THE WOODLANDS, Texas, Oct 06, 2009 (BUSINESS WIRE) -- Repros Therapeutics Inc.
(NasdaqGM:RPRX) today announced results from an exploratory, efficacy and safety
study of its oral investigational product, enclomiphene citrate (Androxal(R)),
in men with secondary hypogonadism who were receiving testosterone replacement
treatment. Secondary hypogonadism is a deficiency state in which the male
hormone testosterone goes below the normal range, even in aging men, due to
inadequate stimulation of the testes by the pituitary. The study was designed to
compare Androxal to Testim(R)1% (Auxilium Pharmaceuticals Inc, Malvern, PA), an
approved topical testosterone gel, indicated for testosterone replacement
therapy in adult males for conditions associated with a deficiency or absence of
endogenous testosterone. Transdermal testosterone use has been associated with
suppression of pituitary gonadotrophic hormones, luteinizing hormone (LH) and
follicle stimulating hormone (FSH), both necessary for stimulating testosterone
production and spermatogenesis in the testes. Androxal is an oral therapy
intended to restore normal brain-pituitary-testes interaction and thus
testicular function in men with secondary hypogonadism.
Study Design
This small trial was designed as a two-center, three-arm, randomized,
open-label, fixed dose, active-control, proof-of-principle study in men between
46 and 51 years of age who were treated previously with a topical testosterone
gel. Upon qualifying for study participation, and after a three-week wash-out
period the men were randomized to one or the other of the first two treatment
arms. A third arm was added after the first two arms were fully recruited:
-- 3 week wash-out followed by 25 mg Androxal daily for 6 months (Group A);
-- 3 week wash-out followed by daily Testim 1% gel for 6 months (Group B);
-- 3 months wash-out followed by 25 mg Androxal daily for 6 months (Group C).
All treatments were followed by a 1-month post-treatment follow-up period. Key
study parameters were concentrations of serum total testosterone (TT), LH and
FSH as well as sperm counts at 3 and 6 months of treatment.
Study Results
Group A vs. B: 7 men were randomized to Androxal and 5 men to Testim. After
stopping their previous topical testosterone treatment for 3 weeks, the study
subjects had baseline morning mean TT values of 165 ± 66 ng/dL, confirming their
hypogonadal state. At 3 and 6 months of treatment, there was a statistically
significant increase in mean TT compared with baseline in both treatment groups.
TT was not significantly different between the 2 groups at 3 (p = 0.29) and 6
months (p = 0.90). At 6 months, mean TT levels were 545 ± 269 and 525 ± 256
ng/dL for the men receiving Testim and Androxal, respectively. These values are
well within the normal range (300-1000 ng/dL).
Androxal consistently elevated sperm counts into the normal range after 3 and 6
months of treatment and at follow-up (mean values > 147 x 10(6)/ml; range 75-334
x 10(6)/ml). Testim resulted in sperm counts below 20 x 10(6)/ml (the level
below which a man would be considered infertile) for all 5 men at 3 months. At 6
months, 3 of the 5 Testim treated men remained well below the 20 x 10(6)/ml
level exhibiting little to no detectable sperm count, whereas the other two
showed levels > 20 x 10(6)/ml. The sperm count was statistically significantly
higher in the Androxal than the Testim treated group at 3 (p = 0.004) and 6
months (p = 0.009).
Androxal increased both LH and FSH while men on Testim had significantly lower
levels of these important fertility related hormones. The baseline LH and FSH
levels for men in the study were 1.02 ± 1.44 mIU/ml and 0.99 ± 1.00 mIU/ml,
respectively. These values are at the low end of normal. Androxal stimulated
statistically significant increases in LH and FSH compared to Testim at all time
points. Androxal increased mean LH significantly at 3 months to 5.7 ± 3.2 mIU/ml
(p = 0.013) and to 6.1 ± 3.1 mIU/ml (p = 0.004) at 6 months. The mean FSH levels
for men on Androxal were 4.5 ± 2.4 mIU/ml at 3 months (p = 0.015) and 5.5 ± 2.5
mIU/ml at 6 months (p = 0.003). In contrast, men on Testim had significantly
lower mean levels of these important fertility related hormones, both of which
were in the 0.6 -- 1.06 mIU/ml range across the treatment periods. At one month
follow-up, testosterone levels had decreased to pre-study, hypogonadal level (<
300 ng/dl) for all men in both treatment groups. Upon discontinuation of
treatment, LH and FSH levels in Androxal-treated men decreased and in
Testim-treated men increased back to low normal range.
Group C: 9 men were enrolled in the study arm with a longer, 3 months wash-out
period after discontinuation of treatment with the topical gel. Although the men
showed a normalization of sperm count during this off-treatment study run-in
period, their testosterone levels remained below normal (mean TT 214.00 ± 44.50
ng/dl). Due to lost to follow-up and/or poor adherence by the men to study
visits at month 3 and 6, the Company was not able to collect meaningful data on
the men in this group, which prohibits comparisons with Groups A and B.
Results from Groups A and B show that Androxal significantly increased TT and
sperm counts. The increases in LH and FSH with Androxal have been demonstrated
before in a long term study for over a year in men with secondary hypogonadism
and this study confirms that this is the mechanism by which testosterone levels
can be normalized through endogenous testosterone while fertility is restored.
Overall, treatment with Androxal and Testim was well tolerated in this study,
with few side effects being reported.
Dr. Jed Kaminetsky (Department of Urology, New York University Medical Center),
the lead investigator noted, "Androxal may fill the need for a drug that is able
to restore testicular function and at the same time provide the benefits that
normalization of testosterone provides to hypogonadal men. If Androxal can be
safely developed, it will represent an important new treatment option for men
with secondary hypogonadism with a continued fertility interest."
The Company hopes to submit a request for a meeting to the FDA to determine
whether the Agency deems these observations to be clinically relevant and
whether a development program can be designed to confirm the findings of this
exploratory study, and ultimately support a label for the treatment of secondary
hypogonadism in men who wish to preserve their fertility.
About Repros Therapeutics Inc.
Repros Therapeutics focuses on the development of oral small molecule drugs for
major unmet medical needs that treat male and female reproductive disorders.
Any statements that are not historical facts contained in this release are
forward-looking statements that involve risks and uncertainties, including
Repros' ability to raise needed additional capital in the immediate future in
order for it to continue its operations on acceptable terms or at all, to settle
or otherwise resolve its outstanding liabilities resulting from the Proellex
clinical trials recently put on clinical hold, to successfully defend itself
against the recently-filed class action complaints, to continue to maintain its
listing on any Nasdaq trading market, whether a clear clinical path for Androxal
can be realized, the eventual outcome of the recent discussions and
correspondence with the FDA regarding the Proellex clinical trials currently on
clinical hold and whether clinical trials of Proellex(R) may be resumed, whether
any safe and effective dose for Proellex can be determined, whether the NIH
license for Proellex can be maintained, and such other risks which are
identified in the Company's most recent Annual Report on Form 10-K and in any
subsequent quarterly reports on Form 10-Q. These documents are available on
request from Repros Therapeutics or at www.sec.gov. Repros disclaims any
intention or obligation to update or revise any forward-looking statements,
whether as a result of new information, future events or otherwise.
For more information, please visit the Company's website at
http://www.reprosrx.com.
SOURCE: Repros Therapeutics Inc.
CONTACT:
Repros Therapeutics Inc.
Chief Executive Officer
Joseph S. Podolski, 281-719-3447
Copyright Business Wire 2009
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