Phone: 919-590-0813

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place