December 01, 2018
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Clinical trial will investigate contraceptive gel for men

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A clinical trial funded by the National Institutes of Health will evaluate a male contraceptive gel for its ability to prevent pregnancy, according to a press release from the institution.

The gel formulation was developed by the Population Council and NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The Population Council will collaborate with NIH to conduct the study in NICHD’s Contraceptive Clinical Trials Network.

“Many women cannot use hormonal contraception and male contraceptive methods are limited to vasectomy and condoms,” Diana Blithe, PhD, chief of NICHD’s Contraceptive Development Program, said in the release. “A safe, highly effective and reversible method of male contraception would fill an important public health need.”

The gel formulation, called NES/T, includes the progestin compound segesterone acetate (brand name Nestorone), in combination with testosterone. It is applied to the back and shoulders and absorbed through the skin. The progestin blocks natural testosterone production in the testes, reducing sperm production to low or nonexistent levels. The replacement testosterone maintains normal sex drive and other functions that are dependent on adequate blood levels of the hormone.

Researchers plan to enroll approximately 420 couples into the study, according to the release. Men will use the NES/T gel daily for 4 to 12 weeks to determine whether they tolerate the formulation and to ensure they do not experience unacceptable side effects. If sperm levels have not adequately declined, they will continue to use the formulation for up to 16 weeks. Once their sperm levels have declined to a threshold sufficient for contraception, they will enter the efficacy phase, which will evaluate the ability of the formulation to prevent pregnancy. This phase will last for 52 weeks, and the couple will rely on the male partner’s application of the gel as the sole method of contraception.

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Men will remain in the study for observation for an additional 24 weeks after they discontinue the formulation, according to the release.

The study will be conducted at two sites of NICHD’s Contraceptive Clinical Trials Network:

The Los Angeles Biomedical Institute and University of California Los Angeles Medical Center.

As Endocrine Today reported in March, at least four hormonal and two nonhormonal contraceptives for use by men are in the clinical pathway, with first-in-man studies begun or completed, and testing for safety, effectiveness and reversibility underway. In a presentation on the topic at ENDO 2018, Blithe said the topical gel has been shown to fully suppress sperm production in 90% of trial participants by 12 weeks of daily use and is fully reversible.

Two agents are also under investigation as possible contraceptive pills or capsules for men, she said. – by Regina Schaffer