- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07845994
SEMAFORCRANIO : Multicenter, Double-blind, Parallel, Randomized Controlled Trial of the Efficacy of Semaglutide in Hypothalamic Obesity Secondary to Craniopharyngioma in Children Aged 12 to 17 Years (SEMAFORCRANIO)
Craniopharyngioma (CP) is a rare embryonic brain tumor of the sellar and parasellar region. Despite its benign histologic characteristics, it is locally aggressive and may cause severe morbidity from invasion into adjacent tissues and structures. Hypothalamic damage due to the tumor or its management is responsible for rapid and massive obesity, one of the most severe sequelae in patients with craniopharyngioma. Current treatment of craniopharyngioma is neurosurgical, possibly completed by radiotherapy. For preventing hypothalamic damage, surgery is the most "sparing" possible for the hypothalamus, possibly completed by a highly conformation radiation treatment, such as proton beam therapy.
Despite these therapeutic advances, obesity remains a significant problem in 30 to 50% of cases today. Most studies showed that the mean BMI at diagnosis of childhood craniopharyngioma was 0.5-0.8 ± 1.5 SD score, the mean BMI gain was +2 to +3 ± 2 SD score within 3 years, with a relative stabilization or a slow increase after 3 years. When there is an anterior and posterior hypothalamic involvement (about 50% of the cases), the mean BMI gain is even higher (+4 ± 3 SD score within 3 years).
Semaglutide, a GLP1RA in weekly injection, has shown its great effectiveness for losing weight in obese adults and adolescents (mean difference in BMI change - 16.7% with semaglutide vs. placebo after 68 weeks). Preliminary data in obese children with craniopharyngioma have shown a mean 25% difference in annual BMI gain (with semaglutide treatment compared to the previous year with no semaglutide in the same children).
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Studietype
Registrering (Antatt)
Fase
- Fase 3
Kontakter og plasseringer
Studiekontakt
- Navn: Regis COUTANT, Professor of Medecine
- Telefonnummer: + 33 (0)2 41 35 56 55
- E-post: ReCoutant@chu-angers.fr
Studer Kontakt Backup
- Navn: Matthieu LE LAY
- Telefonnummer: +33 (0)2 41 35 58 91
- E-post: DRCI-Promotion-Interne@chu-angers.fr
Studiesteder
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Angers, Frankrike
- Service Endocrinologie pédiatrique, Angers University Hospital
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Ta kontakt med:
- Régis COUTANT, Professor of Medecine
- Telefonnummer: +33 (0)2.41.35.56.55
- E-post: recoutant@chu-angers.fr
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Besançon, Frankrike, 25030
- Endocrinologie Pédiatrique, University hospital of Besançon
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Ta kontakt med:
- Brigitte MIGNOT, Doctor of Medecine
- Telefonnummer: +33(0)3.81.21.91.81
- E-post: bmignot@chu-besancon.fr
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Bordeaux, Frankrike
- Service d'endocrinologie, diabétoglogie et obésité pédiatrique, Bordeaux University Hospital
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Ta kontakt med:
- Pascal BARAT, Professor of Medecine
- Telefonnummer: +33(0)5.56.79.87.25
- E-post: pascal.barat@chu-bordeaux.fr
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Bron, Frankrike
- Endocrinologie Pédiatrique, Hôpital Femme Mere Enfants, Lyon University Hospital
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Ta kontakt med:
- Carine VILLANUEVA, Doctor of Medecine
- Telefonnummer: +33(0)4.27.85.53.28
- E-post: carine.villanueva@chu-lyon.fr
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Dijon, Frankrike
- Département de Pédiatrie, Dijon University Hospital
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Ta kontakt med:
- Candace BEN SIGNOR, Doctor of Medecine
- Telefonnummer: +33(0)3.80.29.30.31
- E-post: candace.bensignor@chu-dijon.fr
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La Tronche, Frankrike
- Service de Pédiatrie, Grenoble University Hospital
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Ta kontakt med:
- Cyril RUELLO, Doctor of Medecine
- Telefonnummer: +33(0)4.76.76.89.02
- E-post: CRuello1@chu-grenoble.fr
