- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03091075
Oxandrolone Rotator Cuff Trial (ORCT)
February 27, 2024 updated by: George F. Hatch, University of Southern California
Ability of Oral Steroid (Oxandrolone) to Halt Fatty Infiltration and Aid Rotator Cuff Healing: A Double-Blind, Randomized Clinical Trial
This study is about healing after a rotator cuff tear repair procedure.
We hope to learn if a biologic medication: Oxandrolone, a synthetic derivative of the human hormone Testosterone (the principal male sex hormone and an anabolic steroid), given for 12 weeks following rotator cuff repair, is effective in aiding in the healing process and restoring muscle mass.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Rotator cuff tears are currently one of the most common causes of musculoskeletal pain and disability; the biologic sequelae of a chronic tear are muscle atrophy, fatty infiltration, and intercellular fibrosis of the torn muscle-tendon unit.
Recently, researchers have attempted to address the biologic sequelae of chronic rotator cuff tearing with animal studies examining the effects of anabolic steroids on rotator cuff healing, demonstrating that when administered as an adjuvant to rotator cuff repair, anabolic steroids can halt fatty infiltration, decrease muscle atrophy, and promote healing.
The purpose of this study will be to conduct the first clinical trial using an oral anabolic agent (Oxandrolone, an oral synthetic derivative of testosterone that has been shown to aid in beneficial tissue healing in burn patients) to promote rotator cuff healing.
Men and women aged 40 - 75 scheduled for rotator cuff repair, who have failed nonoperative management of chronic, full thickness rotator cuff tears confirmed by MRI, will be randomized into one of two groups, a control group (receiving placebo medication) and an experimental group (receiving oral Oxandrolone), with dosing (males 12 mg BID, female 6 mg BID) beginning at time of surgery and continuing for 12 weeks postoperative.
Allocation will be performed using computer software and will occur at the pharmacy to ensure that all investigators are blinded.
All participants will undergo a standardized rehabilitation protocol for rotator cuff repair, supervised by a licensed physical therapist.
Study Type
Interventional
Enrollment (Estimated)
116
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: George R Hatch, MD
- Phone Number: 323-442-5860
- Email: uscortho.sports@gmail.com
Study Contact Backup
- Name: George Hatch, MD
- Phone Number: 323-442-5860
- Email: ghatch@med.usc.edu
Study Locations
-
-
California
-
Los Angeles, California, United States, 90033
- Keck School of Medicine of the University of Southern California
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
40 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- scheduled for rotator cuff repair
- failed nonoperative management of chronic, full thickness rotator cuff tears
- full thickness rotator cuff tear confirmed on MRI
Exclusion Criteria:
- patients with prior shoulder surgery or prior rotator cuff repair
- tears larger than 5 cm
- significant glenohumeral arthritis (Hamada Grade 2 or higher)
- Untreated diabetes mellitus
- Pituitary tumor
- Rheumatoid arthritis
- Uncontrolled hypertension
- Congestive heart failure
- Myocardial infarction within the past 6 months
- End-stage renal disease
- Liver enzymes two times the normal value
- Deep Vein Thrombosis (DVT) within the past 6 months
- Disorder of the coagulation system
- Currently taking anticoagulation
- Claustrophobia
- Prior or current use of anabolic steroids
- Chromosomal disorders
- Prostate cancer
- Breast cancer
- Hypercalcemia
- Medications that interfere with testosterone production or function, including but not limited to 5 alpha-reductase inhibitors
- Pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the Screening visit through 6 weeks after the last dose of study treatment
- Any other condition or treatment interfering with completion of the trial
