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CompletedNCT05678192Updated Jun 22, 2023

Effect of Menopausal Hormone Therapy on Immune System Parameters

A Phase 1 interventional study of oral menopausal hormone therapy and transdermal menopausal hormone therapy in Last Period Not Earlier Than 6 Months Ago, sponsored by Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare. Completed at 1 site in Russian Federation. Open to female participants aged 45 Years to 59 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-06-22.

Sponsored by Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare · Phase 1, Interventional, and Prevention

Phase
Phase 1
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
45 Years to 59 Years
Sex
Female
01

Study summary

The objective of the study is to evaluate the effect of menopausal hormone therapy on the parameters of the immune system. To do this, patients took blood to assess the immune status before the start of therapy and after 3 months.

An additional task is to assess the content of blood sex hormones before the start of therapy and after 3 months.

Read the detailed description

A study of 60 perimenopausal and postmenopausal patients was included. The cohort was divided into groups depending on the treatment regimen.

Group 1 (n=20) received transdermal menopausal hormone therapy (MHT). Group 2 (n=20) received oral MHT.

02

Conditions studied

  • Last Period Not Earlier Than 6 Months Ago

Keywords

  • immune status
  • menopausal hormone therapy
03

Who can participate

Ages eligible
45 Years to 59 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • age from 45 to 59;
  • phase of reproductive aging - perimenopause, postmenopause or surgical menopause (ovariectomy);
  • indications for prescribing MHT

Exclusion criteria

Exclusion Criteria:

  1. Absolute contraindications to MHT:

    • Bleeding from the genital tract of unknown origin
    • Breast and endometrial cancer
    • Acute hepatitis
    • Acute deep vein thrombosis
    • Acute thromboembolism
    • Cutaneous porphyria
  2. Obesity;
  3. HIV infection and other congenital and acquired immunodeficiencies;
  4. Systemic connective tissue diseases;
  5. Oncological diseases in history;
  6. History of chemotherapy and/or radiation therapy;
  7. Autoimmune diseases;
  8. Acute diseases and exacerbation of chronic diseases during the last 3 months;
  9. Reception of immunomodulatory drugs during the last 3 months.
04

Study design

Phase
Phase 1
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
40 participants (actual)

Study arms

  • Other
    Transdermal MHT

    The group includes women 45-59 years old, with menopausal symptoms. The choice of transdermal MHT was based on personal history (chronic diseases of the gastrointestinal tract, high blood pressure, etc.), family history (stroke, thromboembolism in relatives, etc.), and patient preferences. Used estradiol hemihydrate 0.6 mg 2 protective pumps. The progesterone component of MHT includes micronized progesterone 100 mg or 200 mg, depending on the MHT regimen (continuous or cyclic). Blood sampling to determine the immune status is carried out before the start of therapy after 3 months.

    Drug: oral menopausal hormone therapy · Drug: transdermal menopausal hormone therapy

  • Other
    Oral MHT

    The group includes women 45-59 years old, with menopausal symptoms. Examination before the appointment of MHT can be carried out according to clinical recommendations. The choice of transdermal MHT was based on the history (chronic diseases of the gastrointestinal tract, high blood pressure, etc.), family history (stroke, thromboembolism in relatives, etc.), the patient's preferences.Drugs used in this group include: Dydrogesterone 5 mg + Estradiol 1 mg or Dydrogesterone 10 mg + Estradiol 1 mg, depending on the MHT regimen. Blood sampling to determine the immune status is performed before the start of therapy and after 3 months

    Drug: oral menopausal hormone therapy · Drug: transdermal menopausal hormone therapy

Interventions

  • Drugoral menopausal hormone therapy

    Dydrogesterone 10 mg + Estradiol 1 mg/Dydrogesterone 5 mg + Estradiol 1 mg

  • Drugtransdermal menopausal hormone therapy

    Estradiol 1,5 mg + Progesterone 200 mg/Estradiol 1,5 mg + Progesterone 100 mg

05

What researchers measure

Primary outcomes

  1. Evaluation of the severity of menopausal syndrome

    The Green scale questionnaire was used initially and after 3 months against the background of menopausal hormone therapy. The questionnaire includes 21 questions from 0 to 3 points, where a lower score means a better result.

    Time frame: 3 months

  2. Changing the assessment of quality of life using the WHO Brief Questionnaire for Quality of Life (WHOQOL-BREF)

    The WHO Brief Questionnaire for Quality of Life (WHOQOL-BREF) was used at baseline and 3 months later. The questionnaire includes 26 questions, from 1 to 5 points, where a higher score means a better result.

    Time frame: 3 months

Secondary outcomes

  1. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: the content cytotoxic T-lymphocytes (CD3+CD8+) in peripheral blood by flow cytometry in %. Literature reference values: 14,0-36,0%.

    Time frame: 3 months

  2. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: content of B-lymphocytes (CD3-CD19+HLA-DR+) in peripheral blood by flow cytometry in %. Literature reference values: 5,0-19,0%.

    Time frame: 3 months

  3. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: content of NK cells (CD3-CD56+CD16+) by flow cytometry in %. Literature reference values: 4,0-26,0%.

    Time frame: 3 months

  4. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: content of classical monocytes (CD14++CD16-) by flow cytometry in %. Literature reference values: 85,0-90,0%.

    Time frame: 3 months

  5. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: content of non-classical monocytes (CD14+CD16++) by flow cytometry in %. Literature reference values: 5,0-10,0%.

    Time frame: 3 months

  6. Evaluation of the effect of therapy on the parameters of the immune status

    Determination of blood parameters of immune status: content of T-helper cells (CD3+CD4+) by flow cytometry in %. Literature reference values: 31,0-61,0%.

    Time frame: 3 months

Other outcomes

  1. Сhanges in the level of sex hormones against the background of MHT

    Assessment of changes in the level of sex hormone in peripheral blood: follicle-stimulating hormone (IU/l). Reference values: 2.0-10.0 IU/l. Blood sampling is performed at baseline and after 3 months.

    Time frame: 3 months

  2. Сhanges in the level of sex hormones against the background of MHT

    Assessment of changes in the level of sex hormone in peripheral blood: estradiol (pmol/l). Reference values: 150 - 450 pmol/l. Blood sampling is performed at baseline and after 3 months.

    Time frame: 3 months

  3. Сhanges in the level of sex hormones against the background of MHT

    Assessment of changes in the level of sex hormone in peripheral blood: testosterone (nmol/l). Reference values: 0,52 - 2,5 nmol/l. Blood sampling is performed at baseline and after 3 months.

    Time frame: 3 months

  4. Assessing satisfaction with MHT using the Menopause symptoms treatment Satisfaction Questionnaire

    The Menopause symptoms treatment Satisfaction Questionnaire is used after 3 months of MHT. The questionnaire includes 8 questions from 1 to 5 points from a very satisfactory result to a completely unsatisfactory one.

    Time frame: 3 months

06

Study locations

1 site
  • Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare
    Moscow, 117997, Russian Federation
07

Registry details

Key details

Study ID
NCT05678192
Lead sponsor
Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare
Responsible party
Sponsor
First posted
Jan 10, 2023
Start date
Dec 1, 2021
Primary completion
Mar 1, 2023
Completion
Mar 1, 2023
Last update
Jun 22, 2023

Study contacts

Marina Averyanova, PhD
principal investigator · FSBI "National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov" Ministry of Healthcare of the Russian Federation

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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