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Le Kremlin-Bicêtre, Frankrike
- Endocrinologie et diabète de l'enfant, Hopital Bicêtre, Paris University Hospital
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Ta kontakt med:
- Cécile TEINTURIER, Doctor of Medecine
- Telefonnummer: +33(0)1.45.21.78.52
- E-post: cecile.teinturier@aphp.fr
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Lille, Frankrike
- Endocrinologie, diabète et obésité pédiatrique, Lille University Hospital
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Ta kontakt med:
- Iva GUEORGUIEVA, Doctor of Medecine
- Telefonnummer: +33(0)3.20.44.50.70
- E-post: Iva.HUBERT@CHRU-LILLE.FR
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Marseille, Frankrike
- Service de pédiatrie multidisciplinaire, Hopital La Timone, Marseille University Hospital
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Ta kontakt med:
- Rachel REYNAUD, Professor of Medecine
- Telefonnummer: +33(0)4.91.38.83.84
- E-post: rachel.reynaud@ap-hm.fr
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Montpellier, Frankrike
- Service de diabétologie et endocrinologie pédiatriques
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Ta kontakt med:
- Essia JOYEZ, Doctor of Medecine
- Telefonnummer: +33(0)4.67.33.65.06
- E-post: e-joyez@chu-montpellier.fr
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Nancy, Frankrike
- Unité Endocrinologie et Diabète, Nancy University hospital
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Ta kontakt med:
- Emeline RENARD, Doctor of Medecine
- Telefonnummer: +33(0)3.83.15.53.11
- E-post: E.RENARD@chru-nancy.fr
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Paris, Frankrike
- Endocrinologie, diabétologie et Gynécologie pédiatrique, Necker Hospital, Paris University Hospital
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Ta kontakt med:
- Dulanjalee KARIYAWASAM, Doctor of Medecine
- Telefonnummer: +33(0)1.44.49.48.02
- E-post: dulanjalee.kariyawasam@aphp.fr
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Paris, Frankrike
- Service d'endocrinologie diabétologie pédiatrique, Paris University Hospital
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Ta kontakt med:
- Ahlam AZAR-KOLAKEZ, Doctor of Medecine
- Telefonnummer: +33(0)1.40.03.41.20
- E-post: ahlam.azar-kolakez@aphp.fr
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Reims, Frankrike
- Service de Pédiatrie A, Reims University Hospital
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Ta kontakt med:
- Aurélie BEROT, Doctor of Medecine
- Telefonnummer: +33(0)3.26.78.94.78
- E-post: aberot@chu-reims.fr
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Rennes, Frankrike
- Unité d'Endocrinologie et Diabétologie Pédiatriques, Rennes University Hospital
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Ta kontakt med:
- Marie-Béatrice SAADE, Doctor of Medecine
- Telefonnummer: +33(0)2.99.26.71.34
- E-post: Marie-beatrice.SAADE@chu-rennes.fr
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Strasbourg, Frankrike
- Service de Pédiatrie, Strasbourg University Hospital
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Ta kontakt med:
- Sylvie ROSSIGNOL, Professor of Medecine
- Telefonnummer: +33(0)3.88.12.77.34
- E-post: sylvie.rossignol@chru-strasbourg.fr
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Toulouse, Frankrike
- Unité d'Endocrinologie, Maladies Osseuses et Génétique, Toulouse University Hospital
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Ta kontakt med:
- Thomas EDOUARD, Professor of Medecine
- Telefonnummer: +33(0)5.34.55.85.49
- E-post: edouard.t@chu-toulouse.fr
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Age 12 to 17 years
Treated craniopharyngioma whose last intervention was >6 months ago and whose tumor is considered stable with :
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surgical treatmentsurgery for the solid area (non-cystic portion) of the tumor was >6 months ago and whose tumor is considered stable
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irradiation treatment
- Appropriate pituitary replacements (including recombinant growth hormone replacement in case of growth hormone deficiency), as assessed by the attending child's physician, according to international recommendations.
