title: Continued efficacy and safety of flibanserin in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD): results from a randomized withdrawal trial.
abstract: BACKGROUND
  Flibanserin is a 5-HT(1A) agonist/5-HT(2A) antagonist that has been shown to increase sexual desire and reduce distress in premenopausal women with Hypoactive Sexual Desire Disorder (HSDD).
  
  
  OBJECTIVE
  To assess the efficacy and safety of flibanserin over 24 weeks of double-blind treatment vs. placebo in premenopausal women with HSDD who showed a predefined response after 24 weeks of open-label treatment with flibanserin.
  
  
  METHODS
  Women (N = 738) were treated with open-label, flexible-dose flibanserin (50 mg or 100 mg/day) for 24 weeks. At week 24, women who showed a predefined response, measured using an eDiary, were randomized to 24 weeks of continued flibanserin therapy at optimized dosage (N = 163) or placebo (N = 170). The criteria for entering the double-blind phase were an increase from baseline to weeks 21-24 of ≥2 satisfying sexual events (SSE) and/or ≥4 "desire days." A "desire day" was one in which a woman reported more than "no" desire.
  
  
  METHODS
  Coprimary endpoints were change from randomization to study end in SSE and desire score. Secondary measures included change in Female Sexual Function Index (FSFI) total and desire domain scores and Female Sexual Distress Scale-Revised (FSDS-R) total and Item 13 scores.
  
  
  RESULTS
  During the open-label period, mean SSE and desire score approximately doubled, and FSFI, FSDS-R total, and Item 13 scores improved. At the end of the double-blind period, flibanserin was superior to placebo in change from randomization in SSE, desire score, FSFI desire domain and total scores, and FSDS-R total and Item 13 scores (P < 0.05, for all). Flibanserin was well tolerated, and withdrawal reactions were not observed.
  
  
  CONCLUSIONS
  At the end of the 24-week randomized withdrawal phase of a 48-week trial in premenopausal women with HSDD, flibanserin was superior to placebo on measures of SSE, sexual desire, overall sexual function, and sexual distress. Flibanserin was well tolerated, and no withdrawal reactions were observed following discontinuation.
authors.affiliation: Hudson Valley Urology, Poughkeepsie, New York, NY 12601, USA. evanrgold@gmail.com
authors.forename: Evan R
authors.initials: ER
authors.lastname: Goldfischer
authors.forename: Jeffery
authors.initials: J
authors.lastname: Breaux
authors.forename: Molly
authors.initials: M
authors.lastname: Katz
authors.forename: Joel
authors.initials: J
authors.lastname: Kaufman
authors.forename: William B
authors.initials: WB
authors.lastname: Smith
authors.forename: Toshio
authors.initials: T
authors.lastname: Kimura
authors.forename: Michael
authors.initials: M
authors.lastname: Sand
authors.forename: Rob
authors.initials: R
authors.lastname: Pyke
mesh_terms: D000328:Adult; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007989:Libido / Q000187:drug effects; D058825:Serotonin 5-HT1 Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D058830:Serotonin 5-HT2 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001562:Benzimidazoles; D058825:Serotonin 5-HT1 Receptor Agonists; D058830:Serotonin 5-HT2 Receptor Antagonists; C098107:flibanserin