- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT01487993
Metformin in Obese Children and Adolescents (MetVoorMin)
An Efficacy, Safety and Pharmacokinetic Study on the Short-term and Long-term Use of Metformin in Obese Children and Adolescents
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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's Hertogenbosch, Olanda
- Jeroen Bosch Hospital
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Nieuwegein, Olanda, 3430EM
- St. Antonius Hospital
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
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.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Triplicare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Comparatore attivo: Metformin
Metformin with lifestyle intervention during 18 months
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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.
Altri nomi:
Lifestyle intervention: 18 months physical therapy and dietary advice
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Comparatore placebo: Placebo
Placebo and lifestyle intervention during 18 months
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Lifestyle intervention: 18 months physical therapy and dietary advice
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in BMI from baseline
Lasso di tempo: 18 months and 36 months
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Change in BMI after part 1 (double blind) and part 2 ( follow-up)
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18 months and 36 months
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Change in Insulin resistance from baseline
Lasso di tempo: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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calculated by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR).
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3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Renal and hepatic function
Lasso di tempo: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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creatinine and alat
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3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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Tolerability
Lasso di tempo: 3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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The amount of reported adverse effects, in relation to the achieved dose level.
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3; 6; 9; 12; 15; 18; 24; 30 and 36 months
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Pharmacokinetics (PK)-parameters: clearance (ml/min)
Lasso di tempo: 9 months
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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.
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9 months
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Body fat percentage
Lasso di tempo: 0, 9, 18 and 36 months
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0, 9, 18 and 36 months
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Physical fitness
Lasso di tempo: 0, 9, 18 and 36 months
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0, 9, 18 and 36 months
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Quality of life
Lasso di tempo: 0, 9, 18 and 36 months
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0, 9, 18 and 36 months
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Long term efficacy
Lasso di tempo: 36 months
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Based on BMI and HOMA-IR values
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36 months
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Long-term safety
Lasso di tempo: 36 months
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Renal and hepatic function after 36 months of metformin use
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36 months
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Long-term tolerability
Lasso di tempo: 36 months
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The amount of adverse effects after 36 months
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36 months
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Microvascular complications
Lasso di tempo: 36 months
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Measured as micro-albuminuria
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36 months
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Macrovascular complications
Lasso di tempo: 36 monthts
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Measured with Pulse Wave Velocity and Augmentation Index.
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36 monthts
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Development of T2DM
Lasso di tempo: 36 months
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36 months
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PK-parameters: volume of distribution (liters)
Lasso di tempo: 9 months
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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.
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9 months
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Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Marja MJ van der Vorst, MD, PhD, St. Antonius Hospital
Pubblicazioni e link utili
Pubblicazioni generali
- van Rongen A, van der Aa MP, Matic M, van Schaik RHN, Deneer VHM, van der Vorst MM, Knibbe CAJ. Increased Metformin Clearance in Overweight and Obese Adolescents: A Pharmacokinetic Substudy of a Randomized Controlled Trial. Paediatr Drugs. 2018 Aug;20(4):365-374. doi: 10.1007/s40272-018-0293-1.
- van der Aa MP, Hoving V, van de Garde EM, de Boer A, Knibbe CA, van der Vorst MM. The Effect of Eighteen-Month Metformin Treatment in Obese Adolescents: Comparison of Results Obtained in Daily Practice with Results from a Clinical Trial. J Obes. 2016;2016:7852648. doi: 10.1155/2016/7852648. Epub 2016 Dec 22.
- van der Aa MP, Elst MA, van Mil EG, Knibbe CA, van der Vorst MM. METFORMIN: an efficacy, safety and pharmacokinetic study on the short-term and long-term use in obese children and adolescents - study protocol of a randomized controlled study. Trials. 2014 Jun 5;15:207. doi: 10.1186/1745-6215-15-207.
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- Metformin 2011-6
- 2010-023980-17 (Numero EudraCT)
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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