An interventional study of GnRHant - Ganirelix acetate and Transdermal estradiol patch in Arterial Stiffening, Aging and Menopause, sponsored by University of Colorado, Denver. Completed at 1 site in United States. Open to female participants aged 18 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-12-24.
Sponsored by University of Colorado, Denver · Not applicable, Interventional, and Basic science
The purpose of this study is to find out why women's arteries stiffen as they go through menopause, and how this is affected by estrogen loss. We believe that arteries stiffen with the loss of estrogen because of "oxidative stress," the production of molecules that can damage cells and tissues in the body, and because the arteries lose their ability to expand, or dilate.
As women get older and go through menopause, estradiol levels decrease. Also with aging, the arteries that are located around the heart get stiffer. Over time this increase in arterial stiffness can lead to a number of health problems such as high blood pressure and heart disease. In this study we want to find out if a short-term drop in estrogen levels in premenopausal and perimenopausal women can cause arteries to become stiffer, and why this happens. Additionally, in postmenopausal women, we want to find out if a short-term increase in estrogen levels causes their arteries to become more flexible (less stiff).
Arterial health (i.e., stiffness) will be examined in premenopausal, perimenopausal and postmenopausal women before and after they are given a drug called Ganirelix™ (for 7 days), which will markedly lower their reproductive hormones. After the first 4 days of taking Ganirelix™, the women will be randomly placed into 1 of 2 treatment groups to take either estrogen (0.075 mg/d skin patch) replacement or placebo for the rest of the Ganirelix treatment. This is to increase estrogen levels back to the normal level. After having the patch on for 4 days, arterial health will be examined again.
Pre-specified Outcome Measures were divided into unit-of-measurement specific Outcome Measure tables for the purposes of results reporting to ClinicalTrials.gov
University of Colorado, Denver is the lead sponsor of 1,499 studies on the registry; 315 are open to participants now.
Of its 139 completed or terminated interventional studies of FDA-regulated products, 89 (64%) have results posted.
Counted across the registry records on this site, refreshed daily.
Healthy women of all races and ethnic backgrounds in one of the following groups:
Exclusion Criteria:
Premenopausal - GnRHant plus estradiol
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch
Premenopausal - GnRHant plus placebo
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch
Perimenopausal (early) - GnRHant plus estradiol
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch
Perimenopausal (early) - GnRHant plus placebo
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch
Perimenopausal (late) - GnRHant plus estradiol
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch
Perimenopausal (late) - GnRHant plus placebo
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch
Postmenopausal - GnRHant plus estradiol
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch
Postmenopausal - GnRHant plus placebo
Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch
1 subcutaneous injection at 0.5 mg then daily injections of 0.25 mg for 6 days (total of 7 days of injections); testing will occur on injection day 4 and day 7
Also known as: Ganirelix
0.075mg/d starting on day 4 of the injections following testing time point two; continue for 3 days and retest (day 7)
Starting on day 4 of the injections following testing time point two; continue for 3 days and retest (day 7)
Arterial Stiffness (Carotid Artery Compliance) During Saline
Carotid artery compliance measured by carotid artery ultrasound and brachial artery blood pressure
Time frame: Baseline, day 4 of GnRHant and day 7 of GnRHant and estradiol or placebo treatment
Endothelial Function
Brachial artery flow-mediated dilation (FMD) assessed by ultrasound. This other outcome measure was originally specified as "Secondary" in error and has been updated to "Primary" to be consistent with the protocol.
Time frame: Baseline, day 4 of GnRHant and Day 7 of GnRHant and estradiol or placebo treatment
Supine Brachial Blood Pressures
Time frame: Baseline, day 4 of GnRHant and day 7 of GnRHant and estradiol or placebo treatment
Estradiol
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. Serum estradiol for clinical characteristics and to detect changes in estradiol levels with the interventions.
Time frame: Baseline, day 4 of GnRHant and day 7 of GnRHant and estradiol or placebo treatment
Progesterone
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. Serum progesterone was measured for clinical characteristics and to determine changes in sex hormones.
Time frame: Baseline, Day 4 GnRHant, Day 7 GnRHant+Add-back
Total Antioxidant Status (TAS)
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. TAS is an antioxidant and is a biomarker of oxidative stress.
Time frame: Baseline, Day 4 GnRHant, Day 7 GnRHant+Add-back
Endothelin-1 (ET-1)
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol.
Time frame: Baseline, Day 4 GnRHant, Day 7 GnRHant+Add-back
Plasma Norepinephrine
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol.
