• Clin Drug Investig · Jun 2014

    Randomized Controlled Trial Comparative Study

    The effect of therapeutic and supratherapeutic oral doses of nomegestrol acetate (NOMAC)/17β-estradiol (E2) on QTcF intervals in healthy women: results from a randomized, double-blind, placebo- and positive-controlled trial.

    • de Kam Pieter-Jan PJ Clinical Research, MSD Pharma, 8 Biomedical Grove, #04-01/05, Neuros Building, Biopolis, 138665, Singapore, Singapore, pieter-jan.de.kam@merck.com., Jacqueline van Kuijk, Otilia Lillin, Teun Post, and Torben Thomsen.
    • Clinical Research, MSD Pharma, 8 Biomedical Grove, #04-01/05, Neuros Building, Biopolis, 138665, Singapore, Singapore, pieter-jan.de.kam@merck.com.
    • Clin Drug Investig. 2014 Jun 1; 34 (6): 413-20.

    Background And ObjectiveNomegestrol acetate (NOMAC)/17β-estradiol (E2) is a monophasic oral contraceptive that contains a progesterone-derived progestogen (NOMAC), and E2, a bio-identical estrogen. The primary objective of this thorough QT/QTc study was to investigate whether once-daily administration of therapeutic (2.5/1.5 mg) and supratherapeutic (12.5/7.5 mg) doses of NOMAC/E2 were associated with prolongation of the mean Fridericia-corrected QT (QTcF) interval in electrocardiograms at steady-state concentrations of NOMAC/E2 versus placebo. The co-primary objective was to establish assay sensitivity after a single dose of moxifloxacin (positive control).MethodsThis was a randomized, double-blind, parallel-group trial comparing 2.5/1.5 mg of NOMAC/E2 (therapeutic dose), 12.5/7.5 mg of NOMAC/E2 (supratherapeutic dose), placebo, and moxifloxacin 400 mg. Double-blind study medication was administered from day -1 to 14. Healthy women aged 18-50 years were randomized.ResultsThe largest time-matched mean QTcF difference compared with placebo for the therapeutic dose of NOMAC/E2 was 1.6 ms, with an upper limit (UL) of a one-sided 95% confidence interval (CI) of 5.2 ms, and 3.1 ms with an UL 95% CI of 7.0 ms for the supratherapeutic dose. The UL for the time-matched QTcF differences compared with placebo were below the 10 ms threshold defined in the ICH E14 guideline for all time points, both for the therapeutic and the supratherapeutic dose. For moxifloxacin, assay sensitivity was demonstrated.ConclusionsThis thorough QT/QTc study showed that therapeutic and supratherapeutic doses of NOMAC/E2 were not associated with clinically relevant QTc interval prolongation in healthy women after a 2-week period of dosing.

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