CClinicalTrials.gg
CompletedNCT00608062SHAPEUpdated Dec 24, 2020Results posted

Sex Hormones and Atherosclerosis Prevention in Perimenopausal Women

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

Phase
Not applicable
Study type
Interventional
Enrollment
155
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
Female
01

Study summary

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.

Read the detailed description

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

02

Conditions studied

  • Arterial Stiffening
  • Aging
  • Menopause

Keywords

  • endothelial function
  • women
  • female
  • estrogen deficiency
  • sex hormones
  • adiposity
  • oxidative stress
  • antioxidants
03

In context

Lead sponsor

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.

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Healthy women of all races and ethnic backgrounds in one of the following groups:

    • Premenopausal: 18-49 years, regular menstrual cycles with no change in observed cycle length (21-35 days)
    • Perimenopausal: 40-55 years, categorized as either early (at least 2 cycles with cycle length changes of at least 7 days) or late (more than 3 months of amenorrhea) transition
    • Postmenopausal: 45-70 years, more than 12 months of amenorrhea as defined by the menopausal staging system (STRAW); additionally, postmenopausal women will be categorized into early and late stages as defined by the STRAW definition, specifically, women who are less than 5 years postmenopause will be considered early, and women more than 6 years will be categorized as late
  • All postmenopausal women will have undergone natural menopause
  • No oral contraceptive or Hormone Replacement Therapy (HRT) use for at least 6 months
  • Resting blood pressure less than 140/90 mmHg
  • Plasma glucose concentrations less than 110 mg/dl under fasting conditions
  • Sedentary or recreationally active (less than 3 days of vigorous aerobic exercise)
  • No use of medications that might influence cardiovascular function
  • Nonsmokers
  • No use of vitamin supplements or willing to stop use for duration of the study

Exclusion criteria

Exclusion Criteria:

  • History of or active estrogen-dependent neoplasms, acute liver or gallbladder disease, vaginal bleeding, venous thromboembolism, hypertriglyceridemia, and cardiovascular disease
  • Known allergy to transdermal patch or GnRHant
  • Other contraindications to HRT and GnRHant
05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
155 participants (actual)

Study arms

  • Experimental
    Pre1

    Premenopausal - GnRHant plus estradiol

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch

  • Placebo comparator
    Pre2

    Premenopausal - GnRHant plus placebo

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch

  • Experimental
    Peri1

    Perimenopausal (early) - GnRHant plus estradiol

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch

  • Placebo comparator
    Peri2

    Perimenopausal (early) - GnRHant plus placebo

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch

  • Experimental
    Peri3

    Perimenopausal (late) - GnRHant plus estradiol

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch

  • Placebo comparator
    Peri4

    Perimenopausal (late) - GnRHant plus placebo

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch

  • Experimental
    Post1

    Postmenopausal - GnRHant plus estradiol

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal estradiol patch

  • Placebo comparator
    Post2

    Postmenopausal - GnRHant plus placebo

    Drug: GnRHant - Ganirelix acetate · Drug: Transdermal placebo patch

Interventions

  • DrugGnRHant - Ganirelix acetate

    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

  • DrugTransdermal estradiol patch

    0.075mg/d starting on day 4 of the injections following testing time point two; continue for 3 days and retest (day 7)

  • DrugTransdermal placebo patch

    Starting on day 4 of the injections following testing time point two; continue for 3 days and retest (day 7)

06

What researchers measure

Primary outcomes

  1. 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

  2. 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

Other outcomes

  1. Supine Brachial Blood Pressures

    Time frame: Baseline, day 4 of GnRHant and day 7 of GnRHant and estradiol or placebo treatment

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

07

Results

Posted Dec 24, 2020
Limitations and caveats
Budget cuts lead to: 1) endothelial cell protein expression outcome not analyzed and deleted; 2) small numbers of early and late perimenopausal groups, thus, it was collapsed into 1 peri group. Ultrasound image quality also lead to small numbers.

Participant flow

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.

