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Metformin in Obese Children and Adolescents (MetVoorMin)

26. april 2017 opdateret af: Van der Vorst, St. Antonius Hospital

An Efficacy, Safety and Pharmacokinetic Study on the Short-term and Long-term Use of Metformin in Obese Children and Adolescents

The purpose of this study is to determine whether metformin is effective in reducing BMI and insulin resistance in obese children and adolescents.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The prevalence of obesity in children and adolescents is increasing rapidly and is associated with significant medical and psychosocial consequences persisting into adulthood.

Obesity may lead to metabolic complications, such as insulin resistance, which can progress via impaired fasted glucose and impaired glucose tolerance to type 2 diabetes mellitus (T2DM) and to the development of micro- and macro-vascular complications.

Metformin, an oral anti-diabetic licensed for T2DM for adults and children from 10 years onwards, is already used off label in obese children and adolescents with insulin resistance, even though the specific effects of metformin in these obese children and adolescents have not been elucidated, particularly upon long-term use.

The rationale for this study is based on the hypothesis that metformin may reduce body mass index (BMI), insulin resistance and percentage of body-fat in obese children and adolescents with insulin resistance. Further more it is anticipated that metformin may delay the progression to T2DM and thereby micro- and macro-vascular complications in obese children and adolescents with insulin resistance.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

62

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Holland
      • 's Hertogenbosch, Holland
        • Jeroen Bosch Hospital
      • Nieuwegein, Holland, 3430EM
        • St. Antonius Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

10 år til 16 år (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age ≥ 10 and ≤ 16 years at study entry
  • Caucasian descent
  • Obesity defined as BMI-SDS > 2.3
  • Insulin resistance defined as HOMA-IR ≥ 3.4.
  • An obtained informed consent from subjects and parents/caregivers.

Exclusion Criteria:

  • Presence of T2DM (American Diabetes Association criteria)
  • Presence of endocrine disorders with steroid therapy
  • Suspicion of polycystic ovarium syndrome;
  • Height < -1.3 SD of target height;
  • Syndrome disorders with or without mental retardation;
  • Use of anti-hyperglycaemic drugs;
  • Pregnancy (pregnancy test will be performed, if applicable);
  • (History of) alcohol abuse;
  • Impaired renal and/or hepatic function (defined as GFR < 80 ml/min. GFR=40 x length (cm) / serumcreatinin (μmol/l and ALAT >150% of normal value for age);
  • Use of ritonavir; use of ACE inhibitors;
  • Insufficient knowledge of the Dutch language.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Metformin
Metformin with lifestyle intervention during 18 months
Medicin: Metformin
Oral administration, 500 mg daily at week 1. Every week metformin dosage increases with 500 mg, to a maximum dose of 1000 mg bid. This maximum dose will be administered till the end of the study.
Andre navne:
  • Glucophage
Adfærdsmæssigt: Lifestyle intervention
Lifestyle intervention: 18 months physical therapy and dietary advice
Placebo komparator: Placebo
Placebo and lifestyle intervention during 18 months
Adfærdsmæssigt: Lifestyle intervention
Lifestyle intervention: 18 months physical therapy and dietary advice

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in BMI from baseline
Tidsramme: 18 months and 36 months
Change in BMI after part 1 (double blind) and part 2 ( follow-up)
18 months and 36 months
Change in Insulin resistance from baseline
Tidsramme: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
calculated by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR).
3; 6; 9; 12; 15; 18; 24; 30 and 36 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Renal and hepatic function
Tidsramme: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
creatinine and alat
3; 6; 9; 12; 15; 18; 24; 30 and 36 months
Tolerability
Tidsramme: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
The amount of reported adverse effects, in relation to the achieved dose level.
3; 6; 9; 12; 15; 18; 24; 30 and 36 months
Pharmacokinetics (PK)-parameters: clearance (ml/min)
Tidsramme: 9 months
Clearance where applicable expressed per body weight, age category, Tanner Stage and gender, clearance will be determined with a two-compartment pharmacokinetic model using non linear mixed effect modelling.
9 months
Body fat percentage
Tidsramme: 0, 9, 18 and 36 months
0, 9, 18 and 36 months
Physical fitness
Tidsramme: 0, 9, 18 and 36 months
0, 9, 18 and 36 months
Quality of life
Tidsramme: 0, 9, 18 and 36 months
0, 9, 18 and 36 months
Long term efficacy
Tidsramme: 36 months
Based on BMI and HOMA-IR values
36 months
Long-term safety
Tidsramme: 36 months
Renal and hepatic function after 36 months of metformin use
36 months
Long-term tolerability
Tidsramme: 36 months
The amount of adverse effects after 36 months
36 months
Microvascular complications
Tidsramme: 36 months
Measured as micro-albuminuria
36 months
Macrovascular complications
Tidsramme: 36 monthts
Measured with Pulse Wave Velocity and Augmentation Index.
36 monthts
Development of T2DM
Tidsramme: 36 months
36 months
PK-parameters: volume of distribution (liters)
Tidsramme: 9 months
Volume of distribution, where applicable expressed per body weight, age category, Tanner Stage and gender, volume of distribution will be determined with a two-compartment pharmacokinetic model using non linear mixed effect modelling.
9 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

St. Antonius Hospital

Samarbejdspartnere

Jeroen Bosch Ziekenhuis

Efterforskere

  • Ledende efterforsker: Marja MJ van der Vorst, MD, PhD, St. Antonius Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2011

Primær færdiggørelse (Faktiske)

1. august 2015

Studieafslutning (Faktiske)

28. februar 2017

Datoer for studieregistrering

Først indsendt

20. oktober 2011

Først indsendt, der opfyldte QC-kriterier

6. december 2011

Først opslået (Skøn)

8. december 2011

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

27. april 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. april 2017

Sidst verificeret

1. april 2017

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Metformin 2011-6
  • 2010-023980-17 (EudraCT nummer)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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Betingelser

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Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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