Time frame: Baseline, Day 4 GnRHant, Day 7 GnRHant+Add-back
Participants were recruited from the Denver metro area between March 2007 and March 2012. The first participant was enrolled on March 6, 2007 and the last participant was enrolled in March 2012.
| Milestone | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Started | 12 | 12 | 19 | 21 | 13 | 15 |
| Completed | 12 | 12 | 19 | 21 | 13 | 15 |
| Not completed | 0 | 0 | 0 | 0 | 0 | 0 |
Carotid artery compliance measured by carotid artery ultrasound and brachial artery blood pressure
| mm2/mm Hg×10-1 | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 1.31 ± 0.27 | 1.34 ± 0.18 | 0.90 ± 0.27 | 1.02 ± 0.33 | 0.89 ± 0.25 | 0.74 ± 0.23 |
| GnRHant alone | 1.27 ± 0.27 | 1.19 ± 0.34 | 0.89 ± 0.27 | 0.94 ± 0.29 | 0.85 ± 0.24 | 0.79 ± 0.22 |
| GnRHant + Add-Back | 1.29 ± 0.26 | 1.14 ± 0.38 | 0.98 ± 0.27 | 0.94 ± 0.27 | 0.92 ± 0.27 | 0.80 ± 0.19 |
Brachial artery flow-mediated dilation (FMD) assessed by ultrasound. This other outcome measure was originally specified as "Secondary" in error and has been updated to "Primary" to be consistent with the protocol.
| % Diameter Change | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 9.8 ± 2.5 | 11.3 ± 2.5 | 7.7 ± 2.6 | 6.1 ± 2.7 | 5.4 ± 1.7 | 5.3 ± 2.2 |
| Day 4 of GnRHant alone | 7.1 ± 2.3 | 8.9 ± 2.7 | 5.8 ± 2 | 6.6 ± 2 | 4.9 ± 1.5 | 4.9 ± 1.4 |
| Day 7 of GnRHant plus treatment | 10.6 ± 3.3 | 7.8 ± 3.0 | 9.6 ± 3.3 | 6.1 ± 2.7 | 8.4 ± 2.4 | 4.2 ± 1.7 |
| Acute Vitamin C Infusion Day 7 | 8.4 ± 3.1 | 11.2 ± 4.8 | 9.3 ± 3.4 | 11.2 ± 3.6 | 7.8 ± 3.4 | 6.7 ± 2.8 |
| mmHg | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 102 ± 10 | 108 ± 9 | 111 ± 13 | 109 ± 15 | 117 ± 10 | 123 ± 13 |
| Day 4 of GnRHant alone | 107 ± 7 | 111 ± 13 | 112 ± 12 | 108 ± 13 | 116 ± 9 | 115 ± 8 |
| Day 7 of GnRHant plus treatment | 103 ± 10 | 110 ± 14 | 108 ± 13 | 109 ± 16 | 112 ± 10 | 111 ± 8 |
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. Serum estradiol for clinical characteristics and to detect changes in estradiol levels with the interventions.
| pmol/L | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 229 (117 to 332) | 270 (128 to 484) | 360 (46 to 508) | 147 (62 to 316) | 39 (37 to 49) | 37 (37 to 42) |
| GnRHant alone | 147 (87 to 183) | 127 (96 to 243) | 92 (37 to 468) | 99 (37 to 321) | 37 (37 to 42) | 37 (37 to 42) |
| GnRhant+Add-back | 202 (140 to 481) | 134 (117 to 183) | 187 (81 to 569) | 106 (37 to 321) | 165 (128 to 223) | 37 (37 to 39) |
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. Serum progesterone was measured for clinical characteristics and to determine changes in sex hormones.
| nmol/L | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 1.8 (0.7 to 2.5) | 2.1 (1.0 to 3.1) | 1.1 (0.6 to 1.9) | 1.3 (1.0 to 1.9) | 1.1 (0.6 to 1.3) | 0.9 (0.6 to 1.3) |
| GnRHant alone | 1.3 (0.4 to 2.9) | 1.7 (0.7 to 3.7) | 1.0 (0.6 to 1.9) | 1.0 (0.6 to 2.5) | 1.0 (0.3 to 1.3) | 0.6 (0.3 to 1.1) |
| GnRhant+Add-back | 1.0 (0.5 to 2.7) | 1.0 (0.6 to 2.1) | 0.8 (0.6 to 3.6) | 1.6 (0.7 to 4.9) | 1.0 (0.6 to 1.0) | 0.6 (0.6 to 1.1) |
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol. TAS is an antioxidant and is a biomarker of oxidative stress.
| nmol/L | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 1.4 ± 0.2 | 1.4 ± 0.2 | 1.3 ± 0.2 | 1.3 ± 0.1 | 1.3 ± 0.2 | 1.3 ± 0.2 |
| GnRHant alone | 1.4 ± 0.2 | 1.5 ± 0.1 | 1.3 ± 0.2 | 1.3 ± 0.2 | 1.3 ± 0.1 | 1.4 ± 0.3 |
| GnRhant+Add-back | 1.4 ± 0.1 | 1.4 ± 0.1 | 1.3 ± 0.1 | 1.3 ± 0.1 | 1.3 ± 0.2 | 1.3 ± 0.2 |
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol.
