Continued efficacy and safety of flibanserin in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD)

Results from a randomized withdrawal trial

Evan R. Goldfischer, Jeffery Breaux, Molly Katz, Joel Kaufman, William Smith, Toshio Kimura, Michael Sand, Rob Pyke

Research output: Contribution to journalArticle

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Abstract

Introduction. Flibanserin is a 5-HT1A agonist/5-HT2A antagonist that has been shown to increase sexual desire and reduce distress in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD). Aim. To assess the efficacy and safety of flibanserin over 24 weeks of double-blind treatment vs. placebo in premenopausal women with HSDD who showed a predefined response after 24 weeks of open-label treatment with flibanserin. Methods. Women (N=738) were treated with open-label, flexible-dose flibanserin (50mg or 100mg/day) for 24 weeks. At week 24, women who showed a predefined response, measured using an eDiary, were randomized to 24 weeks of continued flibanserin therapy at optimized dosage (N=163) or placebo (N=170). The criteria for entering the double-blind phase were an increase from baseline to weeks 21-24 of ≥2 satisfying sexual events (SSE) and/or ≥4 "desire days." A "desire day" was one in which a woman reported more than "no" desire. Main Outcome Measures. Coprimary endpoints were change from randomization to study end in SSE and desire score. Secondary measures included change in Female Sexual Function Index (FSFI) total and desire domain scores and Female Sexual Distress Scale-Revised (FSDS-R) total and Item 13 scores. Results. During the open-label period, mean SSE and desire score approximately doubled, and FSFI, FSDS-R total, and Item 13 scores improved. At the end of the double-blind period, flibanserin was superior to placebo in change from randomization in SSE, desire score, FSFI desire domain and total scores, and FSDS-R total and Item 13 scores (P<0.05, for all). Flibanserin was well tolerated, and withdrawal reactions were not observed. Conclusions. At the end of the 24-week randomized withdrawal phase of a 48-week trial in premenopausal women with HSDD, flibanserin was superior to placebo on measures of SSE, sexual desire, overall sexual function, and sexual distress. Flibanserin was well tolerated, and no withdrawal reactions were observed following discontinuation.

Original languageEnglish (US)
Pages (from-to)3160-3172
Number of pages13
JournalJournal of Sexual Medicine
Volume8
Issue number11
DOIs
StatePublished - Jan 1 2011

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Psychological Sexual Dysfunctions
Safety
Placebos
Random Allocation
Serotonin 5-HT1 Receptor Agonists
Serotonin 5-HT2 Receptor Antagonists
flibanserin
Therapeutics
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

Cite this

Continued efficacy and safety of flibanserin in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD) : Results from a randomized withdrawal trial. / Goldfischer, Evan R.; Breaux, Jeffery; Katz, Molly; Kaufman, Joel; Smith, William; Kimura, Toshio; Sand, Michael; Pyke, Rob.

In: Journal of Sexual Medicine, Vol. 8, No. 11, 01.01.2011, p. 3160-3172.

Research output: Contribution to journalArticle

Goldfischer, Evan R. ; Breaux, Jeffery ; Katz, Molly ; Kaufman, Joel ; Smith, William ; Kimura, Toshio ; Sand, Michael ; Pyke, Rob. / Continued efficacy and safety of flibanserin in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD) : Results from a randomized withdrawal trial. In: Journal of Sexual Medicine. 2011 ; Vol. 8, No. 11. pp. 3160-3172.
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T2 - Results from a randomized withdrawal trial

AU - Goldfischer, Evan R.

AU - Breaux, Jeffery

AU - Katz, Molly

AU - Kaufman, Joel

AU - Smith, William

AU - Kimura, Toshio

AU - Sand, Michael

AU - Pyke, Rob

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N2 - Introduction. Flibanserin is a 5-HT1A agonist/5-HT2A antagonist that has been shown to increase sexual desire and reduce distress in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD). Aim. To assess the efficacy and safety of flibanserin over 24 weeks of double-blind treatment vs. placebo in premenopausal women with HSDD who showed a predefined response after 24 weeks of open-label treatment with flibanserin. Methods. Women (N=738) were treated with open-label, flexible-dose flibanserin (50mg or 100mg/day) for 24 weeks. At week 24, women who showed a predefined response, measured using an eDiary, were randomized to 24 weeks of continued flibanserin therapy at optimized dosage (N=163) or placebo (N=170). The criteria for entering the double-blind phase were an increase from baseline to weeks 21-24 of ≥2 satisfying sexual events (SSE) and/or ≥4 "desire days." A "desire day" was one in which a woman reported more than "no" desire. Main Outcome Measures. Coprimary endpoints were change from randomization to study end in SSE and desire score. Secondary measures included change in Female Sexual Function Index (FSFI) total and desire domain scores and Female Sexual Distress Scale-Revised (FSDS-R) total and Item 13 scores. Results. During the open-label period, mean SSE and desire score approximately doubled, and FSFI, FSDS-R total, and Item 13 scores improved. At the end of the double-blind period, flibanserin was superior to placebo in change from randomization in SSE, desire score, FSFI desire domain and total scores, and FSDS-R total and Item 13 scores (P<0.05, for all). Flibanserin was well tolerated, and withdrawal reactions were not observed. Conclusions. At the end of the 24-week randomized withdrawal phase of a 48-week trial in premenopausal women with HSDD, flibanserin was superior to placebo on measures of SSE, sexual desire, overall sexual function, and sexual distress. Flibanserin was well tolerated, and no withdrawal reactions were observed following discontinuation.

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