- BMI > + 2 SD of the French references (overweight and obesity) or BMI gain ≥ + 1 SD over the past 6 to 12 months (in the absence of overweight or obesity)
- Failure to control weight despite strict adherence to dietary guidelines for at least six months (healthy nutrition and physical activity counseling provided by a dietician or other qualified healthcare professional)
- For women patients with spontaneous menarche (without the use of hormone treatment with oestrogens), highly effective contraceptive methods during all study participation (and until 7 weeks after last study drug intake)
- Subjects covered by or having the rights to medical care assurance
- Written consent signed by the parents or legally acceptable representatives of the subject, and child participation agreement
Exclusion Criteria:
- Other weight loss treatments within 90 days before screening
- Previous surgical treatment for obesity
- Other chronic diseases
- History of pancreatitis (acute or chronic, regardless of the number of years)
- Severe psychiatric disorder (e.g., schizophrenia, bipolar disorder)
- Mental retardation
- A lifetime history of suicidal attempt
- History of NEM2 or medullary thyroid carcinoma, malignant neoplasms/carcinomas in situ, or uncontrolled thyroid disease
- Inability to understand the study
- Major problem of compliance with existing treatments (suggesting that compliance with the protocol will be insufficient)
- Any disorder, unwillingness, or inability, not covered by any of the other exclusion criteria which, in the investigator's opinion, might jeopardize the participant's safety or compliance with the protocol
- Known or suspected abuse of alcohol or recreational drugs
- History of type 1 or type 2 diabetes
- Patient with severe renal insufficiency (eGFR < 30 mL/min/1,73m2)
- Patient with hepatic impairment (mild to severe)
- Participation in another interventional research modifying management or likely to influence the study's assessment criteria
- Pregnancy or desire of pregnancy, breast-feeding patients and parturients
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Placebo komparator: PLACEBO
|
A 40-week randomized, placebo double-blind controlled intervention (versus semaglutide injection), followed by an open phase from weeks 40 to 80 where all participants receive semaglutide. In first 40 weeks period (between 0-40 weeks), placebo is initiated in same timing than semaglutide (in other arm). In second 40 weeks period (between 40-80 weeks), Semaglutide is initiated at a dose of 0.25 mg once weekly for the first 4 weeks, followed by escalation every 4 weeks to 0.50, 1.0, 1.70, and 2.40 mg. The recommended target maintenance dose of semaglutide or placebo is 2.4 mg once weekly. Participants are encouraged to reach the recommended semaglutide or placebo target maintenance dose of 2.4 mg once weekly. Those unable to tolerate this dose will be permitted to stay at a lower dose (maximum tolerated dose). At least one attempt to re-escalate to the immediate upper dose is recommended. |
|
Eksperimentell: SEMAGLUTIDE
|
A 40-week randomized, controlled, double-blind semaglutide (versus placebo) intervention (versus placebo), followed by an open phase from weeks 40 to 80 where all participants receive semaglutide. In first 40 weeks period (0-40 weeks), Semaglutide is initiated at a dose of 0.25 mg once weekly for the first 4 weeks, followed by escalation every 4 weeks to 0.50, 1.0, 1.70, and 2.40 mg. In second 40 weeks period (40-80 weeks), Semaglutide is maintened at maximum tolerated dose form 1st period. The recommended target maintenance dose of semaglutide or placebo is 2.4 mg once weekly. Participants are encouraged to reach the recommended semaglutide or placebo target maintenance dose of 2.4 mg once weekly. Those unable to tolerate this dose will be permitted to stay at a lower dose (maximum tolerated dose). At least one attempt to re-escalate to the immediate upper dose is recommended. |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in BMI SD score (according to french references) at 40 weeks
Tidsramme: 40 weeks
|
Co-primary 1 (S40 - RCT): Change in BMI (in SD for age and sex according to French references) after 40 weeks of treatment with semaglutide (dose escalation over 16 weeks followed by a maintenance dose of 2.4 mg/week for 24 weeks) compared to placebo |
40 weeks
|
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Change in BMI SD score (according to french references) at 80 weeks
Tidsramme: 80 weeks
|
Co-primary 2 (S80 - delayed-start): Change in BMI-SD from baseline to S80: "semaglutide group starting at S0" vs "semaglutide group starting at S40" |
80 weeks
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in BMI in kg/m at 40 weeks compared between semaglutide and placebo
Tidsramme: 40 weeks
|
Evaluation of the variation in Body Mass Index (BMI), expressed in kg/m², from baseline (inclusion) to week 40. This will be compared between two groups: one receiving Semaglutide from the start of the study and the other receiving a placebo for the initial 40 weeks |
