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).
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Faza 3
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Regis COUTANT, Professor of Medecine
- Numer telefonu: + 33 (0)2 41 35 56 55
- E-mail: ReCoutant@chu-angers.fr
Kopia zapasowa kontaktu do badania
- Nazwa: Matthieu LE LAY
- Numer telefonu: +33 (0)2 41 35 58 91
- E-mail: DRCI-Promotion-Interne@chu-angers.fr
Lokalizacje studiów
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Angers, Francja
- Service Endocrinologie pédiatrique, Angers University Hospital
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Kontakt:
- Régis COUTANT, Professor of Medecine
- Numer telefonu: +33 (0)2.41.35.56.55
- E-mail: recoutant@chu-angers.fr
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Besançon, Francja, 25030
- Endocrinologie Pédiatrique, University hospital of Besançon
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Kontakt:
- Brigitte MIGNOT, Doctor of Medecine
- Numer telefonu: +33(0)3.81.21.91.81
- E-mail: bmignot@chu-besancon.fr
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Bordeaux, Francja
- Service d'endocrinologie, diabétoglogie et obésité pédiatrique, Bordeaux University Hospital
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Kontakt:
- Pascal BARAT, Professor of Medecine
- Numer telefonu: +33(0)5.56.79.87.25
- E-mail: pascal.barat@chu-bordeaux.fr
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Bron, Francja
- Endocrinologie Pédiatrique, Hôpital Femme Mere Enfants, Lyon University Hospital
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Kontakt:
- Carine VILLANUEVA, Doctor of Medecine
- Numer telefonu: +33(0)4.27.85.53.28
- E-mail: carine.villanueva@chu-lyon.fr
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Dijon, Francja
- Département de Pédiatrie, Dijon University Hospital
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Kontakt:
- Candace BEN SIGNOR, Doctor of Medecine
- Numer telefonu: +33(0)3.80.29.30.31
- E-mail: candace.bensignor@chu-dijon.fr
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La Tronche, Francja
- Service de Pédiatrie, Grenoble University Hospital
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Kontakt:
- Cyril RUELLO, Doctor of Medecine
- Numer telefonu: +33(0)4.76.76.89.02
- E-mail: CRuello1@chu-grenoble.fr
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Le Kremlin-Bicêtre, Francja
- Endocrinologie et diabète de l'enfant, Hopital Bicêtre, Paris University Hospital
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Kontakt:
- Cécile TEINTURIER, Doctor of Medecine
- Numer telefonu: +33(0)1.45.21.78.52
- E-mail: cecile.teinturier@aphp.fr
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Lille, Francja
- Endocrinologie, diabète et obésité pédiatrique, Lille University Hospital
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Kontakt:
- Iva GUEORGUIEVA, Doctor of Medecine
- Numer telefonu: +33(0)3.20.44.50.70
- E-mail: Iva.HUBERT@CHRU-LILLE.FR
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Marseille, Francja
- Service de pédiatrie multidisciplinaire, Hopital La Timone, Marseille University Hospital
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Kontakt:
- Rachel REYNAUD, Professor of Medecine
- Numer telefonu: +33(0)4.91.38.83.84
- E-mail: rachel.reynaud@ap-hm.fr
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Montpellier, Francja
- Service de diabétologie et endocrinologie pédiatriques
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Kontakt:
- Essia JOYEZ, Doctor of Medecine
- Numer telefonu: +33(0)4.67.33.65.06
- E-mail: e-joyez@chu-montpellier.fr
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Nancy, Francja
- Unité Endocrinologie et Diabète, Nancy University hospital
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Kontakt:
- Emeline RENARD, Doctor of Medecine
- Numer telefonu: +33(0)3.83.15.53.11
- E-mail: E.RENARD@chru-nancy.fr
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Paris, Francja
- Endocrinologie, diabétologie et Gynécologie pédiatrique, Necker Hospital, Paris University Hospital
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Kontakt:
- Dulanjalee KARIYAWASAM, Doctor of Medecine
- Numer telefonu: +33(0)1.44.49.48.02
- E-mail: dulanjalee.kariyawasam@aphp.fr
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Paris, Francja
- Service d'endocrinologie diabétologie pédiatrique, Paris University Hospital
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Kontakt:
- Ahlam AZAR-KOLAKEZ, Doctor of Medecine
- Numer telefonu: +33(0)1.40.03.41.20
- E-mail: ahlam.azar-kolakez@aphp.fr
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Reims, Francja
- Service de Pédiatrie A, Reims University Hospital
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Kontakt:
- Aurélie BEROT, Doctor of Medecine
- Numer telefonu: +33(0)3.26.78.94.78
- E-mail: aberot@chu-reims.fr
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Rennes, Francja
- Unité d'Endocrinologie et Diabétologie Pédiatriques, Rennes University Hospital
