MsFLASH-03: Comparative Efficacy of Low-Dose Estradiol and Venlafaxine XR for Treatment of Menopausal Symptoms

Fred Hutchinson Cancer Center (FHCC)

Status

Completed

Conditions

Menopause

Vasomotor Disturbance

Hot Flashes

Treatments

Drug: Venlafaxine XR

Drug: Placebo

Drug: Low-dose 17-ß-estradiol with progesterone taper

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT01418209

1U01AG032699-01 (U.S. NIH Grant/Contract)

MsFLASH-03

1U01AG032700-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The primary objective of this study is to determine the efficacy of both low-dose oral (by mouth) 17-ß-estradiol and the non-hormonal drug venlafaxine XR compared to placebo in reducing hot flashes. Included in this objective is the intention to compare venlafaxine XR to estradiol therapy, to provide evidence of the relative efficacy of venlafaxine to what is currently considered the most established but also a controversial therapy. 17-ß-estradiol is a type of estrogen. Venlafaxine XR is the extended release (XR) version of venlafaxine. Venlafaxine XR is an serotonin-norepinephrine reuptake inhibitor (SNRI). A placebo is a substance containing no medication.

Full description

The MsFLASH-03 study (Menopausal Strategies: Finding Lasting Answers for Symptoms and Health - 03), Comparative Efficacy of Low-Dose Estradiol and the SNRI Venlafaxine XR for Treatment of Menopausal Symptoms, is a randomized, double-blind, placebo-controlled, three arm clinical trial. The design includes: 3 weeks of daily recording of hot flashes prior to drug treatment; 8 weeks of double-blind treatment with oral estradiol, venlafaxine, or placebo; followed by 14 days of drug taper for those on venlafaxine and 14 days of progesterone treatment for those on estradiol; followed by 2 weeks with no treatment for all groups; and a telephone follow-up post-treatment.

Enrollment

339 patients

Sex

Female

Ages

40 to 62 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Females aged 40-62 years
Postmenopausal or perimenopausal
Having bothersome hot flashes
In general good health
Signed informed consent

Exclusion criteria

Recent use of systemic hormone therapy or hormonal contraceptives
Recent use of any prescribed, over-the-counter or herbal therapies that are taken specifically for hot flashes
Recent use of selective estrogen receptor modulators (SERMS) or aromatase inhibitors
Recent use of psychotropic medications, including SSRIs (selective serotonin reuptake inhibitors), serotonin-norepinephrine reuptake inhibitors (SNRIs), MAOIs (monoamine oxidase inhibitors), and other antidepressants and anxiolytics.
Known hypersensitivity or contraindications (reasons not to take) to venlafaxine, estrogen, or progestins
Not using a medically approved method of birth control, if sexually active and not 12 or more months since last menstrual period
Recent drug or alcohol abuse
Lifetime diagnosis of psychosis or bipolar disorder
Suicide attempt in the past 3 years or any current suicidal ideation
Current major depression (assessed during screening)
Pregnancy, intending pregnancy, or breast feeding
History of:
- Pre-breast cancer or high-risk breast cancer condition
- Abnormal bleeding suggestive of endometrial pre-cancer or endometrial hyperplasia
- Asthma, diabetes mellitus, epilepsy, and migraine disorders that are not stable or under medical management
Abnormal screening blood tests
Current participation in another drug trial or intervention study
Inability or unwillingness to complete the study procedures