Clinically meaningful relief of endometriosis pain1*

ORILISSA showed proven relief across the 3 most common types of endometriosis pain1-3†

Statistical significance for dyspareunia was not achieved with the 150 mg QD dose of ORILISSA.

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Clinical study design: Two robust similar multicenter, double-blind, randomized, prospective, placebo-controlled Phase 3 trials of 6-month treatment at 2 doses (N=1686)1

Responder1,3

""

Rigorous responder
definition included both:

""

Clinically meaningful
pain reduction*

AND

""

Stable or decreased
NSAID or opioid use

*Women were defined as responders if they experienced clinically meaningful pain reduction and stable/decreased rescue analgesic use for endometriosis-associated pain. Clinically meaningful reduction in pain was defined as a calculated threshold of improvement in pain score in each study. The threshold was determined based on an analysis of the change in pain score that corresponded to “much improved” or “very much improved” on the Patient Global Impression of Change Questionnaire.

Results shown below are from ELARIS EM-1. Results in ELARIS EM-2 were consistent and can be viewed by clicking on the ELARIS EM-2 buttons.

ORILISSA 150 mg QD

Dysmenorrhea

Co-primary endpoint: Responder rate for dysmenorrhea at month 31,3‡

ELARIS EM-1

ORILISSA 150 mg QD
46%
(n=248)

Placebo
20%
(n=373)

P≤0.001 vs placebo

Secondary endpoints: Mean dysmenorrhea score reduction from baseline to month 6 (ranked) and mean percent reduction over 6 months (non-ranked)1,3-5§

Reduction in pain score from baseline for ORILISSA 150 mg QD.

Mean baseline dysmenorrhea score: 2.2 (on a scale from 0 to 3)

Mean change in pain score from baseline to month 6 was a ranked secondary endpoint. All other endpoints shown above were non-ranked secondary endpoints and multiplicity adjustments were not applied.

Non-menstrual pelvic pain (NMPP)

Co-primary endpoint: Responder rate for NMPP at month 31,3‡

ELARIS EM-1

ORILISSA 150 mg QD
50%
(n=248)

Placebo
36%
(n=373)

P≤0.001 vs placebo

Secondary endpoints: Mean NMPP score reduction from baseline to month 6 (ranked) and mean percent reduction over 6 months (non-ranked)1,3-5§

Reduction in pain score from baseline for ORILISSA 150 mg QD.

Mean baseline NMPP score: 1.6 (on a scale from 0 to 3)

Mean change in pain score from baseline to month 6 was a ranked secondary endpoint. All other endpoints shown above were non-ranked secondary endpoints and multiplicity adjustments were not applied.

Dyspareunia

Secondary endpoint: Mean dyspareunia reduction from baseline to month 3 (ranked)1,3,4§

ELARIS EM-1

ORILISSA 150 mg QD
Mean change in dyspareunia score at month 3 was not statistically significant3

Mean change in pain score from baseline to month 3 was a ranked secondary endpoint.

EHP-30 scores

Quality of life was studied using the EHP-30 questionnaire

QoL dimensions
studied using EHP-30

Pain|| scores (NON-RANKED SECONDARY ENDPOINT)3,7,8

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

28 point reduction from baseline score for ORILISSA 150mg. 41 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Emotional well-being scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 27 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Sexual intercourse scores (NON-RANKED SECONDARY ENDPOINT)1,3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

17 point reduction from baseline score for ORILISSA 150mg. 25 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Control and powerlessness scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

35 point reduction from baseline score for ORILISSA 150mg. 51 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Self-image scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

16 point reduction from baseline score for ORILISSA 150mg. 29 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Pain|| scores (NON-RANKED SECONDARY ENDPOINT)3,7,8

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

28 point reduction from baseline score for ORILISSA 150mg. 41 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Emotional well-being scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 27 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Sexual intercourse scores (NON-RANKED SECONDARY ENDPOINT)1,3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

17 point reduction from baseline score for ORILISSA 150mg. 25 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Control and powerlessness scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

35 point reduction from baseline score for ORILISSA 150mg. 51 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Self-image scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

16 point reduction from baseline score for ORILISSA 150mg. 29 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Social support scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 32 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Assessed from baseline to the analysis month greater or equal to the following calculated, threshold of improvement in pain score in each study: Dysmenorrhea responder thresholds were ≥0.81-point decrease from baseline in ELARIS EM-1 and ≥0.85-point decrease from baseline in ELARIS EM-2. NMPP responder thresholds were ≥0.36-point decrease from baseline in ELARIS EM-1 and ≥0.43-point decrease from baseline in ELARIS EM-2. The threshold was determined based on analysis of the change in pain score corresponding to "much improved" or "very much improved" on the Patient Global Impression of Change Questionnaire.

