Levonorgestrel 52 mg intrauterine system (Levosert®)/Liletta®) in contraception: a profile of its use

Comparison of two levonorgestrel-releasing intrauterine systems for the treatment of heavy menstrual bleeding: a randomised, controlled, phase 3 trial

PURPOSE

To evaluate the levonorgestrel-releasing intrauterine system Donasert^® (also known as Levosert^®) compared with the reference product Mirena^® for the alleviation of heavy menstrual bleeding (HMB).

MATERIALS AND METHODS

A phase 3 multicentre, non-inferiority, active-controlled study in non-menopausal women with HMB (menstrual blood loss [MBL] ≥ 80 mL) as the primary symptom randomised to either Donasert^® or Mirena^® and followed for 6 months. MBL was evaluated using a validated, modified version of the Wyatt pictogram.

RESULTS

Overall, 312 were randomised (158 to Donasert^® and 154 to Mirena^®). The mean (standard deviation) absolute change in MBL from baseline to 6 months in the per-protocol population (N = 300) was -130 (71.8) mL and -127 (67.3) mL in the Donasert^® and Mirena^® groups, respectively; non-inferiority of Donasert^® was confirmed (p-value <0.0001). Successful treatment of HMB (MBL <80 mL) and a decrease to ≤50% of baseline MBL was achieved in 139/154 (90.3%) and 126/146 (86.3%) participants in the Donasert^® and Mirena^® groups, respectively and the between-treatment difference was non-significant. Most adverse events were mild in severity. Only two device expulsions occurred in the study and there were no uterine perforations.

CONCLUSIONS

Donasert^® has equivalent efficacy and safety during the first 6 months foralleviation of HMB compared to the reference device, Mirena^®.

TRIAL REGISTRATION NUMBER

348 (Clinical Trials Registry of the Ministry of Health of the Russian Federation, http://grls.rosminzdrav.ru/default.aspx).