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment Group
Oxandrolone
|
Treatment group will receive Oxandrolone daily for 12 weeks postoperatively
|
Placebo Comparator: Placebo Group
placebo
|
Placebo group will receive placebo for 12 weeks postoperative
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
change in structural integrity of the rotator cuff/tendon healing
Time Frame: baseline to 52 weeks
|
assessed by MRI, classified based on the Sugaya classification and Goutallier Grade
|
baseline to 52 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
change in ASES shoulder score
Time Frame: baseline to 104 weeks
|
American Shoulder Elbow Surgeon's Shoulder Score, Patient Questionnaire
|
baseline to 104 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
change in VAS pain scale
Time Frame: baseline to 104 weeks
|
Visual Analog Score - pain scale, patient questionnaire
|
baseline to 104 weeks
|
change in PASS Score
Time Frame: baseline to 104 weeks
|
Patient Acceptable Symptom State, patient questionnaire
|
baseline to 104 weeks
|
change in Functional Outcome - Shoulder Strength
Time Frame: baseline to 104 weeks
|
isometric shoulder strength measures using a handheld dynamometer
|
baseline to 104 weeks
|
change in Body Composition
Time Frame: baseline to 104 weeks
|
body composition testing by bioelectric impedence
|
baseline to 104 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: George R Hatch, MD, University of Southern California
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Wolf SE, Thomas SJ, Dasu MR, Ferrando AA, Chinkes DL, Wolfe RR, Herndon DN. Improved net protein balance, lean mass, and gene expression changes with oxandrolone treatment in the severely burned. Ann Surg. 2003 Jun;237(6):801-10; discussion 810-1. doi: 10.1097/01.SLA.0000071562.12637.3E.
- Jeschke MG, Finnerty CC, Suman OE, Kulp G, Mlcak RP, Herndon DN. The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn. Ann Surg. 2007 Sep;246(3):351-60; discussion 360-2. doi: 10.1097/SLA.0b013e318146980e.
- Schroeder ET, Vallejo AF, Zheng L, Stewart Y, Flores C, Nakao S, Martinez C, Sattler FR. Six-week improvements in muscle mass and strength during androgen therapy in older men. J Gerontol A Biol Sci Med Sci. 2005 Dec;60(12):1586-92. doi: 10.1093/gerona/60.12.1586.
- Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000 Apr;82(4):505-15. doi: 10.2106/00004623-200004000-00006.
- Meyer DC, Wieser K, Farshad M, Gerber C. Retraction of supraspinatus muscle and tendon as predictors of success of rotator cuff repair. Am J Sports Med. 2012 Oct;40(10):2242-7. doi: 10.1177/0363546512457587. Epub 2012 Aug 27.
- Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007 May;89(5):953-60. doi: 10.2106/JBJS.F.00512.
- Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994 Jul;(304):78-83.
- Le BT, Wu XL, Lam PH, Murrell GA. Factors predicting rotator cuff retears: an analysis of 1000 consecutive rotator cuff repairs. Am J Sports Med. 2014 May;42(5):1134-42. doi: 10.1177/0363546514525336. Epub 2014 Apr 18.
- Kim HM, Caldwell JM, Buza JA, Fink LA, Ahmad CS, Bigliani LU, Levine WN. Factors affecting satisfaction and shoulder function in patients with a recurrent rotator cuff tear. J Bone Joint Surg Am. 2014 Jan 15;96(2):106-12. doi: 10.2106/JBJS.L.01649.
- Kelly BT, Kadrmas WR, Speer KP. The manual muscle examination for rotator cuff strength. An electromyographic investigation. Am J Sports Med. 1996 Sep-Oct;24(5):581-8. doi: 10.1177/036354659602400504.
- Makhni EC, Steinhaus ME, Morrow ZS, Jobin CM, Verma NN, Cole BJ, Bach BR Jr. Outcomes assessment in rotator cuff pathology: what are we measuring? J Shoulder Elbow Surg. 2015 Dec;24(12):2008-15. doi: 10.1016/j.jse.2015.08.007. Epub 2015 Oct 21.
- Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, Iannotti JP, Mow VC, Sidles JA, Zuckerman JD. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994 Nov;3(6):347-52. doi: 10.1016/S1058-2746(09)80019-0. Epub 2009 Feb 13.