§Baseline and monthly visit values were based on a 35-day mean.

IIEHP-30 questions for this dimension assessed the effects of endometriosis pain on quality-of-life, and did not specify dysmenorrhea, non-menstrual pelvic pain, or dyspareunia only.

Mean reduction in dyspareunia score from baseline was not statistically significant at the 150 mg QD dose of ORILISSA in EM-1 and EM-2.

See ORILISSA safety profile

View safety

ORILISSA 200 mg BID

Dysmenorrhea

Co-primary endpoint: Responder rate for dysmenorrhea at month 31,3‡

ELARIS EM-1

ORILISSA 200 mg BID
76%
(n=244)

Placebo
20%
(n=373)

P≤0.001 vs placebo

Secondary endpoints: Mean dysmenorrhea score reduction from baseline to month 6 (ranked) and mean percent reduction over 6 months (non-ranked)1,3-5§

Reduction in pain score from baseline for ORILISSA 200 mg BID.

Mean baseline dysmenorrhea score: 2.2 (on a scale from 0 to 3)

Mean change in pain score from baseline to month 6 was a ranked secondary endpoint. All other endpoints shown above were non-ranked secondary endpoints and multiplicity adjustments were not applied.

Non-menstrual pelvic pain (NMPP)

Co-primary endpoint: Responder rate for NMPP at month 31,3‡

ELARIS EM-1

ORILISSA 200 mg BID
55%
(n=244)

Placebo
36%
(n=373)

P≤0.001 vs placebo

Secondary endpoints: Mean NMPP score reduction from baseline to month 6 (ranked) and mean percent reduction over 6 months (non-ranked)1,3-5§

Reduction in pain score from baseline for ORILISSA 200 mg BID.

Mean baseline NMPP score: 1.6 (on a scale from 0 to 3)

Mean change in pain score from baseline to month 6 was a ranked secondary endpoint. All other endpoints shown above were non-ranked secondary endpoints and multiplicity adjustments were not applied.

Dyspareunia

Secondary endpoints: Mean dyspareunia score reduction from baseline to month 3 (ranked) and mean percent reduction over 3 months (non-ranked)1,3-5§

Reduction in pain score from baseline for ORILISSA 200 mg BID.

Mean baseline dyspareunia score: 1.6 (on a scale from 0 to 3)

Mean change in pain score from baseline to month 3 was a ranked secondary endpoint. All other endpoints shown above were non-ranked secondary endpoints and multiplicity adjustments were not applied.


EHP-30 scores

Quality of life was studied using the EHP-30 questionnaire

QoL dimensions
studied using EHP-30

Pain|| scores (NON-RANKED SECONDARY ENDPOINT)3,7,8

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

28 point reduction from baseline score for ORILISSA 150mg. 41 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Emotional well-being scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 27 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Sexual intercourse scores (NON-RANKED SECONDARY ENDPOINT)1,3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

17 point reduction from baseline score for ORILISSA 150mg. 25 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Control and powerlessness scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

35 point reduction from baseline score for ORILISSA 150mg. 51 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Self-image scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

16 point reduction from baseline score for ORILISSA 150mg. 29 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Pain|| scores (NON-RANKED SECONDARY ENDPOINT)3,7,8

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

28 point reduction from baseline score for ORILISSA 150mg. 41 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Emotional well-being scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 27 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Sexual intercourse scores (NON-RANKED SECONDARY ENDPOINT)1,3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

17 point reduction from baseline score for ORILISSA 150mg. 25 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Control and powerlessness scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

35 point reduction from baseline score for ORILISSA 150mg. 51 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Self-image scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

16 point reduction from baseline score for ORILISSA 150mg. 29 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Social support scores (ADDITIONAL VARIABLE)3,7

These results were captured as additional variables and endpoints in ELARIS EM-1 and ELARIS EM-2 and not controlled for multiplicity. Nominal values presented are not controlled for a type-1 error.

Decreased scores indicate improvement in QoL dimension.

20 point reduction from baseline score for ORILISSA 150mg. 32 point reduction from baseline score for ORILISSA 200mg.

Adapted from Taylor 2017 et al.

LS=least squares.

Each EHP-30 question was scored from 0 (never) to 4 (always) and normalized to a scale of 0-100 for each dimension. Month 0 refers to baseline.

Assessed from baseline to the analysis month greater or equal to the following calculated, threshold of improvement in pain score in each study: Dysmenorrhea responder thresholds were ≥0.81-point decrease from baseline in ELARIS EM-1 and ≥0.85-point decrease from baseline in ELARIS EM-2. NMPP responder thresholds were ≥0.36-point decrease from baseline in ELARIS EM-1 and ≥0.43-point decrease from baseline in ELARIS EM-2. The threshold was determined based on analysis of the change in pain score corresponding to "much improved" or "very much improved" on the Patient Global Impression of Change Questionnaire.

§Baseline and monthly visit values were based on a 35-day mean.

IIEHP-30 questions for this dimension assessed the effects of endometriosis pain on quality-of-life, and did not specify dysmenorrhea, non-menstrual pelvic pain, or dyspareunia only.

Mean reduction in dyspareunia score from baseline was not statistically significant at the 150 mg QD dose of ORILISSA in EM-1 and EM-2.

See ORILISSA safety profile

View safety

Indication and Important Safety Information

INDICATION1

ORILISSA® (elagolix) is indicated for the management of moderate to severe pain associated with endometriosis.

IMPORTANT SAFETY INFORMATION1

CONTRAINDICATIONS

  • ORILISSA is contraindicated in women who are pregnant (exposure to ORILISSA early in pregnancy may increase the risk of early pregnancy loss), in women with known osteoporosis or severe hepatic impairment, or with concomitant use of strong organic anion transporting polypeptide (OATP) 1B1 inhibitors (e.g., cyclosporine and gemfibrozil).

WARNINGS AND PRECAUTIONS

Bone Loss

  • ORILISSA causes a dose-dependent decrease in bone mineral density (BMD), which is greater with increasing duration of use and may not be completely reversible after stopping treatment.
  • The impact of ORILISSA-associated decreases in BMD on long-term bone health and future fracture risk is unknown. Consider assessment of BMD in patients with a history of low-trauma fracture or other risk factors for osteoporosis or bone loss, and do not use in women with known osteoporosis.
  • Limit the duration of use to reduce the extent of bone loss.

Change in Menstrual Bleeding Pattern and Reduced Ability to Recognize Pregnancy

  • Women who take ORILISSA may experience a reduction in the amount, intensity, or duration of menstrual bleeding, which may reduce the ability to recognize the occurrence of pregnancy in a timely manner. Perform pregnancy testing if pregnancy is suspected, and discontinue ORILISSA if pregnancy is confirmed.

Suicidal Ideation, Suicidal Behavior, and Exacerbation of Mood Disorders

  • Suicidal ideation and behavior, including one completed suicide, occurred in subjects treated with ORILISSA in the endometriosis clinical trials.
  • ORILISSA users had a higher incidence of depression and mood changes compared to placebo and ORILISSA users with a history of suicidality or depression had an increased incidence of depression. Promptly evaluate patients with depressive symptoms to determine whether the risks of continued therapy outweigh the benefits. Patients with new or worsening depression, anxiety, or other mood changes should be referred to a mental health professional, as appropriate.
  • Advise patients to seek immediate medical attention for suicidal ideation and behavior. Reevaluate the benefits and risks of continuing ORILISSA if such events occur.

Hepatic Transaminase Elevations

  • In clinical trials, dose-dependent elevations of serum alanine aminotransferase (ALT) at least 3 times the upper limit of the reference range occurred with ORILISSA.
  • Use the lowest effective dose and instruct patients to promptly seek medical attention in case of symptoms or signs that may reflect liver injury, such as jaundice.
  • Promptly evaluate patients with elevations in liver tests to determine whether the benefits of continued therapy outweigh the risks.

Reduced Efficacy with Estrogen-Containing Contraceptives

  • Based on the mechanism of action of ORILISSA, estrogen-containing contraceptives are expected to reduce the efficacy of ORILISSA. The effect of progestin-only contraceptives on the efficacy of ORILISSA is unknown.
  • Advise women to use non-hormonal contraceptives during treatment and for one week after discontinuing ORILISSA.

ADVERSE REACTIONS

  • The most common adverse reactions (>5%) in clinical trials included hot flushes and night sweats, headache, nausea, insomnia, amenorrhea, anxiety, arthralgia, depression-related adverse reactions, and mood changes.

These are not all the possible side effects of ORILISSA.

Safety and effectiveness of ORILISSA in patients less than 18 years of age have not been established.

US-ORIL-200330

For more information, please click here for full Prescribing Information.

References:

1. ORILISSA [package insert]. North Chicago, IL: AbbVie Inc. 2. Taylor HS, Giudice LC, Lessey BA, et al. Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist. N Engl J Med. 2017;377(1):28-40. 3. Data on file. ABVRRTI66651. 4. Surrey E, Taylor HS, Giudice L, et al. Long-term outcomes of elagolix in women with endometriosis: results from two extension studies. Obstet Gynecol. 2018;132(1):147-160.