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NOMAC-E2

Phase 3

Contraception | Small molecule | Other |Organon & Co.|Last Updated: Feb 16, 2022

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDBiomarker
Total Trials6
Total Enrollment4,901
FDA Designations
No designations recorded
Clinical Trials (6)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00511355Effects on Hemostasis, Lipids, Carbohydrate Metabolism, Adrenal & Thyroid Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG-EE (292004)(COMPLETED)(P05764)PHASE3 COMPLETED 121Oct 1, 2006Jan 1, 2008Feb 9, 2022 -
NCT00511433Effects on Ovarian Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing DRSP/EE (292003)(COMPLETED)(P05723)PHASE3 COMPLETED 48Oct 1, 2006Jan 1, 2008Feb 9, 2022 -
NCT00511342Effects on Bone Mineral Density (BMD) of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG/EE (292005)(P05765)(COMPLETED)PHASE3 COMPLETED 110Sep 1, 2006Jun 1, 2009Feb 9, 2022 -
NCT00413062Efficacy and Safety Study of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing DRSP/EE (292002)(P05722)PHASE3 COMPLETED 2,281Jun 1, 2006Aug 1, 2008Feb 9, 2022 -
NCT00511199Efficacy and Safety of the Combined Oral Contraceptive (COC) NOMAC-E2 Compared to a COC Containing DRSP/EE (292001)(COMPLETED)(P05724)PHASE3 COMPLETED 2,152May 1, 2006Apr 1, 2008Feb 9, 2022 -
NCT00779532Thorough QT/QTc Study of Multiple Oral Doses of NOMAC-E2 (Org 10486 0 + Org 2317) in Healthy Women (Study 292011)(P05802)PHASE1 COMPLETED 189May 1, 2008Nov 1, 2008Feb 16, 2022 -
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Study Endpoints
Primary Endpoints
Serum Concentration of Prothrombin Fragments 1 + 2
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of D-Dimer
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Activated Protein C (APC) Resistance Ratio (Endogenous Thrombin Potential [ETP]-Based)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). APC resistance ratio (ETP-based) measures the anticoagulation response of plasma to APC after activation of the extrinsic coagulation pathway. An increase in the ratio indicates a reduced responsiveness to APC. Each cycle consists of 28 days.

Serum Concentration of Clotting Factor VIIa
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Clotting Factor VIIc
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Clotting Factor VIII
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Clotting Factor II
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Antithrombin III
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Protein S (Free)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Protein S (Total)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Protein C
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

APC Resistance Ratio (Activated Partial Thromboplastin Time [APTT]-Based)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). APC resistance ratio (APTT-based) measures the anticoagulation response of plasma to APC after activation of the intrinsic coagulation pathway. An increase in the ratio indicates a increased responsiveness to APC. Each cycle consists of 28 days.

Serum Concentration of Sex Hormone Binding Globulin (SHBG)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of C-Reactive Protein (CRP)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Total Cholesterol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of High Density Lipoprotein (HDL)-Cholesterol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of HDL2-cholesterol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of HDL3-cholesterol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Low Density Lipoprotein (LDL)-Cholesterol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Apolipoprotein A-1
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Apolipoprotein B
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Lipoprotein(a)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Total Triglycerides
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Area Under the Curve Over 3 Hours (AUC3) for Glucose (Oral Glucose Tolerance Test [OGTT])
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Blood glucose levels were determined as fasting values just before oral glucose intake and each half hour thereafter for 2 hours and again after 3 hours. Oral glucose tolerance was analysed using the (unadjusted) area under the curve over the 3 hours (AUC3). Each cycle consists of 28 days.

Incremental AUC3 for Glucose (OGTT)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Blood glucose levels were determined as fasting values just before oral glucose intake and each half hour thereafter for 2 hours and again after 3 hours. Oral glucose tolerance was analysed using the (unadjusted) area under the curve over the 3 hours (AUC3). Incremental area under the curve was defined as incremental AUC3 = AUC3 - 3\*fasting concentration. Each cycle consists of 28 days.

AUC3 for Insulin (OGTT)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Blood insulin levels were determined as fasting values just before oral glucose intake and each half hour thereafter for 2 hours and again after 3 hours. Oral glucose tolerance was analysed using the (unadjusted) area under the curve over the 3 hours (AUC3). Each cycle consists of 28 days.