Participant flow — Overall Study
MilestonePre1Pre2Peri1Peri2Post1Post2
Started121219211315
Completed121219211315
Not completed000000

Outcome measures

PrimaryArterial 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
Reported as:
Mean · mm2/mm Hg×10-1
Arterial Stiffness (Carotid Artery Compliance) During Saline
mm2/mm Hg×10-1Pre1Pre2Peri1Peri2Post1Post2
Baseline1.31 ± 0.271.34 ± 0.180.90 ± 0.271.02 ± 0.330.89 ± 0.250.74 ± 0.23
GnRHant alone1.27 ± 0.271.19 ± 0.340.89 ± 0.270.94 ± 0.290.85 ± 0.240.79 ± 0.22
GnRHant + Add-Back1.29 ± 0.261.14 ± 0.380.98 ± 0.270.94 ± 0.270.92 ± 0.270.80 ± 0.19
PrimaryEndothelial 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
Reported as:
Mean · % Diameter Change
Endothelial Function
% Diameter ChangePre1Pre2Peri1Peri2Post1Post2
Baseline9.8 ± 2.511.3 ± 2.57.7 ± 2.66.1 ± 2.75.4 ± 1.75.3 ± 2.2
Day 4 of GnRHant alone7.1 ± 2.38.9 ± 2.75.8 ± 26.6 ± 24.9 ± 1.54.9 ± 1.4
Day 7 of GnRHant plus treatment10.6 ± 3.37.8 ± 3.09.6 ± 3.36.1 ± 2.78.4 ± 2.44.2 ± 1.7
Acute Vitamin C Infusion Day 78.4 ± 3.111.2 ± 4.89.3 ± 3.411.2 ± 3.67.8 ± 3.46.7 ± 2.8
Statistical analysis
  • Pre1 vs Pre2 vs Peri1 vs Peri2 vs Post1 vs Post2 · Mixed Models Analysis · p = 0.05
Other pre-specifiedSupine Brachial Blood Pressures
Time frame:
Baseline, day 4 of GnRHant and day 7 of GnRHant and estradiol or placebo treatment
Reported as:
Mean · mmHg
Supine Brachial Blood Pressures
mmHgPre1Pre2Peri1Peri2Post1Post2
Baseline102 ± 10108 ± 9111 ± 13109 ± 15117 ± 10123 ± 13
Day 4 of GnRHant alone107 ± 7111 ± 13112 ± 12108 ± 13116 ± 9115 ± 8
Day 7 of GnRHant plus treatment103 ± 10110 ± 14108 ± 13109 ± 16112 ± 10111 ± 8
Other pre-specifiedEstradiol

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
Reported as:
Median · pmol/L
Estradiol
pmol/LPre1Pre2Peri1Peri2Post1Post2
Baseline229 (117 to 332)270 (128 to 484)360 (46 to 508)147 (62 to 316)39 (37 to 49)37 (37 to 42)
GnRHant alone147 (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-back202 (140 to 481)134 (117 to 183)187 (81 to 569)106 (37 to 321)165 (128 to 223)37 (37 to 39)
Statistical analysis
  • Pre1 vs Pre2 vs Peri1 vs Peri2 vs Post1 vs Post2 · Mixed Models Analysis · p = 0.05
Other pre-specifiedProgesterone

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
Reported as:
Median · nmol/L
Progesterone
nmol/LPre1Pre2Peri1Peri2Post1Post2
Baseline1.8 (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 alone1.3 (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-back1.0 (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)
Statistical analysis
  • Pre1 vs Pre2 vs Peri1 vs Peri2 vs Post1 vs Post2 · Mixed Models Analysis · p = 0.05
Other pre-specifiedTotal 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
Reported as:
Mean · nmol/L
Total Antioxidant Status (TAS)
nmol/LPre1Pre2Peri1Peri2Post1Post2
Baseline1.4 ± 0.21.4 ± 0.21.3 ± 0.21.3 ± 0.11.3 ± 0.21.3 ± 0.2
GnRHant alone1.4 ± 0.21.5 ± 0.11.3 ± 0.21.3 ± 0.21.3 ± 0.11.4 ± 0.3
GnRhant+Add-back1.4 ± 0.11.4 ± 0.11.3 ± 0.11.3 ± 0.11.3 ± 0.21.3 ± 0.2
Other pre-specifiedEndothelin-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
Reported as:
Mean · pg/mL
Endothelin-1 (ET-1)
pg/mLPre1Pre2Peri1Peri2Post1Post2
Baseline5.2 ± 1.55.2 ± 0.95.9 ± 1.36.2 ± 1.66.2 ± 1.46.4 ± 1.1
GnRHant alone5.5 ± 1.75.5 ± 0.96.0 ± 1.85.9 ± 0.96.5 ± 2.16.5 ± 0.9
GnRhant+Add-back6.0 ± 1.15.0 ± 0.75.9 ± 1.65.7 ± 1.96.0 ± 1.86.4 ± 0.9
Other pre-specifiedPlasma 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
Reported as:
Median · pg/mL
Plasma Norepinephrine
pg/mLPre1Pre2Peri1Peri2Post1Post2
Baseline161 (108 to 230)184 (101 to 217)227 (168 to 280)247 (164 to 295)231 (127 to 349)242 (228 to 331)
GnRHant alone144 (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-back146 (118 to 214)217 (152 to 282)231 (168 to 295)217 (152 to 282)204 (168 to 280)221 (162 to 303)

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Pre10/12 (0%)0/12 (0%)8/12 (66.7%)
Pre20/12 (0%)0/12 (0%)4/12 (33.3%)
Peri10/19 (0%)0/19 (0%)9/19 (47.4%)
Peri20/21 (0%)0/21 (0%)8/21 (38.1%)
Post10/13 (0%)0/13 (0%)5/13 (38.5%)
Post20/15 (0%)0/15 (0%)4/15 (26.7%)
Most frequent other events
Most frequent other events
EventPre1Pre2Peri1Peri2Post1Post2
Patch irritationSkin and subcutaneous tissue disorders6/122/123/192/212/132/15
Vaginal bleedingReproductive system and breast disorders4/122/121/191/210/130/15
BloatingGastrointestinal disorders2/121/124/192/212/131/15
NauseaGastrointestinal disorders2/121/122/191/210/130/15
Other urogenitalReproductive system and breast disorders1/120/122/191/212/131/15
Injection site reactionSkin and subcutaneous tissue disorders1/121/120/193/211/132/15
Joint PainMusculoskeletal and connective tissue disorders1/121/121/193/210/130/15
Cardiovascular/neurologyInjury, poisoning and procedural complications0/120/120/191/210/131/15
Breast tendernessReproductive system and breast disorders0/120/121/191/210/130/15

Baseline characteristics

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
Age, Categorical(Participants)Pre1Pre2Peri1Peri2Post1Post2Total
<=18 years0000000
Between 18 and 65 years12121721121185
>=65 years0000022
Age, Continuous
Age, Continuous(years)Pre1Pre2Peri1Peri2Post1Post2Total
Mean32 ± 833 ± 749 ± 350 ± 456 ± 560 ± 647 ± 11
Sex: Female, Male
Sex: Female, Male(Participants)Pre1Pre2Peri1Peri2Post1Post2Total
Female12121721121387
Male0000000
Region of Enrollment
Region of Enrollment(participants)Pre1Pre2Peri1Peri2Post1Post2Total
United States12121721121387
Body Mass
Body Mass(kg)Pre1Pre2Peri1Peri2Post1Post2Total
Mean66.8 ± 15.664.2 ± 11.065.6 ± 8.168.7 ± 11.970.5 ± 14.769.7 ± 9.367.6 ± 11.7
Body Mass Index (BMI)
Body Mass Index (BMI)(kg/m2)Pre1Pre2Peri1Peri2Post1Post2Total
Mean23.8 ± 5.624.4 ± 5.324.1 ± 3.225.2 ± 3.926.7 ± 5.926.5 ± 2.725.1 ± 4.4
Systolic Blood Pressure
Systolic Blood Pressure(mmHg)Pre1Pre2Peri1Peri2Post1Post2Total
Mean109 ± 8110 ± 7113 ± 14115 ± 11117 ± 14120 ± 14114 ± 12
Diastolic Blood Pressure
Diastolic Blood Pressure(mmHg)Pre1Pre2Peri1Peri2Post1Post2Total
Mean70 ± 772 ± 571 ± 973 ± 673 ± 874 ± 1072 ± 8

6 further baseline measures are reported on the registry.

