Treatment of Acromegaly With Somatostatin Analogs: GH vs. IGF-I as Primary Biochemical Target
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Purpose
Treatment of acromegaly with somatostatin analogs (SA) is well-established and are primarily used after insufficient surgical intervention, but also as primary medical treatment in selected patients. Evaluation of treatment control is based on monitoring blood levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I). However, evaluation of disease control during SA treatment is not always straightforward. It is usually based on normalization of IGF-I and achievement of a certain GH level. In approximately 40% of patients discordant values of GH and IGF-I levels are seen after treatment with SA, with normalized IGF-I levels, despite elevated GH levels. The mechanism behind this observation is unknown, but it indicates that SA may affect this difference.
The primary objective of this study is to investigate if disease control during SA treatment is best achieved by monitoring either GH or IGF-I.
| Condition | Intervention | Phase |
|---|---|---|
|
Acromegaly |
Drug: Sandostatin® LAR |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Treatment of Acromegaly With Somatostatin Analogs: GH vs. IGF-I as Primary Biochemical Target |
- Change in Quality of Life [ Time Frame: Baseline and after 12 months ] [ Designated as safety issue: No ]AcroQol (Acromegaly Quality of Life Questionnaire) and PASQ (Patient-Assessed Acromegaly Symptom Questionnaire)
- SA dosage [ Time Frame: After 12 months of treatment ] [ Designated as safety issue: No ]SA dosage at last follow-up
- Change in glucose tolerance [ Time Frame: Baseline and after 12 months ] [ Designated as safety issue: No ]Glucose tolerance during an oral glucose load of 75 gram of glucose
- Change in discordant GH/IGF-I levels [ Time Frame: Baseline and after 12 months ] [ Designated as safety issue: No ]Discordant GH/IGF-I levels are recorded.
- New biomarkers of treatment evaluation [ Time Frame: Baseline and after 12 months ] [ Designated as safety issue: No ]New biomarkers of GH/IGF-I status (bioactive IGF-I)
- New biomarkers of treatment evaluation [ Time Frame: Baseline and after 12 months ] [ Designated as safety issue: No ]New biomarkers of GH/IGF-I status (free GH)
| Estimated Enrollment: | 75 |
| Study Start Date: | June 2012 |
| Estimated Study Completion Date: | June 2015 |
| Estimated Primary Completion Date: | June 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: SA monitored by GH |
Drug: Sandostatin® LAR
Intramuscular injections, dosage based on either GH or IGF-I levels.
|
| Experimental: SA monitored by IGF-I |
Drug: Sandostatin® LAR
Intramuscular injections, dosage based on either GH or IGF-I levels.
|
|
No Intervention: Control
Control, patients who have achieved sufficient disease control by surgery alone.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Written informed consent
- Age > 18 years
- Capable and of age
- Diagnosed with acromegaly
- Sufficient treated for at least 6 months prior to enrollment
Exclusion Criteria:
- Pregnancy or nursing
- Any disease that may compromise the ability to comply with the protocol, as assessed by the investigator
Contacts and Locations| Contact: Jakob Dal, MD. | jakob.dal@ki.au.dk |
| Denmark | |
| Department of Endocrinology, Aarhus University Hospital | Recruiting |
| Aarhus C, Denmark, 8000 | |
| Principal Investigator: Jens Otto L. Jørgensen, Professor | |
| Sub-Investigator: Jakob Dal, MD. | |
| Study Chair: | Jens Otto L. Jørgensen, Professor | Aarhus University Hospital |
More Information
No publications provided
| Responsible Party: | University of Aarhus |
| ClinicalTrials.gov Identifier: | NCT01618513 History of Changes |
| Other Study ID Numbers: | SOM-2012-01 |
| Study First Received: | June 4, 2012 |
| Last Updated: | January 14, 2013 |
| Health Authority: | Denmark: The Regional Committee on Biomedical Research Ethics |
Keywords provided by University of Aarhus:
|
Acromegaly Somatostatin analogs Treatment |
Additional relevant MeSH terms:
|
Acromegaly Bone Diseases, Endocrine Bone Diseases Musculoskeletal Diseases Hyperpituitarism Pituitary Diseases Hypothalamic Diseases Brain Diseases Central Nervous System Diseases Nervous System Diseases Endocrine System Diseases |
Octreotide Somatostatin Antineoplastic Agents, Hormonal Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Gastrointestinal Agents Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 21, 2013