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Kontakt:
- Marie-Béatrice SAADE, Doctor of Medecine
- Numer telefonu: +33(0)2.99.26.71.34
- E-mail: Marie-beatrice.SAADE@chu-rennes.fr
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Strasbourg, Francja
- Service de Pédiatrie, Strasbourg University Hospital
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Kontakt:
- Sylvie ROSSIGNOL, Professor of Medecine
- Numer telefonu: +33(0)3.88.12.77.34
- E-mail: sylvie.rossignol@chru-strasbourg.fr
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Toulouse, Francja
- Unité d'Endocrinologie, Maladies Osseuses et Génétique, Toulouse University Hospital
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Kontakt:
- Thomas EDOUARD, Professor of Medecine
- Numer telefonu: +33(0)5.34.55.85.49
- E-mail: edouard.t@chu-toulouse.fr
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Poczwórny
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
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Komparator placebo: PLACEBO
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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. |
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Eksperymentalny: 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. |
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in BMI SD score (according to french references) at 40 weeks
Ramy czasowe: 40 weeks
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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
Ramy czasowe: 80 weeks
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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
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Change in BMI in kg/m at 40 weeks compared between semaglutide and placebo
Ramy czasowe: 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
|
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Change in BMI in kg/m at 80 weeks between compared between semaglutide and placebo
Ramy czasowe: 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
|
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Intra-individual progression of BMI-DS at each visit depending on Semaglutide treatment
Ramy czasowe: 80 weeks
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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
|
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Effects of 40 weeks of weekly semaglutide treatment on height
Ramy czasowe: 40 weeks
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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
Ramy czasowe: 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
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on arterial blood pressure
Ramy czasowe: 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
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on HbA1C
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on insulin level
Ramy czasowe: 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
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on triglycerides
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on body composition
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on bone age
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on quality of life by PedsQL questionnaire
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on quality of life by Epworth Sleepiness Scale
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on quality of life by IWQOL-Kids questionnaire
Ramy czasowe: 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
|
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Effects of 40 weeks of weekly semaglutide treatment on quality of life by Dykens Hyperphagia questionnaire
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 80 weeks
|
Comparison of the incidence of each category of adverse events (AE) between the two arms (semaglutide versus placebo). |
80 weeks
|
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Kinetics of BMI-DS evolution
Ramy czasowe: 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)
|
Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Régis COUTANT, Professor of Medecine, University Hospital of Angers
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby układu moczowo-płciowego
- Choroby układu hormonalnego
- Nowotwory
- Choroby układu moczowo-płciowego u mężczyzn
- Choroby układu moczowo-płciowego kobiet
- Choroby układu moczowo-płciowego kobiet i powikłania ciąży
- Nowotwory według typu histologicznego
- Zaburzenia gonad
- Wady wrodzone
- Nowotwory neuroektodermalne
- Nowotwory, komórki rozrodcze i embrionalne
- Nowotwory, tkanka nerwowa
- Zaburzenia rozwoju płciowego
- Zaburzenia układu moczowo-płciowego
- Dysgenezja gonad
- Hipogonadyzm
- Wrodzone, dziedziczne i noworodkowe choroby i nieprawidłowości
- Czaszkowo-gardłowy
- Infantylizm seksualny
- Semaglutyd
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- 49RC23_0307
- 2024-511114-20-00 (Ctis)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .