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Active, Not Recruiting

NCT Number: NCT05174884

Casea S Contraceptive Implants (Casea S) Trial

This is a single-center, two-part, Phase 1 study to evaluate the pharmacokinetics (PK) of ENG, removability, safety, and tolerability of Casea S pellets inserted subdermally in healthy women of reproductive age. The goal is to select for further investigation a dose of Casea S that is both safe and has a PK profile consistent with contraceptive protection for at least 78 weeks.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Age range

18 year–45 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 1

Primary location

Clinica Profamilia

Santo Domingo, DN, 10401, Dominican Republic

About this study

In Part 1 of this study, four women will each have a single Casea S pellet (22.2 mg ENG) inserted into the inner aspect of the non-dominant upper arm after a negative urine pregnancy test. The insertion site and pellet location will be verified, marked, and photographed. ISRs and AEs will be assessed.

In Part 2 of this study, approximately sixteen women will each have two Casea S pellets (44.4 mg ENG) inserted into the inner aspect of the non-dominant upper arm. The insertion site and pellet location will be verified, marked, and photographed. ISRs and AEs will be assessed.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Participants may be included in the study if they meet all of the following criteria:

  • willing and able to provide signed informed consent
  • female between 18 to 45 years of age (inclusive)
  • healthy based on results of medical evaluation including medical history, vital signs, and physical exam
  • has regular menstrual cycle (21 to 35 days)
  • not at risk for pregnancy (i.e., sterilized)
  • has a Body Mass Index (BMI) of 18 to 29.9
  • provides normal mammogram results within the last year before enrollment for women 40 or older
  • is willing and able to comply with all study requirements and return to the investigational site for the follow-up procedures and assessments as specified in this protocol
  • Part 2 participants only: has daily access to a smartphone, tablet, or computer with internet access.

Exclusion criteria

Participants will be excluded from participating in this study if they meet any of the following criteria:

  • has multiple risk factors for cardiovascular disease (e.g., smoking, diabetes, obesity, hypertension, high LDL (low density lipoprotein), or high triglyceride levels)
  • has current or history of ischemic heart disease or cerebrovascular disease
  • has current or previous thromboembolic disorders
  • has systemic lupus erythematosus
  • has rheumatoid arthritis on immunosuppressive therapy
  • has migraine with aura
  • has undiagnosed abnormal vaginal bleeding
  • has known or suspected breast cancer, history of breast cancer or other progestin-sensitive cancer
  • has current or history of cervical cancer
  • has cirrhosis, liver tumors (benign or malignant), or active liver disease
  • has one or more baseline liver function test(s) above the local laboratory's normal range
  • has a hemoglobin <10.5 g/dL
  • has used any injectable contraceptive in the past 6 months
  • has used any of the following medications within 4 weeks before enrollment:
  • any investigational drug
  • prohibited drugs (listed in Section 6.3.3.4.4.1 of the study protocol)
  • oral contraceptives, contraceptive ring, or patch
  • levonorgestrel intrauterine device (LNG IUD) or contraceptive implant
  • is pregnant
  • is currently breastfeeding
  • desires to become pregnant in the subsequent 30 months
  • has been pregnant in last 3 months
  • is using or planning to use prohibited drugs for their intended study duration
  • has abnormal cervical cytology requiring treatment
  • has known sensitivity to ENG
  • plans to move to another location in the next 30 months
  • is participating in any other clinical trial with a biomedical intervention
  • has any condition (social or medical), that in the opinion of the site investigator would make study participation unsafe, would interfere with adherence to the clinical study requirements, or complicate data interpretation

Treatment and study plan

22.2 mg Etonogestrel (ENG)

Drug

Subdermal insertion of a single Casea S pellet (22.2 mg ENG) in healthy female participants

Other names: Casea S

44.4 mg Etonogestrel (ENG)

Drug

Subdermal insertion of two Casea S pellets (44.4 mg ENG) in healthy female participants

Other names: Casea S

Primary outcomes

  1. Maximum observed serum concentration (Cmax)

    Time frame: 12 weeks; 52 weeks; 114 weeks

    Maximum observed serum concentration (Cmax) measured by blood samples collected at multiple timepoints before and after pellet insertion

  2. Time to Cmax (tmax)

    Time frame: 12 weeks; 52 weeks; 114 weeks

    Time to Cmax (tmax) measured by blood samples collected at multiple timepoints before and after pellet insertion

  3. Geometric mean serum ENG concentration

    Time frame: 28 days; 84 days; 114 weeks

    Geometric mean serum ENG concentration at treatment days 28 and 84

  4. Area under concentration time curve (AUC 0-28)

    Time frame: 28 days; 84 days; 154 days; 364 days

    Area under the concentration time curve through days 28 and day 84

  5. Predicted concentration at day 546 and probability of exceeding 90 pg/mL through day 546

    Time frame: 52 weeks

    pharmacokinetics of ENG after subdermal insertion of 2 Casea S pellets

  6. Assessment of the removability of Casea S pellets

    Time frame: up to 26 weeks

    Number and descriptions of incidence of removal complications

  7. Assessment Casea S pellets removability

    Time frame: up to 26 weeks

    Time of the procedure duration of procedure

  8. Ability to completely remove the pellet and ease of removal

    Time frame: up to 26 weeks

    Physician's assessment of the removability of Casea S pellets qualified as "complete removal, partial removal, or not removed" on the study removal assessment.

  9. Time to undetectable ENG levels

    Time frame: 114 weeks

    Apparent absorption half-life; Predicted concentration at day 546 and probability of exceeding 90 pg/mL through day 546; Time above 90 pg/mL

Secondary outcomes

  1. Occurrence of treatment emergent adverse events, significant changes in vital signs, weight, vaginal bleeding patterns and perceptions, abnormalities in serum chemistry, occurrence of implant site reactions

    Time frame: up to 114 weeks

    Safety and tolerability of Casea S pellets measured by the occurrence of treatment emergent adverse events, significant changes in vital signs, weight, vaginal bleeding patterns and perceptions, abnormalities in serum chemistry, occurrence of implant site reactions

  2. Assessment of the ease of insertion of Casea S pellets

    Time frame: up to 114 weeks

    Physician's report of success and ease of insertion. Ease of insertion qualified as "easy, moderate, or difficult" on the study insertion assessment.

  3. Assessment of the duration of Casea S pellets insertion

    Time frame: up to 114 weeks

    Time of the procedure duration

  4. Assessment of the complications of insertion of Casea S pellets

    Time frame: up to 114 weeks

    Number and descriptions of the incidence of insertion complications.

  5. Follicular and luteal activity following subdermal insertion of Casea S pellets

    Time frame: up to 114 weeks

    Estradiol (E2) and progesterone (P4) levels

  6. Estimate of ENG release rates using explant analysis

    Time frame: up to 114 weeks

    Cumulative amount of ENG released over time, average daily release in 3 months and up to 130 weeks

Sponsors and collaborators

Lead sponsor

FHI 360

Other

Collaborators

  • Bill and Melinda Gates Foundation

Registry information

Official study title

A Phase 1 Clinical Trial to Evaluate the Pharmacokinetics, Removability, Safety, and Tolerability of Casea S Contraceptive Implants

Important dates

Study start
2023
Primary completion
2027
Study completion
2027
First posted
Jan 3, 2022
Registry last updated
Apr 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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