Pre-pubertal Low Dose Transdermal Estradiol in Turner Syndrome
Ultra-low Dose Transdermal Estradiol Therapy in Prepubertal Girls With Turner Syndrome and Primary Ovarian Insufficiency.
調査の概要
状態
詳細な説明
The investigators hypothesize that ultra-low dose TDE will improve neurocognitive measures without a negative impact on growth and pubertal maturation in the peripubertal period. To test this hypothesis, investigators will conduct a prospective single center pilot trial and recruit up to 15 girls with TS and POI (FSH>10 in the past year), ages 8 to <11.5 years who will receive ultra-low dose TDE [defined as 1/8th patch of 0.025mg/24h applied weekly (delivering 3.125mcg/24h)] for 6 months to address the following objectives.
Primary: Study the effect of ultra-low dose TDE therapy on processing speed and working memory. The investigators will administer the Pattern Comparison Processing Speed Test as well as the List Sorting Working Memory test NIH toolbox EnglishV3 at baseline, and 6-months of TDE treatment.
Secondary: Assess change in pubertal status, FSH, LH and estradiol levels with ultra-low dose TDE therapy. Height, weight measurements, assessment of Tanner staging for breast development, laboratory measurements of ultrasensitive estradiol, FSH, LH, lipid profile at baseline and 6-months of TDE treatment will be completed
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究連絡先
- 名前:Roopa Kanakatti Shankar, MBBS, MS
- 電話番号:202-476-2121
- メール:roopa.shankar@childrensnational.org
研究連絡先のバックアップ
- 名前:Kimberly Pitner, MSHS, BSN, RN
- 電話番号:202-476-1403
- メール:kboucher@childrensnational.org
研究場所
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District of Columbia
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Washington D.C.、District of Columbia、アメリカ、20010
- Children's National Hospital
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コンタクト:
- Kimberly Pitner, MSHS, BSN, RN
- 電話番号:202-476-1403
- メール:kboucher@childrensnational.org
-
主任研究者:
- Roopa Kanakatti Shankar, MBBS, MS
-
-
参加基準
適格基準
就学可能な年齢
- 子
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Provision of signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Female, aged 8 years up to 11 y and 180 days with karyotype confirmed Turner syndrome
- FSH result> 10miu/mL in the past 12 months. Since variability in FSH is not uncommon, a single measure of FSH >10mIU/mL in the past calendar year will be deemed sufficient for inclusion into the study even if repeat measures may be under 10mIU/mL.
- Ability to take the transdermal estradiol medication and be willing to adhere to the treatment regimen
- Ability to complete the primary endpoint testing in English. Non-English speakers may be recruited if the participant is capable of performing the English version of the tests.
Exclusion Criteria:
- Spontaneous thelarche with breast Tanner stage 3 or more, spontaneous menarche or history of abnormal uterine bleeding.
- Previous estrogen exposure
- Cognitive impairment is severe enough to prevent assessment of the primary outcome measures.
- Untreated hypothyroidism or celiac disease: Individuals may be recruited if on treatment and stable medication dose in past 3 months.
- Subjects known to have Y-chromosome material unless they have undergone gonadectomy and have fully external female genitalia
- History of any type of malignancy
- History of a known clotting disorder/deep venous thrombosis
- Any clinically significant abnormality as determined by the principal investigator.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Estradiol Treatment
Patients opt to receive 6 months of transdermal ultra low dose estradiol treatment
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Estradiol transdermal patch 0.025mg/24 hours- 1/8th fractionated patch will be applied and changed weekly for 6 months
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Pattern Comparison processing speed test
時間枠:6 months
|
Changes in the Pattern Comparison processing speed test (PC) at 6 months on the NIH toolbox EnglishV3 compared to baseline.
Pattern Comparison processing speed test (PC) is a measure of the speed of information processing.
Participants see a pair of simple pictures on the iPad screen and must quickly discern whether the pictures are the same or different.
The total raw score is the number of items answered correctly during the 80 seconds of presentation time (Max 133 items).
The raw score is converted to a age-adjusted normative scores.
The Median Response Time Per Item is also available.
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6 months
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List Sorting Working Memory (LSWM) test
時間枠:6 months
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Changes in the List sorting working memory test on the NIH toolbox EnglishV3 at 6 months compared to baseline.
The List Sorting Working Memory test measures a participant's working memory, the ability to hold information in a short-term buffer and then manipulate the information.
Pictures and written names of different foods and animals are displayed with accompanying audio-recorded and visual prompts, and the participant is asked to say the items back in size order from smallest to largest, first within a single dimension and then on two dimensions.
The raw score (up to 24 Max) is then converted to age-adjusted normative scores.
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6 months
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Breast Tanner stage
時間枠:6 months
|
Changes in breast sexual maturity rating (Tanner staging) on examination over 6 months with ultra-low dose estradiol treatment
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6 months
|
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Pubertal hormone changes
時間枠:6 months
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Changes in serum estradiol (measured in pg/mL), after 6 months of ultra-low dose estradiol treatment compared to baseline.
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6 months
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LH
時間枠:6 months
|
Luteinizing hormone (LH) (measured in U/L) over 6 months of estradiol therapy
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6 months
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FSH
時間枠:6 months
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Change in Follicle stimulating hormone (FSH) measured in U/L over 6 months of estradiol therapy
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6 months
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Height velocity
時間枠:6 months
|
Change in annualized height velocity (in cm/year) over 6 months of treatment with ultra-low dose estradiol.
This will be calculated based on height measurements (in cm) at baseline and 6 months.
|
6 months
|
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Lipid profile
時間枠:6 months
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Changes in lipid profile (total cholesterol, triglycerides, high density lipoproteins, low density lipoproteins) over 6 months of treatment with ultra-low dose estradiol will be assessed.
|
6 months
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- STUDY00002034
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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