Relacorilant in Patients With Poorly Controlled Type 2 Diabetes and Autonomous Cortisol Secretion
The purpose of this study is to assess the effect and effectiveness of Relacorilant on improving the glucose levels in the blood, thus potentially improving glucose control in patients with hard to control diabetes.
This study involves the use of an investigational drug called Relacorilant. "Investigational" means that the drug has not yet been approved by the U.S. Food & Drug Administration (FDA) for treating "mild hypercortisolism" in patients with diabetes. Cortisol is a "stress hormone". The excess production of cortisol can rise blood sugar (glucose) levels and worsen diabetes. Those disturbances might be corrected by the study medication Relacorilant to improve the state of your diabetes.
This study will evaluate the effects of Relacorilant on glucose control and its safety profile. Although the safety of this drug has been tested in prior human research studies, some side effects may not yet be known.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
The objective of the study is to investigate the mechanisms by which glucocorticoid receptor (GR) antagonism with relacorilant improves glucose homeostasis in patients with difficult-to-control type 2 diabetes (T2D) and confirmed endogenous hypercortisolism.
Each patient serves as their own control to assess the mechanistic nature of the study. Comparisons made between pre- and post-treatment outcomes. This within-subject design allows detailed assessment of metabolic changes in response to treatment.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
- Fase 1
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ralph DeFronzo, MD
- Telefonnummer: 210 567 6692
- E-mail: defronzo@uthscsa.edu
Undersøgelse Kontakt Backup
- Navn: Eugene Feigin, PhD
- Telefonnummer: 210 567 6707
- E-mail: feigin@uthscsa.edu
Studiesteder
-
-
Texas
-
San Antonio, Texas, Forenede Stater, 78229
- University of Texas Health Science Center at San Antonio
-
Kontakt:
- Ralph DeFronzo, MD
- Telefonnummer: 210-567-6691
- E-mail: defronzo@uthscsa.edu
-
Kontakt:
- Andrea Hansis-Diarte, MPH
- Telefonnummer: 210-567-3208
- E-mail: hansisdiarte@uthscsa.edu
-
San Antonio, Texas, Forenede Stater, 78229-3900
- Texas Diabetes Institute/UH
-
Kontakt:
- Ralph DeFronzo, MD
- Telefonnummer: 210-358-7200
- E-mail: defronzo@uthscsa.edu
-
Ledende efterforsker:
- Ralph DeFronzo, MD
-
Kontakt:
- Andrea Hansis-Diarte, MPh
- Telefonnummer: 210-567-3208
- E-mail: hansisdiarte@uthscsa.edu
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
-
Age between 18 and 75 years.
-
Males or females
-
HbA1c between 7.5% and 10.5%
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Type 2 diabetes with at least one of the following:
- Taking ≥ 3 glucose-lowering drugs
- Taking 2 glucose lowering medication and 2 anti-hypertensive drugs.
- Taking insulin and any other glucose lowering drugs
- Taking ≥ 2 glucose-lowering drugs and presence of microvascular (retinopathy, nephropathy, neuropathy) or ≥ macrovascular (heart attack, heart failure, peripheral vascular disease, atrial fibrillation) disease
-
No changes in diabetes medications in the 4 weeks prior to enrollment.
-
Estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73m².
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Blood pressure lower than 170/110 mmHg.
-
Abnormal dexamethasone suppression test: morning plasma cortisol >1.8 µg/dL with plasma dexamethasone ≥140 ng/dL.
-
Self-reported stable (within ±6 lbs in the last 3 months) body weight and body mass index (BMI) between 25-40 kg/m².
-
Negative Glutamic Acid Decarboxylase (GAD) antibody.
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Hematocrit ≥ 34%.
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Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) ≤ 3× the upper limit of normal.
-
Female participants of childbearing potential must have a negative pregnancy test and agree to use appropriate contraception throughout the study. (Women who are using hormonal contraceptives will need to agree to use an acceptable method of non-hormonal contraception throughout the study and for ≥6 half-lives after the last dose of assigned treatment (7 days prior to randomization).
