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Phase 3 N=1,011 Randomized Double-blind Treatment

Efficacy and Safety of FE 999049 in Controlled Ovarian Stimulation in Pan-Asian Women

Controlled Ovarian Simulation

Enrolled (actual)
1,011
Serious AEs
4.8%
Results posted
Jun 2021
Primary outcome: Primary: Ongoing Pregnancy Rate — 31.3; 25.7 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Follitropin alfa (Drug); Follitropin delta (Drug)
Age
Adult · 20+ yrs
Sex
Female
Sponsor
Ferring Pharmaceuticals
Primary completion
Jan 2020

Outcome Measures

OutcomeResultp-value
PRIMARY
Ongoing Pregnancy Rate
31.3; 25.7
SECONDARY
Positive Beta Unit of Human Chorionic Gonadotropin (βhCG) Rate
41.7; 35.3
SECONDARY
Clinical Pregnancy Rate
36.1; 31.2
SECONDARY
Vital Pregnancy Rate
32.3; 28.0
SECONDARY
Implantation Rate
35.6; 31.3
SECONDARY
Ongoing Implantation Rate
30.7; 25.8
SECONDARY
Proportion of Subjects With Extreme Ovarian Responses
30.3; 35.1; 17.4; 18.9 0.083
SECONDARY
Proportion of Subjects With Early OHSS (Including OHSS of Moderate/Severe Grade) and/or Preventive Interventions for Early OHSS
4.0; 6.5; 3.6; 4.7; 1.2; 3.5 0.075
SECONDARY
Proportion of Subjects With Cycle Cancellation Due to Poor or Excessive Ovarian Response or Embryo Transfer Cancellation Due to Excessive Ovarian Response / OHSS Risk
3.4; 0.8; 0; 0; 5.2; 12.4 0.002 sig
SECONDARY
Number of Follicles on Stimulation Day 6
5.4; 6.4; 2.3; 2.9; 0.3; 0.3 <.001 sig
SECONDARY
Number of Follicles At End-of-stimulation (up to 20 Stimulation Days)
12.4; 14.2; 10.3; 11.9; 6.5; 7.5 <.001 sig
SECONDARY
Size of Follicles on Stimulation Day 6
13.1; 13.2; 11.5; 11.6; 12.5; 12.6 0.140
SECONDARY
Size of Follicles At End-of-stimulation (up to 20 Stimulation Days)
19.8; 19.8; 15.0; 15.1; 18.6; 18.7 0.848
SECONDARY
Number of Oocytes Retrieved
10.0; 12.4 <.001 sig
SECONDARY
Proportion of Subjects With <4, 4-7, 8-14, 15-19 and ≥20 Oocytes Retrieved
11.3; 4.7; 23.0; 22.3; 46.7; 42.6
SECONDARY
Percentage of Metaphase II (MII) Oocytes
79.5; 77.8 0.197
SECONDARY
Fertilization Rate
63.5; 63.9 0.790
SECONDARY
Number and Quality of Embryos
7.0; 8.7; 4.1; 5.2 <.001 sig
SECONDARY
Circulating Concentrations of Luteinizing Hormone (LH)
2.6; 3.1 <0.001 sig
SECONDARY
Circulating Concentrations of LH
1.8; 2.0 0.018 sig
SECONDARY
Circulating Concentrations of Estradiol
7429.3; 9055.8 <0.001 sig
SECONDARY
Circulating Concentrations of Estradiol
7429.3; 9055.8 <0.001 sig
SECONDARY
Circulating Concentrations of Progesterone
2.4; 3.2 <0.001 sig
SECONDARY
Circulating Concentrations of Progesterone
2.4; 3.2 <0.001 sig
SECONDARY
Circulating Concentrations of Inhibin A
361.7; 447.4 <0.001 sig
SECONDARY
Circulating Concentrations of Inhibin A
361.7; 447.4 <0.001 sig
SECONDARY
Circulating Concentrations of Inhibin B
1020.0; 1101.0 0.001 sig
SECONDARY
Circulating Concentrations of Inhibin B
1020.0; 1101.0 0.001 sig
SECONDARY
Circulating Concentrations of Follicle-stimulating Hormone (FSH)
11.6; 11.2 <0.001 sig
SECONDARY
Circulating Concentrations of FSH
5.6; 5.5 0.184
SECONDARY
Circulating Concentrations of FSH
5.6; 5.5 0.184
SECONDARY
Total Gonadotropin Dose
77.5; 109.9 <.001 sig
SECONDARY
Proportion of Subjects With Investigator-requested Gonadotropin Dose Adjustments
