A Phase 1 interventional study of levonorgestrel butanoate (LB) injection in Healthy Women and Female Contraception, sponsored by Premier Research. Active, not recruiting at 7 sites in United States. Open to female participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-10-29.
Sponsored by Premier Research · Phase 1, Interventional, and Prevention
This is a Phase I multicenter, open-label, dose-ranging, three-dose PK and PD study of injectable LB administered as an IM or SQ injection at 40 mg, and subsequently at 50mg SQ and then 60 mg SQ depending on the preliminary pharmacokinetic and pharmacodynamic results obtained with 40 mg dosing.
This is a Phase I multicenter, open-label, dose-ranging, three-dose PK and PD study of injectable LB administered as an IM or SQ injection at 40 mg, and subsequently at 50 mg SQ and then 60 mg SQ depending on the preliminary pharmacokinetic and pharmacodynamic results obtained with 40 mg dosing.
Healthy normal weight and healthy obese women will be enrolled and followed as outpatients until return to ovulation and normal menses. The participation time is estimated to be approximately nine months. During this study, subjects will undergo a screening period prior to enrollment to confirm normal ovulatory function, and then receive active treatment with injection of LB administered via IM or SQ injection. A dose of LB administered IM (40 mg) or SQ (40 mg) was selected for initial evaluation for this study. Subjects will undergo frequent study and safety evaluations and will have serum samples taken to evaluate drug levels and ovulatory function, in addition to a transvaginal ultrasound (TVUS) at selected visits. Follow-up will continue until normal ovulatory cycles resume. Based upon detailed studies in non-human primates and our experience with the 40mg dose groups, it is expected that most subjects will resume menstrual cycles within 12 - 26 weeks after the injection. Subjects will continue to be followed for one normal cycle after the return of menses.
This dose-ranging, PK/PD study will be conducted at seven of the female Contraceptive Clinical Trials Network (CCTN) sites in the U.S. and will enroll approximately 136 women who demonstrate normal ovulatory function during the baseline cycle. Enrollment will be stratified to target that 50% of the subjects have a BMI >30 kg/m\^2 and \<40 kg/m\^2 and approximately 50% of subjects have a BMI \<30 kg/m\^2 in each dose group.
LB injections will be administered at the study site by a trained research nurse or physician. The SQ injections should be done slowly under the skin in the abdomen to ensure drug is dispensed into the tissue layer between the skin and the muscle following standard procedures for subcutaneous injections. For IM injections, the staff should inject LB slowly in the deltoid avoiding the injection into blood vessels following standard procedures for intramuscular injections. (The SQ injection may be given in a different location than the abdomen and the IM injection in a different location than the deltoid with the approval of the Medical Monitor.) The study subject will be observed for at least 30 minutes after the injection before release from the study site.
The different combinations of doses and methods of administration (IM or SQ) will be given in sequential stages, using two different LB concentrations (20 mg/mL or 70 mg/mL) as described below.
Enrollment Stage A: 40 mg IM with 20 mg/ml concentration (27 subjects [18 with BMI \<30 kg/m\^2; 9 with BMI >30 kg/m\^2 and \<40 kg/m\^2])
Enrollment Stage B: 40 mg SQ with 20 mg/ml concentration (32 subjects [25 with BMI \<30 kg/m\^2; 7 with BMI >30 kg/m\^2 and \<40 kg/m\^2])
Enrollment Stage B2: 40 mg SQ with 70 mg/ml concentration (32 subjects [21 with BMI \<30 kg/m\^2; 11 with BMI >30 kg/m\^2 and \<40 kg/m\^2])
Enrollment Stage C: 50 mg IM with 70 mg/ml concentration (8 subjects [8 with BMI \<40 kg/m\^2])
Enrollment Stage D: 60 mg SQ with 70 mg/ml concentration (32 subjects [16 with BMI \<30 kg/m\^2; 16 with BMI >30 kg/m\^2 and \<40 kg/m\^2])
Stages will be performed sequentially; PK/PD assessments will be performed. The target numbers for enrollment in each BMI category are approximate.
Results of the preliminary pharmacokinetic and pharmacodynamic results for the three 40 mg dose groups support moving forward with a maximum dose of 60 mg rather than 70 mg SQ. However, after reviewing these results, the FDA recommended a SAD study with a 50 mg SQ dose before proceeding with 60 mg LB administered SQ. The following enrollment table reflects groups for this revised protocol.
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6a. If subject is postpartum or post-second trimester abortion, she must have 3 menses (2 cycles) prior to enrollment.