- Michener LA, Snyder AR, Leggin BG. Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. J Sport Rehabil. 2011 Feb;20(1):115-28. doi: 10.1123/jsr.20.1.115.
- Michener LA. Patient- and clinician-rated outcome measures for clinical decision making in rehabilitation. J Sport Rehabil. 2011 Feb;20(1):37-45. doi: 10.1123/jsr.20.1.37.
- Mintken PE, McDevitt AW, Cleland JA, Boyles RE, Beardslee AR, Burns SA, Haberl MD, Hinrichs LA, Michener LA. Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial. J Orthop Sports Phys Ther. 2016 Aug;46(8):617-28. doi: 10.2519/jospt.2016.6319.
- Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006 Aug;88(8):1699-704. doi: 10.2106/JBJS.E.00835.
- Vitale MA, Vitale MG, Zivin JG, Braman JP, Bigliani LU, Flatow EL. Rotator cuff repair: an analysis of utility scores and cost-effectiveness. J Shoulder Elbow Surg. 2007 Mar-Apr;16(2):181-7. doi: 10.1016/j.jse.2006.06.013.
- Ensor KL, Kwon YW, Dibeneditto MR, Zuckerman JD, Rokito AS. The rising incidence of rotator cuff repairs. J Shoulder Elbow Surg. 2013 Dec;22(12):1628-32. doi: 10.1016/j.jse.2013.01.006. Epub 2013 Mar 1.
- Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL. National trends in rotator cuff repair. J Bone Joint Surg Am. 2012 Feb 1;94(3):227-33. doi: 10.2106/JBJS.J.00739.
- Lee TQ. Current biomechanical concepts for rotator cuff repair. Clin Orthop Surg. 2013 Jun;5(2):89-97. doi: 10.4055/cios.2013.5.2.89. Epub 2013 May 15.
- Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005 Jun;87(6):1229-40. doi: 10.2106/JBJS.D.02035.
- Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004 Feb;86(2):219-24. doi: 10.2106/00004623-200402000-00002.
- Bjornsson HC, Norlin R, Johansson K, Adolfsson LE. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop. 2011 Apr;82(2):187-92. doi: 10.3109/17453674.2011.566144. Epub 2011 Mar 24.
- Moraiti C, Valle P, Maqdes A, Boughebri O, Dib C, Giakas G, Kany J, Elkholti K, Garret J, Katz D, Leclere FM, Valenti P. Comparison of functional gains after arthroscopic rotator cuff repair in patients over 70 years of age versus patients under 50 years of age: a prospective multicenter study. Arthroscopy. 2015 Feb;31(2):184-90. doi: 10.1016/j.arthro.2014.08.020. Epub 2014 Nov 11.
- Gerber C, Meyer DC, Schneeberger AG, Hoppeler H, von Rechenberg B. Effect of tendon release and delayed repair on the structure of the muscles of the rotator cuff: an experimental study in sheep. J Bone Joint Surg Am. 2004 Sep;86(9):1973-82. doi: 10.2106/00004623-200409000-00016.
- Patel S, Gualtieri AP, Lu HH, Levine WN. Advances in biologic augmentation for rotator cuff repair. Ann N Y Acad Sci. 2016 Nov;1383(1):97-114. doi: 10.1111/nyas.13267. Epub 2016 Oct 17.
- Ruiz-Moneo P, Molano-Munoz J, Prieto E, Algorta J. Plasma rich in growth factors in arthroscopic rotator cuff repair: a randomized, double-blind, controlled clinical trial. Arthroscopy. 2013 Jan;29(1):2-9. doi: 10.1016/j.arthro.2012.08.014.
- Rodeo SA, Delos D, Williams RJ, Adler RS, Pearle A, Warren RF. The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: a prospective, randomized clinical study. Am J Sports Med. 2012 Jun;40(6):1234-41. doi: 10.1177/0363546512442924. Epub 2012 Apr 10.