57.1; 55.3
SECONDARY
Number of Stimulation Days
9.2; 8.7 0.001 sig
SECONDARY
Number of Participants With Adverse Events
46.3; 43.1
SECONDARY
Intensity of Adverse Events
40.1; 37.8; 7.4; 5.9; 3.6; 1.8
SECONDARY
Changes From Baseline in Clinical Chemistry Parameters: Alanine Aminotransferase, Alkaline Phosphatase, Aspartate Aminotransferase and Gamma Glutamyl Transferase
3.9; 4.6; -2.9; -2.7; 0.7; 1.2
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Bicarbonate, Blood Urea Nitrogen, Calcium, Chloride, Cholesterol, Glucose, Phosphate, Potassium and Sodium
-0.83; -0.72; -0.27; -0.23; -0.010; 0.000
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Albumin and Protein
-2.0; -1.6; -2.3; -1.5
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Lactate Dehydrogenase
-3.0; -0.9
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Direct Bilirubin, Bilirubin, Creatinine, Urate
-0.3; -0.2; -1.3; -1.0; -3.4; -3.5
SECONDARY
Proportion of Subjects With Markedly Abnormal Changes of Clinical Chemistry: Alanine Aminotransferase, Aspartate Aminotransferase, Bicarbonate, Calcium, Phosphate
0.2; 0.2; 0; 0.2; 0.2; 0.0
SECONDARY
Change From Baseline in Haematology Parameter: Erythrocytes
-0.13; -0.09
SECONDARY
Change From Baseline in Haematology Parameters: Leukocytes and Platelets
1.161; 0.996; 19.9; 23.8
SECONDARY
Change From Baseline in Haematology Parameter: Haemoglobin
-2.9; -1.7
SECONDARY
Change From Baseline in Haematology Parameter: Haematocrit
-0.012; -0.008
SECONDARY
Change From Baseline in Haematology Parameter: Erythrocyte Mean Corpuscular Volume
0.0; 0.1
SECONDARY
Change From Baseline in Haematology Parameter: Erythrocyte Mean Corpuscular Haemoglobin
0.3; 0.2
SECONDARY
Change From Baseline in Haematology Parameter: Erythrocyte Mean Corpuscular Haemoglobin Concentration
0.2; 0.1
SECONDARY
Change From Baseline in Haematology Parameters: Basophils/Leukocytes, Eosinophils/Leukocytes, Lymphocytes/Leukocytes, Monocytes/Leukocytes and Neutrophils/Leukocytes
-0.01; 0.02; -0.01; -0.07; -2.05; -1.39
SECONDARY
Proportion of Subjects With Markedly Abnormal Changes of Haematology Parameters: Leukocytes, Lymphocytes/Leukocytes
0.7; 0; 0.4; 0.2; 0.7; 0
SECONDARY
Number of Immune-related Adverse Events
0; 0
SECONDARY
Frequency of Injection Site Reactions
23.2; 21.6
SECONDARY
Intensity of Injection Site Reactions
21.6; 21.2; 1.6; 0.4; 0; 0
SECONDARY
Proportion of Subjects With Treatment-induced Anti-FSH Antibodies, Overall as Well as With Neutralizing Capacity
1.40; 0.98; 0; 0
SECONDARY
Intensity of Immune-related Adverse Events
0; 0; 0; 0; 0; 0
SECONDARY
Proportion of Subjects With Cycle Cancellations Due to an Adverse Event, Including Immune-related Adverse Events, or Due to Technical Malfunctions of the Administration Pen
0; 0.2; 0; 0
SECONDARY
Proportion of Subjects With Late OHSS
4.0; 2.0; 3.6; 1.8
SECONDARY
Proportion of Participants With Multi-fetal Gestation
7.7; 9.9
SECONDARY
Proportion of Participants With Early Pregnancy Losses
25.0; 27.2
SECONDARY
Proportion of Participants With Technical Malfunctions of the Administration Pen
0.4; 0

Summary

To demonstrate non-inferiority of FE 999049 compared with GONAL-F with respect to ongoing pregnancy rate in women undergoing controlled ovarian stimulation.