| pg/mL | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 5.2 ± 1.5 | 5.2 ± 0.9 | 5.9 ± 1.3 | 6.2 ± 1.6 | 6.2 ± 1.4 | 6.4 ± 1.1 |
| GnRHant alone | 5.5 ± 1.7 | 5.5 ± 0.9 | 6.0 ± 1.8 | 5.9 ± 0.9 | 6.5 ± 2.1 | 6.5 ± 0.9 |
| GnRhant+Add-back | 6.0 ± 1.1 | 5.0 ± 0.7 | 5.9 ± 1.6 | 5.7 ± 1.9 | 6.0 ± 1.8 | 6.4 ± 0.9 |
This other outcome measure was originally specified as "Secondary" in error and has been updated to "Other, Pre-specified" to be consistent with the protocol.
| pg/mL | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Baseline | 161 (108 to 230) | 184 (101 to 217) | 227 (168 to 280) | 247 (164 to 295) | 231 (127 to 349) | 242 (228 to 331) |
| GnRHant alone | 144 (116 to 164) | 156 (103 to 252) | 235 (183 to 282) | 233 (159 to 341) | 280 (156 to 362) | 217 (180 to 282) |
| GnRhant+Add-back | 146 (118 to 214) | 217 (152 to 282) | 231 (168 to 295) | 217 (152 to 282) | 204 (168 to 280) | 221 (162 to 303) |
Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Pre1 | 0/12 (0%) | 0/12 (0%) | 8/12 (66.7%) |
| Pre2 | 0/12 (0%) | 0/12 (0%) | 4/12 (33.3%) |
| Peri1 | 0/19 (0%) | 0/19 (0%) | 9/19 (47.4%) |
| Peri2 | 0/21 (0%) | 0/21 (0%) | 8/21 (38.1%) |
| Post1 | 0/13 (0%) | 0/13 (0%) | 5/13 (38.5%) |
| Post2 | 0/15 (0%) | 0/15 (0%) | 4/15 (26.7%) |
| Event | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 |
|---|---|---|---|---|---|---|
| Patch irritationSkin and subcutaneous tissue disorders | 6/12 | 2/12 | 3/19 | 2/21 | 2/13 | 2/15 |
| Vaginal bleedingReproductive system and breast disorders | 4/12 | 2/12 | 1/19 | 1/21 | 0/13 | 0/15 |
| BloatingGastrointestinal disorders | 2/12 | 1/12 | 4/19 | 2/21 | 2/13 | 1/15 |
| NauseaGastrointestinal disorders | 2/12 | 1/12 | 2/19 | 1/21 | 0/13 | 0/15 |
| Other urogenitalReproductive system and breast disorders | 1/12 | 0/12 | 2/19 | 1/21 | 2/13 | 1/15 |
| Injection site reactionSkin and subcutaneous tissue disorders | 1/12 | 1/12 | 0/19 | 3/21 | 1/13 | 2/15 |
| Joint PainMusculoskeletal and connective tissue disorders | 1/12 | 1/12 | 1/19 | 3/21 | 0/13 | 0/15 |
| Cardiovascular/neurologyInjury, poisoning and procedural complications | 0/12 | 0/12 | 0/19 | 1/21 | 0/13 | 1/15 |
| Breast tendernessReproductive system and breast disorders | 0/12 | 0/12 | 1/19 | 1/21 | 0/13 | 0/15 |
For primary outcome brachial artery FMD, 91 completed the study. Four participants did not have usable FMD data due to poor ultrasound image quality or technical issues with image acquisition; baseline analysis and results for the remaining 87 women are presented.
| Age, Categorical(Participants) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 12 | 12 | 17 | 21 | 12 | 11 | 85 |
| >=65 years | 0 | 0 | 0 | 0 | 0 | 2 | 2 |
| Age, Continuous(years) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Mean | 32 ± 8 | 33 ± 7 | 49 ± 3 | 50 ± 4 | 56 ± 5 | 60 ± 6 | 47 ± 11 |
| Sex: Female, Male(Participants) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Female | 12 | 12 | 17 | 21 | 12 | 13 | 87 |
| Male | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Region of Enrollment(participants) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| United States | 12 | 12 | 17 | 21 | 12 | 13 | 87 |
| Body Mass(kg) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Mean | 66.8 ± 15.6 | 64.2 ± 11.0 | 65.6 ± 8.1 | 68.7 ± 11.9 | 70.5 ± 14.7 | 69.7 ± 9.3 | 67.6 ± 11.7 |
| Body Mass Index (BMI)(kg/m2) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Mean | 23.8 ± 5.6 | 24.4 ± 5.3 | 24.1 ± 3.2 | 25.2 ± 3.9 | 26.7 ± 5.9 | 26.5 ± 2.7 | 25.1 ± 4.4 |
| Systolic Blood Pressure(mmHg) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Mean | 109 ± 8 | 110 ± 7 | 113 ± 14 | 115 ± 11 | 117 ± 14 | 120 ± 14 | 114 ± 12 |
| Diastolic Blood Pressure(mmHg) | Pre1 | Pre2 | Peri1 | Peri2 | Post1 | Post2 | Total |
|---|---|---|---|---|---|---|---|
| Mean | 70 ± 7 | 72 ± 5 | 71 ± 9 | 73 ± 6 | 73 ± 8 | 74 ± 10 | 72 ± 8 |
6 further baseline measures are reported on the registry.
Plan to share: No
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University of Colorado, Denver