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

21 mars 2019 uppdaterad 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

28

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: AZD4017
400mg oral AZD4017 twice daily for 35 days
Läkemedel: 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-jämförare: Placebo
A placebo tablet containing microcrystalline cellulose and sodium stearyl fumarate to match the active tablets in size, shape and colour.
Läkemedel: Placebo
Matchande placebo

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Skin 11β-HSD1 activity
Tidsram: Change between day 0 and day 28
Enzyme activity radioassay to evaluate AZD4107 efficacy in skin
Change between day 0 and day 28

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Urinary cortisol / cortisone metabolites
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: Day 42
Adverse Event-related participant withdrawals to evaluate safety
Day 42
Body mass index
Tidsram: Change between day 0 and day 35
Body mass index to evaluate safety
Change between day 0 and day 35
Waist-hip ratio
Tidsram: Change between day 0 and day 35
Waist-hip ratio to evaluate safety
Change between day 0 and day 35
Blood pressure (sphygmomanometer)
Tidsram: Change between day 0 and day 35
Blood pressure to evaluate safety
Change between day 0 and day 35
Sudomotor function
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: Change between day 0 and day 28
For skin function
Change between day 0 and day 28

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of Leeds

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

10 april 2018

Primärt slutförande (Faktisk)

27 februari 2019

Avslutad studie (Faktisk)

13 mars 2019

Studieregistreringsdatum

Först inskickad

5 oktober 2017

Först inskickad som uppfyllde QC-kriterierna

17 oktober 2017

Första postat (Faktisk)

18 oktober 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

22 mars 2019

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

21 mars 2019

Senast verifierad

1 mars 2019

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ED17/93260

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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