Eligibility Criteria

Inclusion Criteria

  • Informed Consent Documents signed prior to screening evaluations.
  • In good physical and mental health in the judgement of the investigator.
  • Asian pre-menopausal females between the ages of 20 and 40 years. The participants must be at least 20 years (including the 20th birthday) when they sign the informed consent and no more than 40 years (up to the day before the 41st birthday) at the time of randomization.
  • Infertile women diagnosed with tubal infertility, unexplained infertility, endometriosis stage I/II (defined by the revised American Society for Reproductive Medicine [ASRM] classification, 1996) or with partners diagnosed with male factor infertility, eligible for in vitro fertilisation (IVF) and/or intracytoplasmic sperm injection (ICSI) using fresh or frozen ejaculated sperm from male partner or sperm donor.
  • Infertility for at least one year before randomization for participants <35 years or for at least 6 months for participants ≥35 years (not applicable in case of tubal or severe male factor infertility).
  • The trial cycle will be the participant's first controlled ovarian stimulation cycle for IVF/ICSI.
  • Regular menstrual cycles of 24-35 days (both inclusive), presumed to be ovulatory.
  • Hysterosalpingography, hysteroscopy, saline infusion sonography, or transvaginal ultrasound documenting a uterus consistent with expected normal function (e.g. no evidence of clinically interfering uterine fibroids defined as submucous or intramural fibroids larger than 3 cm in diameter, no polyps and no congenital structural abnormalities which are associated with a reduced chance of pregnancy) within 1 year prior to randomization.
  • Transvaginal ultrasound documenting presence and adequate visualisation of both ovaries, without evidence of significant abnormality (e.g. enlarged ovaries which would contraindicate the use of gonadotropins) and normal adnexa (e.g. no hydrosalpinx) within 1 year prior to randomization. Both ovaries must be accessible for oocyte retrieval.
  • Early follicular phase (cycle day 2-4) serum levels of FSH between 1 and 15 IU/L (results obtained within 3 months prior to randomization).
  • Negative serum Hepatitis B Surface Antigen (HBsAg), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) antibody tests within 2 years prior to randomization.
  • Body mass index (BMI) between 17.5 and 32.0 kg/m2 (both inclusive) at screening.
  • Willing to accept transfer of 1-2 embryos.

Exclusion Criteria

  • Known endometriosis stage III-IV (defined by the revised ASRM classification, 1996).
  • One or more follicles ≥10 mm (including cysts) observed on the transvaginal ultrasound prior to randomization on stimulation day 1 (puncture of cysts is allowed prior to randomization).
  • Known history of recurrent miscarriage (defined as three consecutive losses after ultrasound confirmation of pregnancy (excl. ectopic pregnancy) and before week 24 of pregnancy).
  • Known abnormal karyotype of participant or of her partner / sperm donor, as applicable, depending on source of sperm used for insemination in this trial.
  • Any known clinically significant systemic disease (e.g. insulin-dependent diabetes).
  • Known inherited or acquired thrombophilia disease.
  • Active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events.
  • Known porphyria.
  • Any known endocrine or metabolic abnormalities (pituitary, adrenal, pancreas, liver or kidney) with the exception of controlled thyroid function disease.
  • Known presence of anti-FSH antibodies (based on the information available in the participant's medical records; i.e. not based on the anti-FSH antibody analyses conducted in the trial).
  • Known tumours of the ovary, breast, uterus, adrenal gland, pituitary or hypothalamus which would contraindicate the use of gonadotropins.
  • Known moderate or severe impairment of renal or hepatic function.
  • Any abnormal finding of clinical chemistry, haematology or vital signs at screeni
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03296527). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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