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Copeptin Measurement After Mannitol and Hypertonic Saline for the Diagnosis of Polyuria-polydipsia Syndrome (COMPASS)

4 maja 2026 zaktualizowane przez: University Hospital, Basel, Switzerland
The aim of this study is to evaluate whether a new test using mannitol infusion can diagnose the cause of polyuria-polydipsia syndrome as accurately as the current standard test (hypertonic saline infusion) and to compare which test patients prefer. The goal is to identify a simpler and more patient-friendly diagnostic approach.

Przegląd badań

Szczegółowy opis

Polyuria-polydipsia syndrome (PPS), characterized by excessive urination and fluid intake, can have different underlying causes, including a deficiency of the hormone vasopressin (AVP-D) or excessive fluid intake without AVP-D (primary polydipsia). Correctly identifying the cause is essential, as the treatments differ and an incorrect diagnosis can negatively impact patient care.

A blood marker called copeptin is used to support the diagnosis, as it reflects vasopressin levels in the body. Currently, the most accurate method involves measuring copeptin after stimulation with hypertonic saline. However, this test is complex, requires close medical monitoring, and can be uncomfortable for patients.

Mannitol is a substance already used in routine clinical care and may offer a simpler way to stimulate copeptin release. Early results suggest that it could provide similar diagnostic accuracy with fewer side effects and better patient comfort.

This study is a randomized, cross-over, multicenter trial in which participants undergo both tests (mannitol and hypertonic saline) in random order. The study compares the diagnostic accuracy and patient preference for both methods, as well as safety and tolerability. In addition, it explores whether other clinical and laboratory measures can further improve the diagnosis of PPS.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

144

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kopia zapasowa kontaktu do badania

Lokalizacje studiów

      • Basel, Szwajcaria, 4031
        • University Hospital Basel
        • Główny śledczy:
          • Mirjam Christ-Crain, Prof. Dr.
        • Kontakt:

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  1. Age ≥ 18 years
  2. Hypotonic polyuria/polydipsia syndrome defined as polyuria >40ml/kg body weight/24h and polydipsia >3l/24h; and urine osmolality <800mOsm/L or known AVP-D based on accepted criteria

Exclusion Criteria:

  1. Polyuria/polydipsia secondary to diabetes mellitus, hypercalcemia, or hypokalemia
  2. Diagnosis of AVP-R (Copeptin > 21.4 pmol/L)
  3. Evidence of acute illness
  4. Epilepsy requiring treatment
  5. Uncontrolled arterial hypertension (blood pressure >160/100mmHg at baseline
  6. eGFR < 60 ml/min/1,73 m2
  7. Cardiac failure (NYHA III-IV)
  8. Diagnosis of liver cirrhosis, Child-Pugh Class C
  9. Uncorrected adrenal or thyroidal deficiency
  10. Pregnancy or breastfeeding
  11. Current or unresolved urinary obstruction
  12. Enrollment in a clinical trial within the last 30 days
  13. Patients refusing or unable to give written informed consent
  14. Inability to follow study procedures

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Diagnostyczny
  • Przydział: Randomizowane
  • Model interwencyjny: Zadanie krzyżowe
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Mannitol Infusion
Diagnostic evaluation of polyuria polydipsia syndrome through copeptin measurement after mannitol infusion.
Intravenous infusion of 1.5g/kg body weight (max. 120g) mannitol is given over 30 minutes (≙ 7.5ml/kg body weight).
Aktywny komparator: Hypertonic Saline Infusion (HIS)
Diagnostic evaluation of polyuria polydipsia syndrome through copeptin measurement after HIS
Intravenous infusion of NaCl 3% is given first as a bolus of 250ml over 15 minutes, then with an infusion rate of 0.15ml/kg body weight / minute (≙ 9ml/kg body weight/hour).

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Overall Diagnostic Accuracy
Ramy czasowe: One time assessment at Follow up Visit 2 (10 weeks after baseline)
The overall diagnostic accuracy is defined as the proportion of correct diagnoses out of all diagnoses based on the stimulated copeptin value. Final diagnosis will be made after termination of the study by two endocrine specialists who will be blinded to the copeptin results of the mannitol infusion.
One time assessment at Follow up Visit 2 (10 weeks after baseline)
Patient Test Preference
Ramy czasowe: 1 week after completion of both diagnostic tests
Patient-reported preference between mannitol infusion and hypertonic saline infusion, assessed using a 5-point Likert scale ranging from -2 (strong preference for hypertonic saline) to +2 (strong preference for mannitol).
1 week after completion of both diagnostic tests

