Zarema Barakhoeva1, Lyudmila Vovk2, Yulia Fetisova2, Nina Marilova2, Maria Ovchinnikova3, Marina Tischenko3, Yulia Scherbatyuk3, Alexandra Kolotovkina3, Anna Miskun3, Galina Kasyanova3, Tatyana Teterina1, Irina Zorina1, Nadezhda Belousova1, Ekaterina Morozova2, Sergey Yakovenko4, Valentina Apryshko1, Lali Sichinava5, Raisa Shalinа6, Mikhail Polzikov7. 1. "AltraVita" Human Reproduction Clinic, Moscow, Russia. 2. Perinatal Medical Center, "Mother and Child" group of companies, Moscow, Russia. 3. Lapino Clinical Hospital, "Mother and Child" group of companies, Moscow, Russia. 4. "AltraVita" Human Reproduction Clinic, Moscow, Russia; Lomonosov Moscow State University, Moscow, Russia. 5. Perinatal Medical Center, "Mother and Child" group of companies, Moscow, Russia; Russian National Research Medical University named after N.I. Pirogov, Health Ministry of the Russian Federation, Moscow, Russia; Moscow Center for Family Planning and Reproduction, Moscow Healthcare Department, Moscow, Russia. 6. Lapino Clinical Hospital, "Mother and Child" group of companies, Moscow, Russia; Russian National Research Medical University named after N.I. Pirogov, Health Ministry of the Russian Federation, Moscow, Russia; Moscow Center for Family Planning and Reproduction, Moscow Healthcare Department, Moscow, Russia. 7. IVFarma LLC, Moscow, Russia. Electronic address: mikhail.polzikov@gmail.com.
Abstract
OBJECTIVE: The aim of the present study was to investigate the therapeutic equivalence between the follitropin alpha biosimilar and the reference medication in women undergoing assisted reproductive technologies (ART). STUDY DESIGN: This multicenter, randomized (1:1), embryologist-blinded, parallel-group, comparative phase III study involved 110 women aged 20-35 years old with tubal and/or male factors of infertility. All of the subjects underwent controlled ovarian hyperstimulation (COH) using agonadotropin-releasing hormone antagonist (GnRH-ant) protocol. Over the 5-day fixed-dose regimen, the women received 150 IU/day of follitropin alpha biosimilar (n = 55) or original follitropin alpha (n = 55), followed by dose adaptation. The primary endpoint for assessing the therapeutic equivalence was the number of retrieved oocytes using a pre-determined clinical equivalence margin of ± 3.4 oocytes. RESULTS:Similar numbers of oocytes were retrieved in both groups: 12.16 ± 7.28 in the follitropin alpha biosimilar group and 11.62 ± 6.29 in the original follitropin alpha group, with mean difference of 0.546 ± 1.297 oocytes (95% confidence interval [CI]: -2.026, 3.116), p = 0.002 (intention-to-treat [ITT] population). Additionally, no statistically significant differences were found for secondary endpoints: the onset of biochemical (34.7% and 36.7%, p = 0.883), clinical pregnancy (26.5% and 32.7%, p = 0.507), delivery (26.5% and 24.5%, p = 0.817) and take-home baby rate (28.6% and 26.5%, p = 0.816) for the follitropin biosimilar and original follitropin groups (per-protocol [PP] population). Ovarian hyperstimulation syndrome was observed in subjects with a positive pregnancy test in 0% and 3.64% of cases and after triggering ovulation in 7.27% and 3.64% for the follitropin biosimilar and original follitropin groups, respectively. CONCLUSIONS: This study demonstrated similar therapeutic equivalence and safety profiles between the follitropin alpha biosimilar and the reference follitropin in women who underwent COH in GnRH-ant cycles. TRIAL REGISTRATION NUMBER: 1. Name of the registry: ClinicalTrials.gov. TRIAL REGISTRATION NUMBER: NCT03088137. Date of registration: 02.03.2017, retrospectively registered. Trial conducted between 08.02.2017 and 17.08.2018, the date of enrollment of the first participant - 08.02.2017. 2. Name of the registry: Russian Ministry of Health, grls.rosminzdrav.ru. TRIAL REGISTRATION NUMBER: RCT 754. Date of registration: 26.10.2016, prospectively registered.
RCT Entities:
OBJECTIVE: The aim of the present study was to investigate the therapeutic equivalence between the follitropin alpha biosimilar and the reference medication in women undergoing assisted reproductive technologies (ART). STUDY DESIGN: This multicenter, randomized (1:1), embryologist-blinded, parallel-group, comparative phase III study involved 110 women aged 20-35 years old with tubal and/or male factors of infertility. All of the subjects underwent controlled ovarian hyperstimulation (COH) using a gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. Over the 5-day fixed-dose regimen, the women received 150 IU/day of follitropin alpha biosimilar (n = 55) or original follitropin alpha (n = 55), followed by dose adaptation. The primary endpoint for assessing the therapeutic equivalence was the number of retrieved oocytes using a pre-determined clinical equivalence margin of ± 3.4 oocytes. RESULTS: Similar numbers of oocytes were retrieved in both groups: 12.16 ± 7.28 in the follitropin alpha biosimilar group and 11.62 ± 6.29 in the original follitropin alpha group, with mean difference of 0.546 ± 1.297 oocytes (95% confidence interval [CI]: -2.026, 3.116), p = 0.002 (intention-to-treat [ITT] population). Additionally, no statistically significant differences were found for secondary endpoints: the onset of biochemical (34.7% and 36.7%, p = 0.883), clinical pregnancy (26.5% and 32.7%, p = 0.507), delivery (26.5% and 24.5%, p = 0.817) and take-home baby rate (28.6% and 26.5%, p = 0.816) for the follitropin biosimilar and original follitropin groups (per-protocol [PP] population). Ovarian hyperstimulation syndrome was observed in subjects with a positive pregnancy test in 0% and 3.64% of cases and after triggering ovulation in 7.27% and 3.64% for the follitropin biosimilar and original follitropin groups, respectively. CONCLUSIONS: This study demonstrated similar therapeutic equivalence and safety profiles between the follitropin alpha biosimilar and the reference follitropin in women who underwent COH in GnRH-ant cycles. TRIAL REGISTRATION NUMBER: 1. Name of the registry: ClinicalTrials.gov. TRIAL REGISTRATION NUMBER: NCT03088137. Date of registration: 02.03.2017, retrospectively registered. Trial conducted between 08.02.2017 and 17.08.2018, the date of enrollment of the first participant - 08.02.2017. 2. Name of the registry: Russian Ministry of Health, grls.rosminzdrav.ru. TRIAL REGISTRATION NUMBER: RCT 754. Date of registration: 26.10.2016, prospectively registered.
Authors: Sigal Kaplan; Rachel Levy-Toledano; Miranda Davies; Debabrata Roy; Colin M Howles; Amir Lass Journal: Front Endocrinol (Lausanne) Date: 2021-03-16 Impact factor: 5.555
Authors: Su Jen Chua; Ben W Mol; Salvatore Longobardi; Raoul Orvieto; Christos A Venetis; Monica Lispi; Ashleigh Storr; Thomas D'Hooghe Journal: Reprod Biol Endocrinol Date: 2021-04-02 Impact factor: 5.211