Bioequivalence Trial of Liquid Versus Freeze-Dried Pergoveris® in Pituitary Suppressed Healthy Premenopausal Female Subjects
Condition: Healthy
MeSH terms: Pituitary Diseases
Intervention: Liquid pergoveris; Freeze-dried pergoveris
Intervention description: All subjects will be administered with 900 IU of r-hFSH and 450 IU of r-hLH solution (Liquid Pergoveris) as subcutaneous injection using a disposable pen-injector on Day 1 in either first intervention period or second intervention period.; All subjects will be administered with 900 IU of r-hFSH and 450 IU of r-hLH freeze-dried powder (Freeze-dried Pergoveris) as subcutaneous injection on Day 1 in either first intervention period or second intervention period.
Intervention MeSH terms: Follicle Stimulating Hormone
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Enrollment: 34.0
Sex: Female
Minimum age: 18 Years
Maximum age: 40 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Healthy; Pergoveris; Bioequivalence; Infertility

Summary:

      Some women cannot have children because they cannot produce enough follicle stimulating
      hormone (FSH) and luteinising hormone (LH). When this happens the ovaries fail to produce an
      egg during the menstrual cycle - a condition known as anovulation. Anovulation can be treated
      by giving replacement FSH and LH. Pergoveris is a medication that contains both FSH and LH.
      It is used for the treatment of anovulation in women who do not produce enough FSH and LH.

      A new, liquid formulation of Pergoveris is being tested in this study. It will be compared
      with the current freeze-dried marketed formulation to see if the new formulation gets into
      the blood stream as easily as the current formulation.

      This study will involve 38 healthy female subjects and 2 treatment periods and will last for
      approximately 77 days. Each subject will receive a single dose of the new liquid formulation
      and a single dose of the current marketed formulation separated by an interval of two weeks
      in a randomised (by chance) order. Blood samples will be taken at regular intervals over 2
      weeks after each dose to measure levels of FSH and LH.

      To participate female subjects must have normal ovaries on internal ultrasound scan, a normal
      result from a cervical smear test, be taking the combined oral contraceptive (OC) pill.

      Eligible subjects will have their usual OC pill replaced with another called Marvelon
      throughout the study. After 14 days subjects will have their levels of FSH and LH checked and
      if sufficiently reduced will only then proceed to dosing.

      Subjects will then receive one of the formulations. An ultrasound scan of the ovaries will be
      performed 7 days later, and another one 7 days later just before the next dose. Subjects
      whose ovaries show signs of stimulation will not be given the second dose. The ultrasound
      scan will be repeated 7 days after the second dose.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Premenopausal women aged 18 to 40 years (both inclusive) at Screening

          -  Taking a combined oral contraceptive (COCP) for at least 1 year prior to Screening and
             willing to recommence taking their own COCP from Day 43 of the Marvelon cycle until
             follow-up

          -  Normal follicle-stimulating hormone (FSH) (less than [<] 12 international units per
             liter [IU/L]) and estradiol levels (<100 picogram per milliliter [pg/mL])

          -  Gave written informed consent prior to any trial-related procedure

          -  Forearm veins suitable for cannulation or repeated venipuncture

          -  Body weight of greater than or equal to (>=) 48 kilogram (kg) and a body mass index
             (BMI) between 18.5 and 29.9 kilogram per square meter (kg/m^2) (both inclusive)

          -  Clinically acceptable values for vital signs (systolic blood pressure [SBP], diastolic
             blood pressure [DBP], pulse rate, and body temperature), as assessed by the
             Investigator

          -  Non-smoking or having refrained from smoking for at least 6 months prior to Screening
             and with a history of <10 pack years [number of pack years = (number of cigarettes per
             day/20)*number of years smoked]

          -  Able to communicate well with the Investigator, understanding the protocol
             requirements and restrictions, and willing to comply with the requirements of the
             entire trial

          -  Negative pregnancy test at Screening, before the start of the Marvelon cycle, and at
             admission (Day -1 Period 1 and Day -1 Period 2)

