Clinical trial NCT01569763: Minerva Pivotal Study to Evaluate Safety and Efficacy of the Aurora Endometrial Ablation System Compared to Hysteroscopic Rollerball Ablation
Official title: Minerva Pivotal Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Menorrhagia
Keywords: endometrial ablation
Lead sponsor: Minerva Surgical, Inc.
Sponsor class: INDUSTRY
First posted: 2012-04-03
Enrollment: 153
Sex: FEMALE
Minimum age (years): 25
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The primary objective of this study is to evaluate the safety and effectiveness of the Aurora Endometrial Ablation System as compared to hysteroscopic rollerball endometrial ablation in reducing menstrual blood loss at 12 months post-treatment.

Detailed description: Menorrhagia is defined as menstrual bleeding in the ovulatory woman exceeding 80 ml per month. Approximately 20-25% of healthy premenopausal women have abnormal uterine bleeding. Menorrhagia can have a negative impact on a woman's lifestyle and self-perception, often leading her to seek definitive treatment. Pharmacologic treatment for menorrhagia is not always successful, and dilatation and curettage typically provides relief for only a few menstrual cycles. Traditionally hysterectomy has been the definitive treatment for menorrhagia. This clinical study evaluates the safety and effectiveness of the Aurora Endometrial Ablation System to provide a therapeutic treatment for menorrhagia due to benign causes by ablating the endometrial lining of the uterus in pre-menopausal women for whom childbearing is complete. Subjects who are randomized to the control group will receive hysteroscopic rollerball/resection ablation. Subjects randomized to the test arm will be treated with the Aurora Endometrial Ablation System.

Eligibility criteria: Inclusion Criteria:

* Refractory menorrhagia with no definable organic cause
* Female subject from (and including) age 25 to 50 years
* Uterine sound measurement of no greater than10.0cm (external os to internal fundus) and a minimum uterine cavity length of 4.0cm
* A minimum menstrual blood loss of ≥ 160 ml for two baseline cycles within three months prior to treatment as measured by alkaline hematin extraction; OR,

  * A minimum menstrual blood loss of ≥ 160 ml for one baseline cycle for women who either
  * had at least 3 prior months documented failed medical therapy; or
  * had a contraindication to medical therapy
* Premenopausal at enrollment as determined by FSH measurement ≤ 40 IU/L
* Not pregnant and no desire to conceive at any time
* Subject agrees to use a reliable form of contraception up to the 12-month follow-up visit. If a hormonal birth control method is used for contraception, the subject must have been on said method for ≥ 3 months prior to enrollment and agrees to remain on the same hormonal regimen through the initial 12-month follow-up
* Able to provide written informed consent using a form that has been approved by the reviewing IRB/EC
* Subject agrees to follow-up exams and data collection requirements
* Subject who is literate or demonstrates an understanding on how to collect menstrual blood loss products for the alkaline hematin method of analysis

Exclusion Criteria:

* Pregnancy or subject with a desire to conceive
* Endometrial hyperplasia as confirmed by histology
* Presence of active endometritis
* Active pelvic inflammatory disease
* Active sexually transmitted disease (STD)
* Presence of bacteremia, sepsis, or other active systemic infection
* Active infection of the genitals, vagina, cervix, uterus or urinary tract at the time of the procedure
* Known/suspected abdominal pelvic or gynecological malignancy within the past 5 years
* Known clotting defects or bleeding disorders
* Untreated/unevaluated cervical dysplasia, except CIN I
* Prior uterine surgery (except low segment cesarean section) that interrupts the integrity of the uterine wall (e.g., transmural myomectomy or classical cesarean section)
* Previous endometrial ablation procedure
* Presence of an implantable (intrauterine) contraceptive device (e.g. Essure™ or Adiana™)
* Currently on medications that could thin the myometrial muscle, such as long-term steroid use (except inhaler or nasal therapy for asthma)
* Currently on anticoagulants
* Abnormal or obstructed cavity as confirmed by hysteroscopy, SIS or vaginal ultrasound
* Presence of an intrauterine device (IUD) which the Subject is unwilling to have removed at the time of the operative visit
* Subject currently on hormonal birth control therapy (including the Mirena device) for \<3 months prior to enrollment
* Subject who is unwilling to use birth control post-ablation whether non-hormonal birth control or the same hormonal birth control therapy as before the procedure
* Subject who is within 6-weeks post partum
* Any subject who is currently participating or considers future participation in a research study of an investigational drug or device during the course of this investigational study
* Any general health condition which, in the opinion of the Investigator, could represent an increased risk for the subject

Primary outcomes:
measure: Reduction of Menstrual Bleeding to Normal or Below Normal at 12 Months
timeFrame: 12 months
Secondary outcomes:
measure: Procedure Time
timeFrame: < 1 hour
Other outcomes:
Locations:
city: Chandler
country: United States
facility: New Horizons Women's Care
state: Arizona
city: Phoenix
country: United States
facility: Women's Health Research
state: Arizona
city: Newburgh
country: United States
facility: Basinski, LLC
state: Indiana
city: Wichita
country: United States
facility: Cypress Medical Research Center, LLC
state: Kansas
city: Edina
country: United States
facility: Minnesota Gynecology and Surgery
state: Minnesota
city: Saint Louis
country: United States
facility: Mercy Clinic Minimally Invasive Gynecology
state: Missouri
city: Nashville
country: United States
facility: Tennessee Women's Care PC
state: Tennessee
city: Fort Worth
country: United States
facility: Baylor Research Institute
state: Texas
city: Hamilton
country: Canada
facility: McMaster University/Hamilton Health Sciences
state: Ontario
city: Ville Lassalle
country: Canada
facility: Hôpital LaSalle
state: Quebec
city: Regina
country: Canada
facility: Regina Qu'Appelle Health Region
state: Saskatchewan
city: Quebec
country: Canada
facility: La Cite Medicale
city: Monterrey
country: Mexico
facility: Hospital Universitario, UANL
state: Nuevo Leon
Study officials:
affiliation: Minerva Surgical, Inc.
name: Eugene Skalnyi, MD
role: STUDY_DIRECTOR
References: