Rescue of Steroidogenic Capacity in Adrenocortical Failure Study (RADS)
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Purpose
This is a pilot study of B lymphocyte depletion therapy in an attempt to salvage adrenal steroidogenic capacity in ten subjects with early autoimmune Addison's disease. During the first twelve weeks of treatment, additional glucocorticoid therapy (prednisolone) will be given to ensure wellbeing and to rest the steroidogenic apparatus that is the target of the autoimmune attack. Glucocorticoids will be gradually withdrawn, in a controlled fashion, and adrenal function re-evaluated at 13, 26, 39 and 52 weeks. The primary endpoint will be restoration of steroidogenic function as judged by conventional endocrine indices of adrenocortical function. B cell depletion may ameliorate the autoimmune attack against adrenal cells, potentially allowing a state of immune tolerance to be restored with subsequent recovery of adrenal steroidogenic capacity.
| Condition | Intervention | Phase |
|---|---|---|
|
Autoimmune Adrenocortical Failure |
Drug: Solu-medrone, Mabthera |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Immunotherapeutic Rescue of Steroidogenic Function in Autoimmune Adrenocortical Failure: Pilot Study |
- Peak serum cortisol, basal or post ACTH [ Time Frame: 13, 26, 39, 52 weeks from first treatment ] [ Designated as safety issue: No ]
- 21-OHase antibodies [ Time Frame: 13, 26,39, 52 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 6 |
| Study Start Date: | September 2008 |
| Study Completion Date: | April 2012 |
| Primary Completion Date: | April 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Receiving active treatment
|
Drug: Solu-medrone, Mabthera
125mg, 1gram, twice day 1 and day 15
|
Eligibility| Ages Eligible for Study: | 16 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clear evidence of primary adrenal failure (elevated ACTH, pigmentation, electrolyte disturbance)
- Basal or stimulated cortisol <400 nmol/l but >100nmol/l
Exclusion Criteria:
- Active viral infection, pregnancy or breast feeding, previous immunosuppression, diabetes, cardiorespiratory disease, renal failure, hepatic disease, cancer
- Calcified or enlarged adrenals on CT scan, active TB
Contacts and Locations| United Kingdom | |
| Clinical Research Facility, Royal Victoria Infirmary | |
| Newcastle upon Tyne, United Kingdom, NE1 4LP | |
| Principal Investigator: | Simon Pearce, MD, FRCP | Newcastle University |
More Information
No publications provided by Newcastle University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | SHS Pearce, Professor of Endocrinology, Newcastle University |
| ClinicalTrials.gov Identifier: | NCT00753597 History of Changes |
| Other Study ID Numbers: | NUTH/2006/4071, EU ID: 2007-003062-18 |
| Study First Received: | September 12, 2008 |
| Last Updated: | February 5, 2013 |
| Health Authority: | United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by Newcastle University:
|
B cell depletion steroidogenesis |
Additional relevant MeSH terms:
|
Methylprednisolone acetate Prednisolone acetate Methylprednisolone Methylprednisolone Hemisuccinate Prednisolone Prednisolone hemisuccinate Prednisolone phosphate Rituximab Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions Antiemetics Autonomic Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Neuroprotective Agents Protective Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents Immunologic Factors Antirheumatic Agents |
ClinicalTrials.gov processed this record on May 19, 2013