- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving 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
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert 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.
Studietype
Registrering (Faktiske)
Fase
- Fase 3
Kontakter og plasseringer
Studiesteder
-
-
-
's Hertogenbosch, Nederland
- Jeroen Bosch Hospital
-
Nieuwegein, Nederland, 3430EM
- St. Antonius Hospital
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
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
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Trippel
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: Metformin
Metformin with lifestyle intervention during 18 months
|
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 navn:
Lifestyle intervention: 18 months physical therapy and dietary advice
|
|
Placebo komparator: Placebo
Placebo and lifestyle intervention during 18 months
|
Lifestyle intervention: 18 months physical therapy and dietary advice
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
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
|
Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Marja MJ van der Vorst, MD, PhD, St. Antonius Hospital
Publikasjoner og nyttige lenker
Generelle publikasjoner
- 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.
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- Metformin 2011-6
- 2010-023980-17 (EudraCT-nummer)
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