08

Study locations

1 site
  • University of Colorado Anschutz Medical Center, Clinical Translational Research Center and Exercise Research Laboratory
    Aurora, Colorado 80045, United States
09

References and documents

Publications

  • Moreau KL, Donato AJ, Seals DR, DeSouza CA, Tanaka H. Regular exercise, hormone replacement therapy and the age-related decline in carotid arterial compliance in healthy women. Cardiovasc Res. 2003 Mar;57(3):861-8. doi: 10.1016/s0008-6363(02)00777-0. PubMed 12618248 ↗
  • Moreau KL, Gavin KM, Plum AE, Seals DR. Ascorbic acid selectively improves large elastic artery compliance in postmenopausal women. Hypertension. 2005 Jun;45(6):1107-12. doi: 10.1161/01.HYP.0000165678.63373.8c. Epub 2005 May 2. PubMed 15867135 ↗
  • Virdis A, Ghiadoni L, Pinto S, Lombardo M, Petraglia F, Gennazzani A, Buralli S, Taddei S, Salvetti A. Mechanisms responsible for endothelial dysfunction associated with acute estrogen deprivation in normotensive women. Circulation. 2000 May 16;101(19):2258-63. doi: 10.1161/01.cir.101.19.2258. PubMed 10811592 ↗
  • Ihionkhan CE, Chambliss KL, Gibson LL, Hahner LD, Mendelsohn ME, Shaul PW. Estrogen causes dynamic alterations in endothelial estrogen receptor expression. Circ Res. 2002 Nov 1;91(9):814-20. doi: 10.1161/01.res.0000038304.62046.4c. PubMed 12411396 ↗
  • Eskurza I, Monahan KD, Robinson JA, Seals DR. Effect of acute and chronic ascorbic acid on flow-mediated dilatation with sedentary and physically active human ageing. J Physiol. 2004 Apr 1;556(Pt 1):315-24. doi: 10.1113/jphysiol.2003.057042. Epub 2004 Jan 30. Erratum In: J Physiol. 2004 May 1;556(Pt 3):1014. PubMed 14754992 ↗
  • Gavin KM, Jankowski C, Kohrt WM, Stauffer BL, Seals DR, Moreau KL. Hysterectomy is associated with large artery stiffening in estrogen-deficient postmenopausal women. Menopause. 2012 Sep;19(9):1000-7. doi: 10.1097/gme.0b013e31825040f9. PubMed 22692329 ↗
  • Moreau KL, Meditz A, Deane KD, Kohrt WM. Tetrahydrobiopterin improves endothelial function and decreases arterial stiffness in estrogen-deficient postmenopausal women. Am J Physiol Heart Circ Physiol. 2012 Mar 1;302(5):H1211-8. doi: 10.1152/ajpheart.01065.2011. Epub 2012 Jan 13. PubMed 22245769 ↗
  • Moreau KL, Hildreth KL, Meditz AL, Deane KD, Kohrt WM. Endothelial function is impaired across the stages of the menopause transition in healthy women. J Clin Endocrinol Metab. 2012 Dec;97(12):4692-700. doi: 10.1210/jc.2012-2244. Epub 2012 Sep 11. PubMed 22969140 ↗

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 24, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00608062
Lead sponsor
University of Colorado, Denver
Collaborators
National Institute on Aging (NIA)
Responsible party
Sponsor
First posted
Feb 6, 2008
Start date
Mar 2007
Primary completion
Oct 25, 2012
Completion
Oct 25, 2012
Results posted
Dec 24, 2020
Last update
Dec 24, 2020

Study contacts

Kerrie L Moreau, PhD
principal investigator · University of Colorado, Denver

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Dec 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion