Treatment of Acromegaly With Somatostatin Analogs: GH vs. IGF-I as Primary Biochemical Target
Treatment of acromegaly with somatostatin analogs (SA) is well-established and are primarily used after insufficient surgical intervention, but also as primary medical treatment in selected patients. Evaluation of treatment control is based on monitoring blood levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I). However, evaluation of disease control during SA treatment is not always straightforward. It is usually based on normalization of IGF-I and achievement of a certain GH level. In approximately 40% of patients discordant values of GH and IGF-I levels are seen after treatment with SA, with normalized IGF-I levels, despite elevated GH levels. The mechanism behind this observation is unknown, but it indicates that SA may affect this difference.
The primary objective of this study is to investigate if disease control during SA treatment is best achieved by monitoring either GH or IGF-I.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Aarhus C, Denmark, 8000
- Department of Endocrinology, Aarhus University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Written informed consent
- Age > 18 years
- Capable and of age
- Diagnosed with acromegaly
- Sufficient treated for at least 6 months prior to enrollment
Exclusion Criteria:
- Pregnancy or nursing
- Any disease that may compromise the ability to comply with the protocol, as assessed by the investigator
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: SA monitored by GH
|
Intramuscular injections, dosage based on either GH or IGF-I levels.
|
|
Experimental: SA monitored by IGF-I
|
Intramuscular injections, dosage based on either GH or IGF-I levels.
|
|
No Intervention: Control
Control, patients who have achieved sufficient disease control by surgery alone.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Quality of Life
Time Frame: Baseline and after 12 months
|
AcroQol (Acromegaly Quality of Life Questionnaire) and PASQ (Patient-Assessed Acromegaly Symptom Questionnaire)
|
Baseline and after 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
SA dosage
Time Frame: After 12 months of treatment
|
SA dosage at last follow-up
|
After 12 months of treatment
|
|
Change in glucose, FFA and insulin
Time Frame: Baseline and after 12 months
|
Glucose tolerance during an oral glucose load of 75 gram of glucose
|
Baseline and after 12 months
|
|
Change in discordant GH/IGF-I levels
Time Frame: Baseline and after 12 months
|
Discordant GH/IGF-I levels are recorded.
|
Baseline and after 12 months
|
|
New biomarkers of treatment evaluation
Time Frame: Baseline and after 12 months
|
New biomarkers of GH/IGF-I status (bioactive IGF-I)
|
Baseline and after 12 months
|
|
New biomarkers of treatment evaluation2
Time Frame: Baseline and after 12 months
|
New biomarkers of GH/IGF-I status (free GH)
|
Baseline and after 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Jens Otto L. Jørgensen, Professor, Aarhus University Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Endocrine System Diseases
- Musculoskeletal Diseases
- Hypothalamic Diseases
- Bone Diseases
- Bone Diseases, Endocrine
- Hyperpituitarism
- Pituitary Diseases
- Acromegaly
- Antineoplastic Agents
- Gastrointestinal Agents
- Antineoplastic Agents, Hormonal
- Octreotide
Other Study ID Numbers
Other Study ID Numbers
- SOM-2012-01
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