- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT03313297
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
Tutkimuksen yleiskatsaus
Yksityiskohtainen kuvaus
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.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Vaihe 2
Yhteystiedot ja paikat
Opiskelupaikat
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Leeds, Yhdistynyt kuningaskunta, LS9 7TF
- Leeds Teaching Hospitals Trust
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
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
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Nelinkertaistaa
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Active Comparator: 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 Comparator: 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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Vastaava lumelääke
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Skin 11β-HSD1 activity
Aikaikkuna: 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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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Urinary cortisol / cortisone metabolites
Aikaikkuna: Change between day 0 and day 35
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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
Aikaikkuna: Change between day 0 and day 28
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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
Aikaikkuna: Change between day 0 and day 28
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Quantification of AZD4017 concentration in plasma to evaluate skin AZD4107 exposure
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Change between day 0 and day 28
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Discontinuation due to Adverse Event
Aikaikkuna: 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
Aikaikkuna: Change between day 0 and day 35
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Body mass index to evaluate safety
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Change between day 0 and day 35
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Waist-hip ratio
Aikaikkuna: 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)
Aikaikkuna: 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
Aikaikkuna: Change between day 0 and day 35
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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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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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Yhteistyökumppanit ja tutkijat
Sponsori
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
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