Incremental AUC3 for Insulin (OGTT)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Blood insulin levels were determined as fasting values just before oral glucose intake and each half hour thereafter for 2 hours and again after 3 hours. Oral glucose tolerance was analysed using the (unadjusted) area under the curve over the 3 hours (AUC3). Incremental area under the curve was defined as incremental AUC3 = AUC3 - 3\*fasting concentration. Each cycle consists of 28 days.

Serum Concentration of Hemoglobin Type A1c (HbA1c)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). HbA1c was determined before glucose loading. Each cycle consists of 28 days.

Serum Concentration of Total Cortisol
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Corticosteroid Binding Globulin (CBG)
Baseline to Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Thyroid Stimulating Hormone (TSH)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Free Thyroxine (T4)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Serum Concentration of Thyroxin Binding Globulin (TBG)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)

Serum samples were obtained under fasting conditions (no food or alcoholic beverages within 12 hours of serum sampling). Each cycle consists of 28 days.

Effect on Ovarian Function as Determined by the Number of Participants With an Occurrence of Ovulation
Cycle 1, Cycle 2, and Cycle 6

During treatment, ovulation was assessed for each participant by the investigator on the basis of ultrasound scanning (USS). The final analysis was based on assessor-blind adjudication.

Effect on Ovarian Function as Determined by the Maximum Follicle Diameter
Screening cycle, Cycle 1, Cycle 2, Cycle 3, and Cycle 6

The maximum follicular diameter was defined as the largest follicular diameter during a treatment cycle.

Effect on Ovarian Function as Determined by the Maximum Progesterone Value
Screening cycle, Cycle 1, Cycle 2, Cycle 3, and Cycle 6

The maximum progesterone value was defined as the largest value during a cycle.

Effect on Ovarian Function as Determined by 17 Beta-estradiol (E2)
Cycle 1, Cycle 2, Cycle 3, and Cycle 6

The parameter was measured at pre-defined study days.

Effect on Ovarian Function as Determined by Follicle Stimulating Hormone (FSH)
Cycle 1, Cycle 2, Cycle 3, and Cycle 6

The parameter was measured at pre-defined study days.

Effect on Ovarian Function as Determined by Luteinizing Hormone (LH)
Cycle 1, Cycle 2, Cycle 3, and Cycle 6

The parameter was measured at pre-defined study days.

Mean Change From Baseline in Z-scores of the Lumbar Spine (L2-L4) and Femoral Neck
Baseline and after cycle 26 (2 years)

BMD was measured by a Dual Energy X-ray Absorptiometry (DEXA) machine. The Z-score measures the distance of the measured BMD value from the appropriate normal age matched population mean value in units of standard deviation of this population. More negative scores indicate less BMD compared to age matched population, \& more positive scores indicate higher BMD compared to age matched population. The adjusted mean change from baseline to the after Cycle 26 visit of the Z-scores is estimated using a baseline-adjusted analysis of covariance (ANCOVA).

Number of In-treatment Pregnancies (With +2 Day Window) Per 100 Woman Years of Exposure (Pearl Index)
1 year (13 cycles)

In-treatment pregnancies were pregnancies with an estimated date of conception from the day of first intake of trial medication up to and including the day of last (active or placebo) intake of trial medication extended with a maximum of two days. Each 13 cycles (28 days per cycle) of exposure constitutes a woman year. The Pearl Index was obtained by dividing the number of in-treatment pregnancies that occurred by the time (in 100 women years) that the women were under risk of becoming pregnant.

Number of In-treatment Pregnancies (With +14 Day Window) Per 100 Woman Years of Exposure (Pearl Index)
1 year (13 cycles)

In-treatment pregnancies were pregnancies with an estimated date of conception from the day of first intake of trial medication up to and including the day of last (active or placebo) intake of trial medication extended with a period of 14 days. Each 13 cycles (28 days per cycle) of exposure constitutes a woman year. The Pearl Index was obtained by dividing the number of in-treatment pregnancies that occurred by the time (in 100 women years) that the women were under risk of becoming pregnant.

