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Glucocorticoids and Skin Healing in Diabetes (GC-SHealD) (GC-SHealD)

21. mars 2019 oppdatert av: Ana Tiganescu, PhD, University of Leeds

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

The study aims to investigate effects of inhibiting glucocorticoid activation on skin function and wound healing in patients with type 2 diabetes. Half of patients will be given a drug to inhibit glucocorticoid activation and the other half will be given a placebo.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

  1. Oral AZD4017 inhibits 11β-HSD1 activity in skin
  2. AZD4017 is safe and well-tolerated in patient with T2DM
  3. Oral AZD4017 regulates skin function
  4. 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.

Studietype

Intervensjonell

Registrering (Faktiske)

28

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Storbritannia
      • Leeds, Storbritannia, LS9 7TF
        • Leeds Teaching Hospitals Trust

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. Able and willing to consent
  2. Type 2 diabetes with HbA1c ≤11% (≤97 mmol/mol) at screening while taking standard therapy at a stable dose for ≥10 weeks

Exclusion Criteria:

  1. Women of child-bearing potential
  2. Active leg/foot ulceration
  3. Clinically relevant acute electrocardiogram anomalies
  4. Uncontrolled hypertension
  5. Endocrine disorder (other than type 2 diabetes ), including type 1 or secondary diabetes (except treated hypothyroidism)
  6. Gilbert's disease
  7. Alanine aminotransferase and/or aspartate aminotransferase and/or alkaline phosphatase >1.5x upper limit of normal (ULN)
  8. Bilirubin >1.5x ULN
  9. Estimated glomerular filtration rate <45 ml/min/m2
  10. Creatine kinase >2x ULN
  11. Drug abuse within the last year
  12. Any glucocorticoid treatment within 3 months of screening
  13. Anti-coagulant medication
  14. Probenecid therapy
  15. Medical/surgical procedure or trauma during drug administration or one week after drug cessation (excluding skin biopsies)
  16. Involvement in trial planning and/or conduct
  17. Participation in other clinical study within 1 month
  18. Deemed inappropriate to participate by the trial team

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: AZD4017
400mg oral AZD4017 twice daily for 35 days
Legemiddel: AZD4017
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.
Placebo komparator: Placebo
A placebo tablet containing microcrystalline cellulose and sodium stearyl fumarate to match the active tablets in size, shape and colour.
Legemiddel: Placebo
Matchende placebo

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Skin 11β-HSD1 activity
Tidsramme: Change between day 0 and day 28
Enzyme activity radioassay to evaluate AZD4107 efficacy in skin
Change between day 0 and day 28

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Urinary cortisol / cortisone metabolites
Tidsramme: Change between day 0 and day 35
Urine samples for tetrahydrocortisol / tetrahydrocortisone metabolite ratios to evaluate systemic AZD4107 efficacy
Change between day 0 and day 35
AZD4017 in plasma
Tidsramme: Change between day 0 and day 28
Quantification of AZD4017 concentration in plasma to evaluate systemic AZD4107 exposure
Change between day 0 and day 28
AZD4017 in skin
Tidsramme: Change between day 0 and day 28
Quantification of AZD4017 concentration in plasma to evaluate skin AZD4107 exposure
Change between day 0 and day 28
Discontinuation due to Adverse Event
Tidsramme: Day 42
Adverse Event-related participant withdrawals to evaluate safety
Day 42
Body mass index
Tidsramme: Change between day 0 and day 35
Body mass index to evaluate safety
Change between day 0 and day 35
Waist-hip ratio
Tidsramme: Change between day 0 and day 35
Waist-hip ratio to evaluate safety
Change between day 0 and day 35
Blood pressure (sphygmomanometer)
Tidsramme: Change between day 0 and day 35
Blood pressure to evaluate safety
Change between day 0 and day 35
Sudomotor function
Tidsramme: Change between day 0 and day 35
Conducted with a Sudoscan device to measure c-fiber innervation in hands and feet for skin function
Change between day 0 and day 35
Skin hydration
Tidsramme: Change between day 0 and day 35
Conducted with a Corneometer device to measure skin water content for skin function
Change between day 0 and day 35
Epidermal barrier function
Tidsramme: Change between day 0 and day 35
Conducted with a Tewameter device to measure skin trans-epidermal water loss for skin function
Change between day 0 and day 35
Epidermal barrier integrity
Tidsramme: Change between day 0 and day 28
Conducted by tape tripping to a pre-determined trans-epidermal water loss rate for skin function
Change between day 0 and day 28
Skin thickness
Tidsramme: Change between day 0 and day 35
Conducted by Optical Coherence Tomography imaging for skin function
Change between day 0 and day 35
Wound healing
Tidsramme: Change between day 0 and day 2
Conducted by Optical Coherence Tomography imaging for skin function
Change between day 0 and day 2
Wound healing
Tidsramme: Change between day 0 and day 7
Conducted by Optical Coherence Tomography imaging for skin function
Change between day 0 and day 7
Wound healing
Tidsramme: Change between day 28 and day 30
Conducted by Optical Coherence Tomography imaging for skin function
Change between day 28 and day 30
Wound healing
Tidsramme: Change between day 28 and day 35
Conducted by Optical Coherence Tomography imaging for skin function
Change between day 28 and day 35
Skin RNA-seq gene expression profiling
Tidsramme: Change between day 0 and day 28
For skin function
Change between day 0 and day 28

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Leeds

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

10. april 2018

Primær fullføring (Faktiske)

27. februar 2019

Studiet fullført (Faktiske)

13. mars 2019

Datoer for studieregistrering

Først innsendt

5. oktober 2017

Først innsendt som oppfylte QC-kriteriene

17. oktober 2017

Først lagt ut (Faktiske)

18. oktober 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

22. mars 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

21. mars 2019

Sist bekreftet

1. mars 2019

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • ED17/93260

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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