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WithdrawnNCT04184323SAFERUpdated Nov 17, 2021

SIRT-1 Antagonism for Endometrial Receptivity

A Phase 2 interventional study of EX-527 (Selisistat) and Placebo in Endometriosis, Uterine Diseases and Endometrial Diseases, sponsored by Wake Forest University Health Sciences. Withdrawn at 1 site in United States. Open to female participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2021-11-17.

Sponsored by Wake Forest University Health Sciences · Phase 2, Interventional, and Treatment

Why this study was withdrawn
Lack of funding
Phase
Phase 2
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
Female
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Study summary

Progesterone resistance is mediated through epigenetic modification through SirT1 activation and is thought to contribute to infertility and progression of endometriosis. Endometriosis is a leading cause of unexplained IVF failure secondary to inflammatory changes that induce SirT1. The current study is designed to investigate a small molecule inhibitor of SirT1, in the clinical setting of In Vitro Fertilization and Embryo Transfer. The SAFER trial will compare EX-527 to placebo in a randomized, double-blind trial. Primary endpoints include Live Birth Rate (LBR) and secondary outcomes include pregnancy rate (PR), miscarriage rate (MR) and implantation failure rate.

Read the detailed description

The SAFER Trial will enroll women with unexplained failure after embryo transfer with euploid embryos. Subjects must have existing euploid embryos for transfer and test positive for SirT1 testing on endometrial biopsy. To qualify, they must be 18 to 40 years of age, have a normal uterine cavity, no serious systemic diseases (diabetes, lupus, cancer, etc) and be willing to be randomized to treatment with a SirT1 inhibitor, EX-527 or placebo. The medication will be provided and administered for 5 days prior to embryo transfer, after progesterone therapy is begun. The drug will be stopped 24 hr before embryo transfer. Standard protocols will be used including administration of progesterone, checking hCG 8 days after transfer, ultrasound monitoring of pregnancy and pregnancy outcomes recording, with Live Birth Rate (LBR) being the primary outcome of interest. We expect to enroll 30 women, with 15 subjects per arm. The goal of this study is to demonstrate efficacy for a specific inhibitor of SirT1 as a primary treatment of defects in endometrial receptivity due to endometriosis.

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Conditions studied

  • Endometriosis
  • Uterine Diseases
  • Endometrial Diseases
  • Infertility Unexplained
  • Infertility; Female, Nonimplantation

Keywords

  • endometriosis
  • SIRT1
  • Progesterone resistance
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In context

Infertility

2,506 studies on the registry are indexed under Infertility; 407 are open to participants now.

Browse Infertility studies →

Lead sponsor

Wake Forest University Health Sciences is the lead sponsor of 1,320 studies on the registry; 199 are open to participants now.

Of its 323 completed or terminated interventional studies of FDA-regulated products, 243 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Must test positive for SIRT1 on mid-luteal endometrial biopsy
  • Prior failed embryo transfer with euploid embryos
  • Have at least one euploid embryo for transfer

Exclusion criteria

Exclusion Criteria:

  • systemic illness affecting kidneys or liver; chronic headache or severe migraine
  • Endometritis, hydrosalpinges, and known adenomyosis
  • Uterine septum, uterine fibroids, endometrial polyps
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    EX-527

    The drug will be administered daily for 5 days beginning with the start of progesterone therapy and ended 24 hours before embryo transfer

    Drug: EX-527 (Selisistat)

  • Placebo comparator
    Placebo

    The placebo will be administered daily for 5 days beginning with the start of progesterone therapy and ended 24 hours before embryo transfer

    Drug: Placebo

Interventions

  • DrugEX-527 (Selisistat)

    EX-527 is a specific inhibitor of the histone deacetylase Sirtuin-1 (SirT1). It is being given to reverse the effects of endometriosis, namely progesterone resistance, that is thought to interfere with the establishment of pregnancy in women with endometriosis

    Also known as: SEN0014196

  • DrugPlacebo

    We will use the same vehicle for producing the active drug such as maltose without any hormones or active components

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What researchers measure

Primary outcomes

  1. Live birth rate

    The number of successful pregnancies ending in live birth at the conclusion of the study divided by the number of embryo transfers in each group

    Time frame: 9 months to 2 years

Secondary outcomes

  1. Pregnancy rate

    The number of subjects with a demonstrated pregnancy based on elevated and sustained hCG levels divided by the number of embryo transfers per group

    Time frame: 9 months to 2 years

  2. Miscarriage rate

    The number of sustained pregnancies lost divided by the number of pregnancies in each group

    Time frame: 9 months to 2 years

07

Study locations

1 site
  • Wake Forest School of Medicine
    Winston-Salem, North Carolina 27157, United States
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References and documents

Publications

  • Westerberg G, Chiesa JA, Andersen CA, Diamanti D, Magnoni L, Pollio G, Darpo B, Zhou M. Safety, pharmacokinetics, pharmacogenomics and QT concentration-effect modelling of the SirT1 inhibitor selisistat in healthy volunteers. Br J Clin Pharmacol. 2015 Mar;79(3):477-91. doi: 10.1111/bcp.12513. PubMed 25223836 ↗
  • Yoo JY, Kim TH, Fazleabas AT, Palomino WA, Ahn SH, Tayade C, Schammel DP, Young SL, Jeong JW, Lessey BA. KRAS Activation and over-expression of SIRT1/BCL6 Contributes to the Pathogenesis of Endometriosis and Progesterone Resistance. Sci Rep. 2017 Jul 28;7(1):6765. doi: 10.1038/s41598-017-04577-w. PubMed 28754906 ↗
  • Likes CE, Cooper LJ, Efird J, Forstein DA, Miller PB, Savaris R, Lessey BA. Medical or surgical treatment before embryo transfer improves outcomes in women with abnormal endometrial BCL6 expression. J Assist Reprod Genet. 2019 Mar;36(3):483-490. doi: 10.1007/s10815-018-1388-x. Epub 2019 Jan 4. PubMed 30610661 ↗
  • Almquist LD, Likes CE, Stone B, Brown KR, Savaris R, Forstein DA, Miller PB, Lessey BA. Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study. Fertil Steril. 2017 Dec;108(6):1063-1069. doi: 10.1016/j.fertnstert.2017.09.017. Epub 2017 Nov 7. PubMed 29126613 ↗

Individual participant data

Plan to share: Yes — The demographic data, group assignment, and outcome data for each subject will be shared with other researchers including embryo grade, stage, pregnancy results (pregnant, not pregnant, miscarriage, ongoing pregnancy, Live birth)

Supporting information: Study protocol, Sap, Csr

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 17, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04184323
Lead sponsor
Wake Forest University Health Sciences
Responsible party
Sponsor
First posted
Dec 3, 2019
Start date
Jan 2022 (estimated)
Primary completion
Dec 2023 (estimated)
Completion
Dec 2023 (estimated)
Last update
Nov 17, 2021

Study contacts

Bruce A Lessey, MD, PhD
principal investigator · Wake Forest University Health Sciences

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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

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