The clinical relevance of the effect of ospemifene on symptoms of vulvar and vaginal atrophy

Climacteric. 2015 Apr;18(2):233-40. doi: 10.3109/13697137.2014.975199. Epub 2014 Dec 16.

Abstract

Objectives: To explore clinically relevant differences in severity of vulvar and vaginal atrophy (VVA) in postmenopausal women treated with ospemifene compared with placebo.

Methods: Analysis of two multicenter, randomized, double-blind, 12-week phase-III studies in postmenopausal women (40-80 years, with VVA, treated with ospemifene 60 mg/day or placebo (Study 310 and Study 821)). Severity of vaginal dryness and dyspareunia were evaluated using a four-point scoring system and clinically relevant differences between ospemifene and placebo were analyzed and are presented as improvement (reduction in ≥ 1 unit on four-point scoring system), substantial improvement (reduction in 2-3 units on four-point scoring system) and relief (severity score of mild/none after 12 weeks).

Results: In Study 310, significantly more women with a most bothersome symptom of dyspareunia had improvement (68.3% vs. 54.1%; p = 0.0255) or relief (57.5% vs. 41.8%; p = 0.0205) in the severity of dyspareunia from baseline to week 12 with ospemifene compared with placebo. For those with a most bothersome symptom of vaginal dryness, significantly more experienced improvement (74.6% vs. 57.7%; p = 0.0101), substantial improvement (42.4% vs. 26.9%; p = 0.0172) and relief (66.1% vs. 49.0%; p = 0.0140) of vaginal dryness from baseline to week 12 with ospemifene compared with placebo. Proportions of women with improvement/substantial improvement/relief of symptoms of vaginal dryness or dyspareunia were similar in Study 821. Clinically relevant differences were noticeable by week 4.

Conclusions: Treatment with ospemifene was consistently associated with greater improvement, substantial improvement or relief in the severity of the most bothersome symptoms of vaginal dryness or dyspareunia compared with placebo.

Keywords: DYSPAREUNIA; OSPEMIFENE; RANDOMIZED CLINICAL TRIALS; VAGINAL DRYNESS; VULVAR AND VAGINAL ATROPHY.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrophy
  • Double-Blind Method
  • Dyspareunia / drug therapy*
  • Dyspareunia / etiology
  • Female
  • Humans
  • Middle Aged
  • Placebos
  • Selective Estrogen Receptor Modulators*
  • Tamoxifen / analogs & derivatives*
  • Tamoxifen / therapeutic use
  • Treatment Outcome
  • Vagina / pathology*
  • Vaginal Diseases / drug therapy
  • Vulva / pathology*

Substances

  • Placebos
  • Selective Estrogen Receptor Modulators
  • Tamoxifen
  • Ospemifene