Investigate whether once daily multiple therapeutic and supra-therapeutic doses of NOMAC-E2 prolong the mean QTcF interval at steady state to the threshold of regulatory concern compared to placebo
16 days
Establish assay sensitivity after single dose of 400 mg moxifloxacin
16 days
Secondary Endpoints
Serum Concentration of Total Testosterone
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)
Serum Concentration of Free Testosterone
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)
Serum Concentration of Dehydroepiandrosterone Sulphate (DHEAS)
Baseline and Cycle 6 (between Days 15 and 21 of the cycle)
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposePREVENTION
Treatment Arms
ArmTypeDescription
NOMAC-E2EXPERIMENTALNomegestrol Acetate (NOMAC) and Estradiol (E2), 2.5 mg NOMAC and 1.5 mg E2 monophasic combined oral contraceptive
LNG-EEACTIVE_COMPARATORLevonorgestrel and Ethinyl Estradiol Tablets (LNG-EE), 150 mcg LNG and 30 mcg EE
DRSP-EEACTIVE_COMPARATORDrospirenone (DRSP) and Ethinyl Estradiol (EE), 3 mg DRSP and 30 mcg EE monophasic combined oral contraceptive
Group AACTIVE_COMPARATOROnce daily intake (orally) of 5 NOMAC-E2 placebo tablets from Day -1 to Day 14. Once daily intake (orally) of one moxifloxacin placebo capsule at Day -1. Once daily intake (orally) of one moxifloxacin capsule of 400 mg at Day 14.
Group BEXPERIMENTALOnce daily intake (orally) of 4 NOMAC-E2 placebo tablets and 1 NOMAC-E2 (2.5/1.5 mg) tablet from Day 1 to Day 14. Once daily intake (orally) of 5 NOMAC-E2 placebo tablets and 1 moxifloxacin placebo capsule at Day -1. Once daily intake (orally) of 1 moxifloxacin placebo capsule at Day 14.
Group CEXPERIMENTALOnce daily intake (orally) of 5 NOMAC-E2 (2.5/1.5 mg) tablets from Day 1 to Day 14. Once daily intake (orally) of 5 NOMAC-E2 placebo tablets and 1 moxifloxacin placebo capsule at Day -1. Once daily intake (orally) of 1 moxifloxacin placebo capsule at Day 14
Group DPLACEBO_COMPARATOROnce daily intake (orally) of 5 NOMAC-E2 placebo tablets from Day -1 to Day 14. Once daily intake (orally) of 1 moxifloxacin placebo capsule at Days -1 and 14.
Interventions
NameTypeDescription
NOMAC-E2DRUGNomegestrol Acetate and Estradiol (NOMAC-E2) Tablets, 2.5 mg NOMAC and 1.5 mg E2 taken once daily from Day 1 of menstrual period up to and including Day 28 for 6 consecutive 28-day cycles.
Levonorgestrel and Ethinyl EstradiolDRUGLevonorgestrel and Ethinyl Estradiol (LNG-EE) Tablets, 150 mcg LNG and 30 mcg EE taken once daily from Day 1 of menstrual period up to and including Day 28 for 6 consecutive 28-day cycles.
DRSP-EEDRUGDrospirenone and Ethinyl Estradiol Tablets, 3 mg DRSP and 30 mcg EE taken once daily from Day 1 of menstrual period up to and including Day 28 for 6 consecutive 28-day menstrual cycles.
LNG-EEDRUGLevonorgestrel and Ethinyl Estradiol Tablets, 0.150 mg Levonorgestrel and 0.030 mg Ethinyl Estradiol taken once daily from Day 1 of menstrual period up to and including Day 28 for 26 consecutive 28-day menstrual cycles (2 years).
MoxifloxacinDRUGCapsules containing 400 mg moxifloxacin, on Day 14 only
NOMAC-E2 (Org 10486-0 + Org 2317)DRUGTablets containing 2.5 mg NOMAC and 1.5 mg E2, once daily dosing, orally taken. Daily dose either NOMAC-E2 2.5/1.5 mg or 12.5/7.5 mg.
Moxifloxacin placeboDRUGMoxifloxacin-placebo capsule taken orally, Day -1 and Day 14 only
NOMAC-E2 placeboDRUGTablets containing NOMAC-E2 placebo, once daily dosing, orally taken.
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Eligibility Criteria
Age Range18 Years — 50 Years
SexFEMALE
Healthy VolunteersYes

Inclusion Criteria: * Sexually active women, at risk for pregnancy and not planning to use during trial medication use; * Women in need for contraception and willing to use an oral contraceptive (OC) for 6 months (6 cycles); * At least 18 but not older than 50 years of age at the time of screening;...

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