6b. If subject had a first trimester abortion or pregnancy loss, she must have one spontaneous menses prior to enrollment.
7. Have a negative urine pregnancy test at the injection visit and no unprotected heterosexual intercourse for the previous 10 days.
8. Not at risk for pregnancy for the duration of study participation (screening through last phone contact), defined as one of the following: 8a. heterosexually abstinent; 8b. previous female permanent contraception procedure; 8c. in a monogamous relationship with a vasectomized partner; 8d. consistent use of a non-hormonal barrier method with every act of intercourse (e.g. condoms or diaphragm + spermicide).
8e. use copper IUD 9. Subjects must be ovulatory as confirmed by a documented screening progesterone (P4) level ≥ 3 ng/ml by local laboratory.
10. In the opinion of the investigator, subject is willing and able to comply with the protocol requirements.
11. Willing to record requested information in the daily diary. 12. Lives within the study site catchment area or within a reasonable distance from the site.
13. Understands and signs an Institutional Review Board (IRB) approved informed consent form prior to undergoing any screening assessments (including fasting blood draw).
14. Agrees not to participate in any other clinical trials during the course of this study.
Exclusion Criteria:
27 subjects (18 with BMI \<30mg\^2; 9 with BMI \>=30kg/m\^2 and \<40kg/m\^2) were administered a single dose of levonorgestrel butanoate (LB) injection 40mg intramuscular (IM) using 20 mg/ml concentration
Biological: levonorgestrel butanoate (LB) injection
32 subjects (25 with BMI \<30mg\^2; 7 with BMI \>=30kg/m\^2 and \<40kg/m\^2) were administered a single dose of levonorgestrel butanoate (LB) injection 40mg subcutaneous (SC) using 20 mg/ml concentration
Biological: levonorgestrel butanoate (LB) injection
8 subjects (8 with BMI \<40 kg/m2) will be administered a single dose of levonorgestrel butanoate (LB) injection 50mg intramuscular (IM) using 70 mg/ml concentration
32 subjects (16 with BMI \<30mg\^2; 16 with BMI \>=30kg/m\^2 and \<40kg/m\^2) will be administered a single dose of levonorgestrel butanoate (LB) injection 60mg subcutaneous (SC) using 70 mg/ml concentration
32 subjects (21 with BMI \<30mg\^2; 11 with BMI \>=30kg/m\^2 and \<40kg/m\^2) were administered a single dose of levonorgestrel butanoate (LB) injection 40mg subcutaneous (SC) using 70 mg/ml concentration
Biological: levonorgestrel butanoate (LB) injection
The initial formulation of the investigational product (IP) is LB Injectable Suspension at a concentration of 40 mg/2 mL (20 mg/mL). Each vial contains 2 mL at 20mg/mL for a total of 40 mg. This formulation will only be used for dosing groups A and B with the injections completed as 40 mg IM (2 mL) or 40 mg SQ (2 mL). The second formulation of the investigational product (IP) is LB Injectable Suspension is a concentration of 140 mg/2 mL (70 mg/mL). Each vial contains 2 mL at 70 mg/mL for a total of 140 mg. This formulation will only be used for dosing groups B2, C, and D with the injections completed as 40 mg SQ (0.57 mL), 50 mg SQ (0.71 mL), and 60 mg SQ (0.86 mL).
Measurement of levonorgestrel serum concentrations
Time frame: 0, 2, 4, 6, 8, 24, 48, 96, 168, and 240 hours. Then weekly for up to 26 weeks.
Ultrasound measurements of ovarian follicular development and ovulation including follicle diameter, total number of follicles, and the number of follicles exceeding a pre-specified threshold
Time frame: Weekly up to 26 weeks
Measurement of Endometrial thickness
Time frame: Weekly up to 26 weeks
Steroid hormone (Estradiol) concentration
Time frame: Weekly up to 26 weeks
Gonadotropin (Follicle Stimulating Hormone and Luteinizing Hormone) concentrations
Time frame: Weekly up to 26 weeks
Sex Hormone Binding Globulin (SHGB) concentration
Time frame: Weekly up to 26 weeks
Bleeding patterns (spotting and light, moderate or heavy bleeding) reported through weekly subject diaries
Time frame: Weekly up to 26 weeks
Side effects of LB as measured by adverse events reported
Time frame: Weekly up to 26 weeks
Plan to share: No
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This study is active, not recruiting, as verified in Oct 2025. You cannot join it, but the record below documents what was studied.
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