TherapeuticsMD, Inc. (NYSE MKT: TXMD) - Pharmacokinetic study being presented tomorrow evening in a poster session at The North American Menopause Society 2013 Annual Meeting in Dallas suggests that the first combination 17β-estradiol and progesterone capsule in clinical development may have overcome the well-recognized difficulties of achieving good bioavailability with oral administration of these hormones in combination.
In a study of 66 healthy postmenopausal women, bioavailability of TX 12-001-HR, a capsule containing both 17β-estradiol and progesterone for oral use being developed by TherapeuticsMD, Inc., was found to be similar to that of the standard reference products for the human hormones estradiol (Estrace ®) and progesterone (Prometrium ®), when taken concurrently. Hormone therapy is widely used to alleviate the symptoms of menopause and to reduce the health risks resulting from hormone deficiencies associated with menopause.
“It has been notoriously difficult to combine these two body-identical hormones and obtain consistently good bioavailability. And, when compounding pharmacies create specialized blends of these hormones, there is a great deal of variability in what is produced,” according to James H. Pickar, M.D., Adjunct Associate Professor of Obstetrics and Gynecology, Columbia University College of Physicians & Surgeons in New York, who presented the study findings. In two FDA surveys of compounding pharmacies, the amount of hormone found in the compounded products was not the amount claimed in approximately 34% of compounded products sampled and in 29% of hormone samples, versus the <2% variability found for commercially manufactured products. 1,2
In this study, bioequivalence criteria were met for all analytes, except C max for total estrone. The extent of absorption of the estradiol and progesterone in the Test capsule was similar to that for Estrace and Prometrium, while the rate of estradiol absorption for the Test capsule appeared to be slightly faster than for the Estrace reference.“The similarity in bioavailability of progesterone and estradiol in the test product to that of the two reference products suggests that the safety profile also should be similar,” Dr. Pickar said. Studies suggest that products more closely resembling the human hormones progesterone and estradiol may have a more favorable safety profile than synthetic hormones. 3,4 Dr. Pickar also noted that this investigational therapy offers the additional advantage of avoiding use of the known allergen, peanut oil, which is used in Prometrium and its generic equivalents. The need to ensure adequate bioavailability is critical for progesterone, which protects the endometrium from estrogen stimulation. “When progesterone levels are inadequate, women taking estrogen are put at unnecessary risk for uterine cancer,” added Dr. Pickar.