- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01877512
GH and Cardiovascular Risk Factors
Effect of Growth Hormone Replacement Therapy on Cardiovascular Risk Factors in Adult Patients With Severe Growth Hormone Deficiency: Association With IGF-I Concentration
Rationale: Abnormally low and high levels of insulin-like growth factor-I (IGF-I) are both associated with increased metabolic risk. Since (U-shaped) associations of IGF-I, within the normal range, have also been found with cardiovascular risk factors and disease in the general population, it would be interesting to investigate if this association can also be found in growth hormone deficient (GHD) adults treated with Growth Hormone (GH). This could be of interest for endocrinologists prescribing GH in clinical practice because strict dosing may become even more important. Next to that, scientific evidence for clinical practice is wanted.
Objective: Next to cardiovascular risk factors (main objectives: body composition and lipid profile; secondary objectives: remainder) we investigate the effect on glucose metabolism, physical performance, and neuropsychological functioning of different levels of IGF-I in GH treated GHD men and women.
Study design: Open-label randomized trial.
Study population: At least 32 subjects, both childhood as adult onset GHD men and women, receiving GH treatment for at least one year, with an age between 20 and 65 years.
Intervention: At entry subjects are already receiving GH treatment according to general clinical practice, and are expected to demonstrate an IGF-I concentration of 0 - 1 SD score (SDS) (normal dose). The group of men and group of women will be randomized to receive either a decrease of their regular dose of GH treatment (IGF-I target level of -2 - -1 SDS) (low dose), or an increase of their regular dose, (IGF-I target level of 1 - 2 SDS) (high dose) for at least 24 weeks.
Studieoversigt
Status
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
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PO Box 7057
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Amsterdam, PO Box 7057, Holland, 1007 MB
- VU University Medical Center
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Ongoing surveillance at our centre (VUmc)
- Stable substitution therapy for other pituitary hormone deficiencies
Exclusion Criteria:
- Subjects with a craniopharyngioma as cause of their GHD or pituitary deficiencies
- Contraindications for the use of GH treatment
- (Receiving treatment for) malignant disease (in the past)
- Cardiovascular event less than one year prior to inclusion
- Participation in other studies
- Subjects, who in the opinion of the investigator, are unsuitable in any other way to participate in this study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Aktiv komparator: Low dose Growth Hormone
Halve of the group of men and group of women will receive a decrease of their regular dose of Growth Hormone treatment, with the IGF-I target level of -2 - -1 SD score (low dose=LD).
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Andre navne:
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Aktiv komparator: High dose Growth Hormone
Halve of the group of men and group of women will receive an increase of their regular dose of Growth Hormone treatment, with the IGF-I target level of 1 - 2 SD score (high dose=HD).
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Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Change in cardiovascular risk (body composition and lipid profile)
Tidsramme: 24 weeks
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24 weeks
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Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Change in cardiovascular risk (inflammatory markers, vascular stiffness, endothelial function, presence of the metabolic syndrome)
Tidsramme: 24 weeks
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24 weeks
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Change in physical performance (muscle strength, physical activity)
Tidsramme: 24 weeks
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24 weeks
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Change in glucose metabolism (fasting and 2hr postprandial glucose, insulin resistance)
Tidsramme: 24 weeks
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24 weeks
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Change in neuropsychological functioning (QoL, cognition, mood)
Tidsramme: 24 weeks
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24 weeks
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: Madeleine L. Drent, MD PhD, Amsterdam UMC, location VUmc
Publikationer og nyttige links
Generelle publikationer
- van Bunderen CC, Meijer RI, Lips P, Kramer MH, Serne EH, Drent ML. Titrating Growth Hormone Dose to High-Normal IGF-1 Levels Has Beneficial Effects on Body Fat Distribution and Microcirculatory Function Despite Causing Insulin Resistance. Front Endocrinol (Lausanne). 2021 Feb 9;11:619173. doi: 10.3389/fendo.2020.619173. eCollection 2020.
- van Bunderen CC, Deijen JB, Drent ML. Effect of low-normal and high-normal IGF-1 levels on memory and wellbeing during growth hormone replacement therapy: a randomized clinical trial in adult growth hormone deficiency. Health Qual Life Outcomes. 2018 Jul 6;16(1):135. doi: 10.1186/s12955-018-0963-2.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Glukosemetabolismeforstyrrelser
- Metaboliske sygdomme
- Hjernesygdomme
- Sygdomme i centralnervesystemet
- Sygdomme i nervesystemet
- Sygdomme i det endokrine system
- Muskuloskeletale sygdomme
- Hypothalamus sygdomme
- Insulin resistens
- Hyperinsulinisme
- Knoglesygdomme
- Knoglesygdomme, endokrine
- Hypofysesygdomme
- Dværgvækst
- Knoglesygdomme, udviklingsmæssige
- Hypopituitarisme
- Hjerte-kar-sygdomme
- Metabolisk syndrom
- Dværgvækst, hypofyse
- Lægemidlers fysiologiske virkninger
- Hormoner, hormonsubstitutter og hormonantagonister
- Hormoner
Andre undersøgelses-id-numre
- 2013/12
- U1111-1142-9659 (Anden identifikator: Universal Trial Number)
- 2012-005066-36 (EudraCT nummer)
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Kliniske forsøg med Hjerte-kar-sygdomme
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Ottawa Hospital Research InstituteAfsluttetStress | Crisis Resource Management (CRM) færdigheder | Advanced Cardiovascular Life Support (ACLS) færdighederCanada
Kliniske forsøg med Change in daily dosage of Growth Hormone
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