Evidence map›Paper›PMID 34157312›Full record

Trial reportContraception2021

Pharmacodynamics and pharmacokinetics of a copper intrauterine contraceptive system releasing ulipristal acetate: A randomized proof-of-concept study.

Vivian Brache, Carolina Sales Vieira, Marlena Plagianos, Maud Lansiaux, Ruth Merkatz, Heather Sussman, Leila Cochon, Ana S Tejada, Narender Kumar, Daniel Loeven and 6 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Contraception, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 5 countries.

Vivian BracheInvestigaciones Biomédicas de Profamilia, Clínica Profamilia. Santo Domingo, Dominican Republic.
Carolina Sales VieiraDepartment of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. Electronic address: carol.sales@uol.com.br.
Marlena PlagianosPopulation Council, New York City, NY, United States.
Maud LansiauxPopulation Council, New York City, NY, United States.
Ruth MerkatzPopulation Council, New York City, NY, United States.
Heather SussmanPopulation Council, New York City, NY, United States.
Leila CochonInvestigaciones Biomédicas de Profamilia, Clínica Profamilia. Santo Domingo, Dominican Republic.
Ana S TejadaInvestigaciones Biomédicas de Profamilia, Clínica Profamilia. Santo Domingo, Dominican Republic.
Narender KumarPopulation Council, New York City, NY, United States.
Daniel LoevenPopulation Council, New York City, NY, United States.
Diana L BlitheContraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.
Abi Santhosh ApremHLL LifeCare, Thiruvananthapuram, India.
Alistair Rw WilliamsDepartment of Pathology, The University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh.
Athilakshmi KannanUniversity of Illinois at Urbana-Champaign, Urbana, IL, United States.
Indrani C BagchiUniversity of Illinois at Urbana-Champaign, Urbana, IL, United States.
Regine Sitruk-WarePopulation Council, New York City, NY, United States.
Population Council · USProfamilia · DOUniversity of Illinois Urbana-Champaign · USEdinburgh Royal Infirmary · GBHLL Lifecare (India) · INNational Institutes of Health · USUniversidade de Ribeirão Preto · BR

Funding

SPECIALIZED CONTRACEPTIVE DEVELOPMENT RESEARCH CENTERU54HD029990 · NICHD · POPULATION COUNCIL · PI KUMAR, NARENDER · 1992 to 2016
$27.7M
Development of novel contraceptive methods for men and womenZIBHD008987 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI BLITHE, DIANA · 2019 to 2025
$7.2M
Intramural NIH HHS ZIB HD008987NICHD NIH HHS U54 HD029990
6 · The paper itself

Abstract

objectivesTo assess pharmacodynamic and pharmacokinetic outcomes of a novel copper (Cu) intrauterine system (IUS) releasing ulipristal acetate (UPA) in healthy women. STUDY

designIn this single-blinded, randomized proof-of-concept study, ovulatory women received one of three Cu-IUSs releasing low-dose UPA (5, 20 or 40 µg/d) for 12 weeks. The study included a baseline cycle, three 4-week treatment-cycles and 2 recovery cycles. Primary outcomes included effects of the IUS on bleeding profile, ovarian function, and the occurrence of progesterone receptor modulator associated endometrial changes (PAEC). Pharmacokinetics and safety profile were secondary outcomes. We compared outcomes in treatment-cycle 3 with baseline, using generalized linear mixed models with orthogonal contrasts.

resultsWe randomized 29 women (5 µg/d = 10, 20 µg/d = 10, 40 µg/d = 9). All had a successful IUS insertion; 27 completed the 12-week treatment period. Compared to baseline, the mean number of bleeding-only days at treatment-cycle 3 declined by 16.7% in the 5 µg/d group (3.6 vs 3.0, p = 0.66), 40.5% in the 20 µg/d group (4.2 vs 2.5, p = 0.14), and 77% in the 40 µg/d group (3.9 vs 0.9, p = 0.002). Most women reported reduction in the amount of bleeding: 4/8, 8/10, and 7/9 for the 5 µg/d, 20 µg/d, and 40 µg/d groups, respectively. During IUS use, ovulation occurred in most cycles [5 µg/d: 23/24 (96%), 20 µg/d: 26/30 (87%), 40 µg/d: 22/27 (81%)]. The frequency of PAEC at IUS removal was 1/10 (10%), 1/10 (10%) and 4/9 (44%) in the 5 µg/d, 20 µg/d, and 4 0 µg/d groups, respectively. No serious adverse events occurred.

conclusionsReduction in bleeding, low incidence of PAEC, and no serious adverse events are reassuring findings of the novel Cu-UPA-IUS. The 20 µg/d seems the lowest dose promoting a favorable bleeding profile and limiting PAEC. IMPLICATIONS: The preliminary results of this short-term study of a novel copper intrauterine system (IUS) delivering ulipristal acetate showed reduction of bleeding, low incidence of progesterone receptor modulator associated endometrial changes, and absence of serious adverse events. By preventing copper-induced increase in bleeding, this IUS could provide a noncontraceptive benefit, especially for women with low hemoglobin.

Indexed as

Contraceptive Agents, FemaleIntrauterine Devices, MedicatedNorpregnadienesFemaleHumansLevonorgestrelContraceptive Agents, FemaleLevonorgestrelNorpregnadienesulipristal acetateBleeding profileCopper intrauterine devicePharmacokineticProgesterone receptor modulator associated endometrial changesUlipristal acetate

Identifiers

PMID34157312
PMCPMC8434982
OpenAlexW3176273937

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.