- Gulotta LV, Kovacevic D, Ehteshami JR, Dagher E, Packer JD, Rodeo SA. Application of bone marrow-derived mesenchymal stem cells in a rotator cuff repair model. Am J Sports Med. 2009 Nov;37(11):2126-33. doi: 10.1177/0363546509339582. Epub 2009 Aug 14.
- Gerber C, Meyer DC, Nuss KM, Farshad M. Anabolic steroids reduce muscle damage caused by rotator cuff tendon release in an experimental study in rabbits. J Bone Joint Surg Am. 2011 Dec 7;93(23):2189-95. doi: 10.2106/JBJS.J.01589.
- Gerber C, Meyer DC, Fluck M, Benn MC, von Rechenberg B, Wieser K. Anabolic Steroids Reduce Muscle Degeneration Associated With Rotator Cuff Tendon Release in Sheep. Am J Sports Med. 2015 Oct;43(10):2393-400. doi: 10.1177/0363546515596411. Epub 2015 Aug 24.
- Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health. 2008 Apr;31(2):180-91. doi: 10.1002/nur.20247.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
September 23, 2018
Primary Completion (Estimated)
May 1, 2024
Study Completion (Estimated)
December 1, 2024
Study Registration Dates
First Submitted
March 13, 2017
First Submitted That Met QC Criteria
March 20, 2017
First Posted (Actual)
March 27, 2017
Study Record Updates
Last Update Posted (Actual)
March 1, 2024
Last Update Submitted That Met QC Criteria
February 27, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HS-17-00272
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
Data will be shared as required with the USC Health Sciences Institutional Review Board.
Participant data will be coded with coding identifiers kept separately by research personnel only and destroyed upon completion of the study.
Study Data/Documents
-
Study Protocol
Information identifier: APP-17-01020
-
Informed Consent Form
Information identifier: APP-17-01020
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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.
Clinical Trials on Rotator Cuff Tear
-
Bezmialem Vakif UniversityNot yet recruitingRotator Cuff Tears | Partial Tear of Rotator CuffTurkey
-
Keele UniversityUniversity Hospitals, Leicester; Liverpool University Hospitals NHS Foundation... and other collaboratorsWithdrawnTraumatic Rotator Cuff TearUnited Kingdom
-
Rush University Medical CenterSmith & Nephew, Inc.CompletedRotator Cuff Tear Repair Anchors
-
University of MichiganCompletedFull Thickness Rotator Cuff Tear
-
Johannes Kepler University of LinzCompletedFull Thickness Rotator Cuff TearAustria
-
Lawson Health Research InstituteCompleted
-
Orthofix Inc.TerminatedPEMF as Adjunctive Treatment Following Surgical Repair of Full Thickness Rotator Cuff Tears (RCStim)Full-thickness Rotator Cuff TearUnited States
-
InGeneron, Inc.CompletedRotator Cuff Tear - Partial ThicknessUnited States
-
Izmir Katip Celebi UniversityTerminatedPartial Thickness Rotator Cuff TearTurkey
-
BioMimetic TherapeuticsCompletedFull Thickness Rotator Cuff TearCanada
Clinical Trials on Oxandrolone
-
Thomas Jefferson UniversityNational Institute of Neurological Disorders and Stroke (NINDS)Completed
-
National Institute of Neurological Disorders and...Jefferson Medical College of Thomas Jefferson UniversityCompletedTurner's SyndromeUnited States
-
CJ CheilJedangNot yet recruitingPharmacokinetics
-
National Institute of Diabetes and Digestive and...Completed
-
Denver Health and Hospital AuthorityWithdrawnAnemia | Trauma | Functional Iron DeficiencyUnited States
-
US Department of Veterans AffairsCompletedSpinal Cord InjuryUnited States
-
Sunnybrook Health Sciences CentreUnited States Department of Defense; Walter Reed National Military Medical...WithdrawnTrauma Injury
-
University of UtahCompleted
-
US Department of Veterans AffairsTerminated
-
Par Pharmaceutical, Inc.Cetero Research, San AntonioCompletedTo Determine the Bioequivalence Under Fasting ConditionsUnited States