- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00399893
Octreotide Therapy in Children and Young Adults With Prader-Willi Syndrome (PWS)
Investigation of the Developmental, Nutritional and Hormonal Regulation of Ghrelin in Children and Young Adults With Prader-Willi Syndrome (PWS): Octreotide Intervention Sub-study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Obesity continues to be a prevalent health concern affecting every race of the American population. According to data from the World Health Organization, 54% of U.S. adults are overweight (body mass index (BMI) >25 kg/m2 ) and 22% are obese (BMI >30 kg/m2) (1). In addition, 25% of U.S. children are overweight or obese (1). Studies show that obese children are likely to become obese adults (2-5). Also, recent studies report significant years of life lost due to the impact of being an obese adult (6, 7). Thus, insights into the pathogenesis of childhood obesity and preventative measures are needed to combat the inevitable increase in worldwide incidence of obesity and its associated co-morbidities. Recent studies have identified a new gastroenteric hormone, ghrelin, as a long-term regulator of energy balance in humans (12). Ghrelin is a 28 amino acid acylated peptide which is an endogenous ligand of the growth hormone secretagogue receptor (GHS-R), a hypothalamic G-protein-coupled receptor (13). Enteroendocrine cells (X/A-like cells) of the stomach are the major site of ghrelin synthesis, although a minor proportion of ghrelin synthesis occurs in other sites such as the hypothalamus, pituitary, duodenum, jejunum and lung (14) (15, 16).
The hypothesis that hyperghrelinemia causes some of the features of PWS predicts that this disorder will be ameliorated (partially or completely) by lowering ghrelin levels. We have recently shown that the somatostatin agonist, octreotide, suppresses ghrelin levels in humans. If octreotide remains effective in longer term studies, the drug may become an adjuvant therapy, in addition to growth hormone, to control the insatiable appetite and morbid obesity seen in this condition.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of PWS confirmed by chromosome analysis
- Ages 5 years to 21 years
- BMI for age ≥ (greater-than or equal to)85th percentile
- Written informed consent and assent obtained and willingness to comply with the study schedule and procedures
- Free T4, Thyroid stimulating hormone (TSH) values in the normal range (either endogenous or with thyroxine replacement)
Exclusion Criteria:
- Patients with any other clinically significant disease that would have an impact on body composition, including diabetes mellitus, chronic inflammatory bowel disease, chronic severe liver or kidney disease or neurologic disorders
- Concomitant use of an investigational drug or Octreotide in the past year
- Use of steroids for longer than 7 days within the past 30 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Octreotide
Octreotide to be administered by subcutaneous injection three times daily while on study
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Octreotide to be administered by subcutaneous injection three times daily
Other Names:
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Placebo Comparator: Placebo
Placebo to be administered by subcutaneous injection three times daily while on study
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Placebo to be administered by subcutaneous injection three times daily while on study
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Decrease in Fasting Total Ghrelin
Time Frame: 6 months
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Number of participants showing a decrease in Fasting total ghrelin from baseline to 6 months of treatment with Octreotide or placebo
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6 months
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Number of Participants With Decrease in Weight From Baseline to 6 Months
Time Frame: 6 months
|
Number of participants who had a decrease in weight from baseline to 6 months of Octreotide or placebo therapy
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6 months
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Number of Participants With Decreased BMI Z-score From Baseline to 6 Months
Time Frame: 6 months
|
Number of participants with decreased BMI z-score from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Number of Participants With Decreased Skin-fold Measurements From Baseline to 6 Months
Time Frame: 6 months
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Number of participants with decreased skin-fold measurements from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Number of Participants With Decrease in Hunger and Food Intake
Time Frame: 6 months
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Measured by hunger and hyperphagia by questionnaires and parent-reported 72-hour food recall from baseline to 6 months.
Multiple questionnaires consisting of a battery of free text answer questions and food diaries are combined in order to make a behavioral assessment of the participants food state of hunger and food intake.
There is no defined scale for this assessment.
Each participants responses and parent responses are combined.
|
6 months
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Number of Participants With Improved Insulin Regulation From Baseline to 6 Months
Time Frame: 6 months
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Number of participants with improved Insulin regulation from baseline to 6 months of Octreotide or Placebo therapy.
Insulin regulation was measured by immunochemiluminescent assay.
|
6 months
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Number of Participants With Improved Adiponectin Regulation From Baseline to 6 Months
Time Frame: 6 months
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Number of participants with improved Adiponectin regulation from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Number of Participants With Improved Leptin Regulation From Baseline to 6 Months
Time Frame: 6 months
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Number of participants with improved Leptin regulation from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Number of Participants With Improved Peptide YY (PYY) Regulation From Baseline to 6 Months
Time Frame: 6 months
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Number of participants with improved Peptide YY (PYY) regulation from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Decreased Body Composition From Baseline to 6 Months by BOD POD®
Time Frame: 6 months
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Number of participants with decreased body-composition as Measured by BOD POD® body composition tracking system from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Number of Participants With Decreased Body-composition From Baseline to 6 Months by DEXA
Time Frame: 6 months
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Number of participants with decreased body-composition as Measured by Dual Energy X-ray Absorptiometry (DEXA) scan from baseline to 6 months of Octreotide or Placebo therapy
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6 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Andrea M Haqq, MD, Duke University
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Disease
- Congenital Abnormalities
- Overnutrition
- Nutrition Disorders
- Genetic Diseases, Inborn
- Intellectual Disability
- Abnormalities, Multiple
- Chromosome Disorders
- Obesity
- Syndrome
- Prader-Willi Syndrome
- Antineoplastic Agents
- Gastrointestinal Agents
- Antineoplastic Agents, Hormonal
- Octreotide
Other Study ID Numbers
- Pro00005426
- Protocol #00005426 (Other Grant/Funding Number: NIH:1K23-RR021979, GCRC M01-RR-30 (NCRR))
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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