Difference in GC-induced Adrenal Insufficiency in RA Related to Polymorphisms in the Glucocorticoid Receptor Gene
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Purpose
Development of glucocorticoid (GC)-induced adrenal insufficiency is a serious adverse effect of GC treatment. It is today not possible to predict this adverse effect. The project aims at investigating a possible individual aspect, which may render subjects more or less sensitive to glucocorticoids, and thereby influence development of GC induced adrenal insufficiency. The hypothesis is that subjects with one or another of the polymorphisms in the GC receptor gene will either have increased or diminished GC sensitivity. This may be responsible for differences in development of GC induced adrenal insufficiency.
| Condition | Intervention |
|---|---|
|
Rheumatoid Arthritis |
Other: No intervention |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Observational Cohort Study on Difference in Glucocorticoid-induced Adrenal Insufficiency in Patients With Rheumatoid Arthritis Related to Different Sensitivity Polymorphisms in the Glucocorticoid Receptor Gene |
- adrenal insufficiency [ Time Frame: upon first visit within average 1 month ] [ Designated as safety issue: Yes ]test for adrenal function by stimulation test
- quality of life [ Time Frame: upon inclusion (baseline) ] [ Designated as safety issue: No ]test by questionnaires
Biospecimen Retention: Samples With DNA
blood samples and DNA from gene analyses
| Estimated Enrollment: | 50 |
| Study Start Date: | April 2011 |
| Estimated Study Completion Date: | March 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
RA treated with glucocorticoid
50 pts with RA
|
Other: No intervention
No intervention
|
Detailed Description:
Blood is sampled from 200 pts with rheumatoid arthritis (RA), fulfilling the inclusion criteria and their GR haplotypes will be determined by polymerase chain reaction (PCR). 2 x 25 patients with the interesting GR polymorphisms, and these will be included for a Synacthen test of their adrenal function. Information from the results of the study will be able to assist clinicians to identify patients at risk and thus individualize GC therapy in a tailored fashion. Results of the study will be important for all patient groups worldwide on GC therapy.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
50 consecutive patients with rheumatoid arthritis
Inclusion Criteria:
- Adult patients > 18 years)
- Caucasian classified with rheumatoid arthritis.
- 1987 ACR-classification criteria.
- Prednisolone min 5mg/day for at least 6 months.
- Presence of either BclI (high GC sensitivity) or 9β (low GC sensitivity)polymorphisms.
Exclusion Criteria:
- Other major organ disease
- Endocrine disease
- Active infection
Contacts and Locations| Contact: Ulla Feldt-Rasmussen, Professor | +45 35451023 | ufeldt@rh.dk |
| Denmark | |
| Rigshospitalet | Recruiting |
| Copenhagen, Denmark, 2100 | |
| Contact: Ulla Feldt-Rasmussen, Professor +4535451023 ulla.feldt-rasmussen@dadlnet.dk | |
| Principal Investigator: Ulla Feldt-Rasmussen, Professor | |
| Principal Investigator: | Ulla Feldt-Rasmussen, Professor | Rigshospitalet, Denmark |
More Information
No publications provided
| Responsible Party: | Ulla Feldt-Rasmussen, Professor, Rigshospitalet, Denmark |
| ClinicalTrials.gov Identifier: | NCT01411046 History of Changes |
| Other Study ID Numbers: | GCR-RA-CSI |
| Study First Received: | July 28, 2011 |
| Last Updated: | March 10, 2013 |
| Health Authority: | Denmark: The Ministry of the Interior and Health |
Keywords provided by Rigshospitalet, Denmark:
|
Glucocorticoid polymorphism Glucocorticoid receptor gene |
rheumatoid arthritis adrenal insufficiency prednisolone treatment |
Additional relevant MeSH terms:
|
Adrenal Insufficiency Addison Disease Arthritis Arthritis, Rheumatoid Adrenal Gland Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases Joint Diseases |
Musculoskeletal Diseases Rheumatic Diseases Connective Tissue Diseases Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013