40 weeks
|
|
Change in BMI in kg/m at 80 weeks between compared between semaglutide and placebo
Tidsramme: 80 weeks
|
Evaluation of the variation in BMI, expressed in kg/m², from baseline (inclusion) to week 80. This will be compared between two groups: one receiving Semaglutide from the start of the study and the other receiving a placebo for the initial 40 weeks |
80 weeks
|
|
Intra-individual progression of BMI-DS at each visit depending on Semaglutide treatment
Tidsramme: 80 weeks
|
Intra-individual progression of BMI-SDS values measured at the scheduled visits outlined in the protocol from week 0 to week 80 depending on Semaglutide treatment periods. |
80 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on height
Tidsramme: 40 weeks
|
Comparison of height between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
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Effects of 40 weeks of weekly semaglutide treatment on weight
Tidsramme: 40 weeks
|
Comparison of weight between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
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Effects of 40 weeks of weekly semaglutide treatment on waist circumference
Tidsramme: 40 weeks
|
Comparison of waist circumference between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on arterial blood pressure
Tidsramme: 40 weeks
|
Comparison of arterial blood pressure between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on fasting blood glucose
Tidsramme: 40 weeks
|
Comparison of fasting blood glucose between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on HbA1C
Tidsramme: 40 weeks
|
Comparison of HbA1C between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on insulin level
Tidsramme: 40 weeks
|
Comparison of insulin level between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
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Effects of 40 weeks of weekly semaglutide treatment on cholesterol
Tidsramme: 40 weeks
|
Comparison of cholesterol between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on triglycerides
Tidsramme: 40 weeks
|
Comparison of triglycerides between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on body composition
Tidsramme: 40 weeks
|
Comparison of body composition (by DEXA) between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on bone age
Tidsramme: 40 weeks
|
Comparison of bone age (by X-ray of the left hand and wrist) between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on quality of life by PedsQL questionnaire
Tidsramme: 40 weeks
|
Comparison of quality of life by PedsQL questionnaire score between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on quality of life by Epworth Sleepiness Scale
Tidsramme: 40 weeks
|
Comparison of quality of life by Epworth Sleepiness Scale score between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on quality of life by IWQOL-Kids questionnaire
Tidsramme: 40 weeks
|
Comparison of quality of life by IWQOL-Kids score between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on quality of life by Dykens Hyperphagia questionnaire
Tidsramme: 40 weeks
|
Comparison of quality of life by Dykens Hyperphagia questionnaire score between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Effects of 40 weeks of weekly semaglutide treatment on quality of life by Daily Hunger Score
Tidsramme: 40 weeks
|
Comparison of quality of life by Daily Hunger Score score between patient with 40 weeks of weekly semaglutide treatment (dose escalation over 16 weeks followed by a maximum maintenance dose of 2.4 mg/week during 24 weeks depending on treatment tolerance) versus placebo |
40 weeks
|
|
Safety between 2 arms
Tidsramme: 80 weeks
|
Comparison of the incidence of each category of adverse events (AE) between the two arms (semaglutide versus placebo). |
80 weeks
|
|
Kinetics of BMI-DS evolution
Tidsramme: End of study V10 (106 weeks)
|
Difference in the kinetics of BMI (in DS) evolution depending on whether it occurs in the presence or absence of semaglutide |
End of study V10 (106 weeks)
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Régis COUTANT, Professor of Medecine, University Hospital of Angers
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
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
Ytterligere relevante MeSH-vilkår
- Urogenitale sykdommer
- Sykdommer i det endokrine systemet
- Neoplasmer
- Mannlige urogenitale sykdommer
- Kvinnelige urogenitale sykdommer
- Kvinnelige urogenitale sykdommer og graviditetskomplikasjoner
- Neoplasmer etter histologisk type
- Gonadal lidelser
- Medfødte abnormiteter
- Nevroektodermale svulster
- Neoplasmer, kjønnsceller og embryonale
- Neoplasmer, nervevev
- Forstyrrelser i kjønnsutvikling
- Urogenitale abnormiteter
- Gonadal dysgenese
- Hypogonadisme
- Medfødte, arvelige og neonatale sykdommer og abnormiteter
- Kraniofaryngiom
- Seksuell infantilisme
- semaglutid
Andre studie-ID-numre
- 49RC23_0307
- 2024-511114-20-00 (Ctis)
Plan for individuelle deltakerdata (IPD)
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