Glucocorticoids and Skin Healing in Diabetes (GC-SHealD) (GC-SHealD)
A Double-blind, Randomized, Placebo-controlled Phase II Pilot Trial Investigating Efficacy, Safety and Feasibility of 11β-hydroxysteroid Dehydrogenase Type 1 Inhibition by AZD4017 to Improve Skin Function and Wound Healing in Patients With Type 2 Diabetes
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Glucocorticoids are known to impair skin function and wound healing which are also compromised in patients with type 2 diabetes. The enzyme 11 beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activates glucocorticoids in target tissues including skin. Pre-clinical data demonstrate that 11β-HSD1 inhibition improves skin function and wound healing but this has not been investigated in man.
Using the 11β-HSD1 inhibitor AZD4017, we will investigate if
- Oral AZD4017 inhibits 11β-HSD1 activity in skin
- AZD4017 is safe and well-tolerated in patient with T2DM
- Oral AZD4017 regulates skin function
- Systemic glucocorticoid levels and skin 11β-HSD1 activity, independently or in combination correlate with measures of skin function
Study feasibility will also be assessed; if successful, data from this pilot study will inform power calculations for a future trial to investigate the ability of 11β-HSD1 inhibition to promote foot ulcer healing in type 2 diabetes.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Leeds, Det Forenede Kongerige, LS9 7TF
- Leeds Teaching Hospitals Trust
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Able and willing to consent
- Type 2 diabetes with HbA1c ≤11% (≤97 mmol/mol) at screening while taking standard therapy at a stable dose for ≥10 weeks
Exclusion Criteria:
- Women of child-bearing potential
- Active leg/foot ulceration
- Clinically relevant acute electrocardiogram anomalies
- Uncontrolled hypertension
- Endocrine disorder (other than type 2 diabetes ), including type 1 or secondary diabetes (except treated hypothyroidism)
- Gilbert's disease
- Alanine aminotransferase and/or aspartate aminotransferase and/or alkaline phosphatase >1.5x upper limit of normal (ULN)
- Bilirubin >1.5x ULN
- Estimated glomerular filtration rate <45 ml/min/m2
- Creatine kinase >2x ULN
- Drug abuse within the last year
- Any glucocorticoid treatment within 3 months of screening
- Anti-coagulant medication
- Probenecid therapy
- Medical/surgical procedure or trauma during drug administration or one week after drug cessation (excluding skin biopsies)
- Involvement in trial planning and/or conduct
- Participation in other clinical study within 1 month
- Deemed inappropriate to participate by the trial team
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: AZD4017
400mg oral AZD4017 twice daily for 35 days
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AZD4017 is a novel orally bioavailable small molecule inhibitor of 11β-HSD1 enzyme activity.
It is potent and highly selective in vitro and in vivo.
The half maximal inhibitory concentration (IC50) for inhibition of 11β-HSD1 activity (cortisone to cortisol conversion) is 2nM.
AZD4017 is selective (> 2000x) for 11β-HSD1 over human recombinant 11β-HSD2 and the closely-homologous enzymes 17β-hydroxysteroid dehydrogenase 1 and 17β-hydroxysteroid dehydrogenase 3 in vitro.
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Placebo komparator: Placebo
A placebo tablet containing microcrystalline cellulose and sodium stearyl fumarate to match the active tablets in size, shape and colour.
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Matchende placebo
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Skin 11β-HSD1 activity
Tidsramme: Change between day 0 and day 28
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Enzyme activity radioassay to evaluate AZD4107 efficacy in skin
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Change between day 0 and day 28
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Urinary cortisol / cortisone metabolites
Tidsramme: Change between day 0 and day 35
|
Urine samples for tetrahydrocortisol / tetrahydrocortisone metabolite ratios to evaluate systemic AZD4107 efficacy
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Change between day 0 and day 35
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AZD4017 in plasma
Tidsramme: Change between day 0 and day 28
|
Quantification of AZD4017 concentration in plasma to evaluate systemic AZD4107 exposure
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Change between day 0 and day 28
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AZD4017 in skin
Tidsramme: Change between day 0 and day 28
|
Quantification of AZD4017 concentration in plasma to evaluate skin AZD4107 exposure
|
Change between day 0 and day 28
|
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Discontinuation due to Adverse Event
Tidsramme: Day 42
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Adverse Event-related participant withdrawals to evaluate safety
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Day 42
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Body mass index
Tidsramme: Change between day 0 and day 35
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Body mass index to evaluate safety
|
Change between day 0 and day 35
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Waist-hip ratio
Tidsramme: Change between day 0 and day 35
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Waist-hip ratio to evaluate safety
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Change between day 0 and day 35
|
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Blood pressure (sphygmomanometer)
Tidsramme: Change between day 0 and day 35
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Blood pressure to evaluate safety
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Change between day 0 and day 35
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Sudomotor function
Tidsramme: Change between day 0 and day 35
|
Conducted with a Sudoscan device to measure c-fiber innervation in hands and feet for skin function
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Change between day 0 and day 35
|
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Skin hydration
Tidsramme: Change between day 0 and day 35
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Conducted with a Corneometer device to measure skin water content for skin function
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Change between day 0 and day 35
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Epidermal barrier function
Tidsramme: Change between day 0 and day 35
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Conducted with a Tewameter device to measure skin trans-epidermal water loss for skin function
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Change between day 0 and day 35
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Epidermal barrier integrity
Tidsramme: Change between day 0 and day 28
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Conducted by tape tripping to a pre-determined trans-epidermal water loss rate for skin function
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Change between day 0 and day 28
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Skin thickness
Tidsramme: Change between day 0 and day 35
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Conducted by Optical Coherence Tomography imaging for skin function
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Change between day 0 and day 35
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Wound healing
Tidsramme: Change between day 0 and day 2
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Conducted by Optical Coherence Tomography imaging for skin function
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Change between day 0 and day 2
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Wound healing
Tidsramme: Change between day 0 and day 7
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Conducted by Optical Coherence Tomography imaging for skin function
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Change between day 0 and day 7
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Wound healing
Tidsramme: Change between day 28 and day 30
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Conducted by Optical Coherence Tomography imaging for skin function
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Change between day 28 and day 30
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Wound healing
Tidsramme: Change between day 28 and day 35
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Conducted by Optical Coherence Tomography imaging for skin function
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Change between day 28 and day 35
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Skin RNA-seq gene expression profiling
Tidsramme: Change between day 0 and day 28
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For skin function
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Change between day 0 and day 28
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- ED17/93260
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