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Diagnostic Performance Measures for AVP-D
Ramy czasowe: At completion of follow-up, 10 weeks after last diagnostic test
Sensitivity, specificity, positive predictive value, and negative predictive value of mannitol infusion and hypertonic saline infusion for diagnosing AVP deficiency using predefined copeptin cut-offs.
At completion of follow-up, 10 weeks after last diagnostic test
Diagnostic Performance Measures for PP
Ramy czasowe: At completion of follow-up, 10 weeks after last diagnostic test
Sensitivity, specificity, positive predictive value, and negative predictive value of mannitol infusion and hypertonic saline infusion for diagnosing PP using predefined copeptin cut-offs.
At completion of follow-up, 10 weeks after last diagnostic test
Optimal copeptin cut-off after mannitol infusion
Ramy czasowe: At completion of follow-up, 10 weeks after last diagnostic test
Exploratory determination and validation of optimal copeptin cut-off values for differentiating AVP deficiency from primary polydipsia following mannitol stimulation.
At completion of follow-up, 10 weeks after last diagnostic test
Frequency and severity of clinical symptoms
Ramy czasowe: During each test day (baseline to end of monitoring period 90 minutes/ 240 minutes)
Frequency and severity of symptoms (e.g., thirst, headache, nausea, malaise) assessed using numeric rating scales during mannitol and hypertonic saline tests.
During each test day (baseline to end of monitoring period 90 minutes/ 240 minutes)
Subjective burden of each test assessed by numeric rating scale
Ramy czasowe: Immediately after each test day
Patient-reported burden of each diagnostic test assessed using a numeric rating scale (NRS) (0-10).
Immediately after each test day
Psychopathological assessment (STAI-T)
Ramy czasowe: Baseline
General anxiety levels is assessed by State-Trait Anxiety Inventory (STAI-T) questionnaire. The total trait score (STAI-T) ranges from 20 to 80, with higher scores indicating more pronounced anxiety.
Baseline
Autistic traits
Ramy czasowe: Baseline
Autistic traits is assessed by Autism-Spectrum Quotient (AQ) questionnaire. The AQ consists of 50 items, with four choices for each item from "definitely agree" to "definitely disagree" and a total score from 0 to 50. A score above the proposed cut-off of 29 highlights significant traits of autism.
Baseline
Quality of Life in Posterior Pituitary Disease
Ramy czasowe: Baseline and follow-up (10 weeks )
Currently, no disease-specific tool exists to assess treatment success for either desmopressin or oxytocin (OXT) therapy in patients with arginine vasopressin deficiency (AVP-D). To address this gap, we developed a novel multidimensional questionnaire in close collaboration with patients, patient representatives, and patient advocates. The PP-QoL consists of three parts: Part A assesses symptoms related to AVP-D (15 items), while Parts B (17 items) and C (21 items) focus on domains associated with OXT deficiency.
Baseline and follow-up (10 weeks )
Change in oxytocin/neurophysin I levels
Ramy czasowe: Baseline and 90 minutes post-stimulation
Change in circulating oxytocin and neurophysin I levels before and after each diagnostic test.
Baseline and 90 minutes post-stimulation
Spearman's rank correlation coefficient between psychopathology questionnaires and oxytocin levels
Ramy czasowe: Baseline and 90 minutes post-stimulation
Correlation between psychopathological questionnaires and oxytocin levels will be described using Spearman's rank correlation coefficient.
Baseline and 90 minutes post-stimulation
Spearman's rank correlation coefficient between psychopathology questionnaire and neurophysin I levels
Ramy czasowe: Baseline and 90 minutes post-stimulation
Correlation between psychopathological questionnaires and neurophysin I levels will be described using Spearman's rank correlation coefficient.
Baseline and 90 minutes post-stimulation
Validation of clinical diagnostic score
Ramy czasowe: After test day 2 and 10 weeks thereafter
Validation of a predefined diagnostic score using clinical and basal parameters
After test day 2 and 10 weeks thereafter
Change of urinary copeptin levels
Ramy czasowe: During test day 1 and test day 2 with a maximum of 3 month in between the two test days
Change in urinary copeptin levels before and after mannitol and hypertonic saline stimulation.
During test day 1 and test day 2 with a maximum of 3 month in between the two test days
Optimal urinary copeptin cut-offs
Ramy czasowe: 10 weeks after test day 2
Exploratory determination of optimal urinary copeptin thresholds for differential diagnosis.
10 weeks after test day 2
Sex-specific copeptin response
Ramy czasowe: During test day 1 and test day 2 with a maximum of 3 month in between the two test days and at study completion
Evaluation of sex-specific differences in stimulated copeptin levels and corresponding diagnostic cut-offs.
During test day 1 and test day 2 with a maximum of 3 month in between the two test days and at study completion
Cost-efficiency of diagnostic tests
Ramy czasowe: One time assessment at Follow up Visit 2 (10 weeks after baseline)
Exploratory assessment of healthcare costs associated with mannitol infusion versus hypertonic saline infusion.
One time assessment at Follow up Visit 2 (10 weeks after baseline)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Śledczy

  • Krzesło do nauki: Mirjam Christ-Crain, Prof. Dr., University Hospital of Basel

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 lipca 2026

Zakończenie podstawowe (Szacowany)

1 czerwca 2030

Ukończenie studiów (Szacowany)

1 czerwca 2030

Daty rejestracji na studia

Pierwszy przesłany

30 marca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

4 maja 2026

Pierwszy wysłany (Rzeczywisty)

6 maja 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

6 maja 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

4 maja 2026

Ostatnia weryfikacja

1 maja 2026

Więcej informacji

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 .

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