Exclusion Criteria:
- Diagnosis of type 1 diabetes
- New-onset diabetes of less than 1 year duration.
- Presence of severe acute medical, psychiatric, or surgical illness.
- Use of systemic (oral, IV, intra-articular, or inhaled) or topical glucocorticoids within the past 3 months.
- Use of systemic glucocorticoid during the study is prohibited except in the event of medical emergency OR Requires inhaled glucocorticoid use and may require systemic glucocorticoids if their condition deteriorates during the study
- Night shift workers (unless able to temporarily change sleep schedule to complete dexamethasone test).
- Severe untreated sleep apnea. (Severe untreated sleep apnea, defined as an Apnea-Hypopnea Index (AHI) ≥ 30 events per hour on polysomnography, or a documented clinical diagnosis of severe sleep apnea in patients who are not receiving effective therapy (e.g., CPAP, BiPAP, oral appliance, or surgical treatment).
- Excessive alcohol intake: >14 drinks/week for men or >7 drinks/week for women.
- Diagnosed with or having treatment plans for Cushing syndrome
- Known hypersensitivity to dexamethasone or relacorilant.
- Severe, uncontrolled hypertension (>170/110 mmHg) at screening.
- Use of another investigational drug within 4 weeks or less than 5 half-lives of the compound, whichever is longer.
- Pregnant or lactating women or women of childbearing potential (including all women <50 years old, women whose surgical sterilization was performed <6 months ag; and women who have had a menstrual period in the last 12 months; and women who have a positive pregnancy test before dexamethasone administration.)
- Women with a history of unexplained vaginal bleeding, endometrial hyperplasia with atypia or endometrial carcinoma.
- Diagnosed with or having treatment plans for Cushing syndrome using any of the following treatments: mifepristone, metyrapone, osilodrostat, ketoconazole, fluconazole, aminoglutethimide, etomidate, octreotide, larazotide, pasireotide, long-acting octreotide or pasireotide.
- Uncontrolled thyroid disease (hypo- or hyperthyroidism) prior to first dose of relacorilant as confirmed by TSH outside of normal range (0.4 to 5.0 mIU/L).
- Has plans for adrenalectomy or adrenal nodulectomy during the study period.
- Taking any co-medications that is disallowed with strong CYP3A inhibitors and cannot undergo dose modifications on coadministration with a strong CYP3A inhibitor
- Ongoing use of any strong CYP3A4 inducer
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Study Investigational Drug Group
Participants will receive study intervention once daily after screening and dexamethasone suppression test. |
A capsule that will be given once daily starting at 100mg and increasing gradually to 400mg once a day.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
HbA1c (measure of average blood sugar over 3 months) levels
Tidsramme: Baseline to 24 weeks
|
Lab test performed on whole blood hemoglobin to determine the blood sugar level over a 3 month period |
Baseline to 24 weeks
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Beta-cell funtion
Tidsramme: Baseline to 24 weeks
|
Disposition index and C-peptide response during OGTT and euglycemic insulin clamp. |
Baseline to 24 weeks
|
|
Change in total body fat
Tidsramme: Baseline to 24 weeks
|
Measured by DEXA scan |
Baseline to 24 weeks
|
|
Liver and visceral fat
Tidsramme: Baseline to 24 weeks
|
Measured using MRI PDFF (magnetic resonance imaging-proton density fat fraction) |
Baseline to 24 weeks
|
|
Liver stiffness
Tidsramme: Baseline to 24 weeks
|
Assessed using Fibroscan |
Baseline to 24 weeks
|
|
Change in insulin sensitivity
Tidsramme: Baseline to 20-24 weeks
|
Assessed using the Oral glucose tolerance test |
Baseline to 20-24 weeks
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Ralph DeFronzo, MD, The University of Texas Health Science Center at San Antonio
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
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
- STUDY00002401
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Study participant research data, which is for purposes of statistical analysis and scientific reporting, will be transmitted to and stored at the Diabetes division at UT Health. This will not include the participant's contact or identifying information. Rather, individual participants and their research data will be identified by a unique study identification number.
IPD-delingstidsramme
After study completion and data analysis
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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