          -  Willing to use additional nonhormonal contraceptives (for example, condoms or
             occlusive cap [diaphragm or cervical/vault cap] with spermicide, nonhormonal
             intrauterine device, previous sterilization of the subject or her partner, being
             sexually inactive) from Day 1 of the Marvelon cycle up to follow-up

          -  Normal liquid-based cervical cytology assessment (Papanicolaou test score <II) within
             the last 12 months before Screening. If not performed as part of routine clinical
             care, a cervical cytology assessment must be performed as part of the Screening
             assessments and the result must be normal

        Exclusion Criteria:

          -  Any surgical or medical condition, including findings in the medical history or in the
             pre-trial assessments, that in the opinion of the Investigator, constitutes a risk or
             a contraindication for the participation of the subject in the trial or that could
             interfere with the trial objectives, conduct, or evaluation

          -  Any clinically relevant abnormality in the safety laboratory parameters, as judged by
             the Investigator

          -  Any clinically significant abnormality on the 12-lead resting electrocardiogram (ECG),
             as judged by the Investigator

          -  Positive results from the serology examination for hepatitis B surface antigen,
             hepatitis C virus, or the human immunodeficiency virus

          -  Contraindications to COCP use shown by a history of conditions specified in the
             protocol

          -  History of tumors of the pituitary gland or hypothalamus

          -  Clinically significant abnormalities of the genital organs as determined by
             gynecological examination and transvaginal ultrasound (TVUS) and based on the
             Investigator's judgment for example, ovarian tumors, nonfunctional ovarian cysts,
             endometrial hyperplasia)

          -  Not successfully down-regulated by showing luteinizing hormone (LH) and
             follicle-stimulating hormone (FSH) levels above 1.0 IU/L and estradiol levels above
             100 pg/mL before investigational medicinal product (IMP) administration or showing
             more than12 immature follicles per ovary. In that case there should be no signs of
             polycystic ovary syndrome (PCOS) morphology

          -  Polycystic ovarian syndrome as defined in the protocol

          -  Ovarian follicle-like structures larger than 13 millimeter (mm) during COCP use (at
             Screening)

          -  Contraindication to treatment with gonadotropins (ovarian enlargement or cyst not due
             to PCOS and of unknown origin, gynecological hemorrhages of unknown etiology, ovarian,
             uterine, or mammary carcinoma, tumors of the hypothalamus and pituitary gland,
             hypersensitivity to gonadotropins or to any of the excipients, extrauterine pregnancy
             in the previous 3 months, and medical history or risk factors for thromboembolic
             events)

          -  Pregnant or breastfeeding a child

          -  Prior treatment with FSH and or LH containing products

          -  Definite or suspected personal history or family history of an adverse drug reaction
             or hypersensitivity to drugs with a similar chemical structure to FSH or LH

          -  History or presence of asthma (with the exception of childhood asthma) or any serious
             allergy (requiring hospitalization or prolonged systemic treatment)

          -  History or presence of drug or alcohol abuse

          -  Positive test for drugs of abuse (including alcohol)

          -  Loss or donation of more than 500 mL of blood within 90 days prior to the first IMP
             administration

          -  Administration of any IMP or use of any investigational device within 60 days prior to
             the first IMP administration

          -  Use of drugs that may reduce the effectiveness of COCP from the start of the Marvelon
             cycle until last pharmacokinetic sample. For example, phenytoin, barbiturates,
             primidone, carbamazapine, oxcarbazepine, topiramate, felbamate, rifampicin,
             nelfinavir, ritonavir, griseofulvin, oral ketoconazole, and herbal remedies containing
             Hypericum perforatum (St John's Wort)

          -  Unlikely to comply with the protocol requirements, instructions, and trial-related
             restrictions for example, uncooperative attitude, inability to return for follow-up,
             and improbability of completing the trial

          -  Is (or is a relative of) the Principal Investigator or any Sub-investigator, Research
             Assistant, Pharmacist, Trial Coordinator, or other staff directly involved in the
             conduct of the trial

          -  Vulnerable subjects (for example, persons kept in detention)