Assessment of the Treatment of Severely Burned With Anabolic Agents on Clinical Outcomes, Recovery and Rehabilitation - Full Text View

Sponsor:	The University of Texas, Galveston
Collaborators:	U.S. Department of Education National Institutes of Health (NIH) Shriners Hospitals for Children
Information provided by:	The University of Texas, Galveston
ClinicalTrials.gov Identifier:	NCT00675714

Purpose

The purpose of the program is to study and characterize the outcome of burn injury with particular attention to improving the rehabilitation of burn survivors, including children. Various agents are assessed for effectiveness on long term burn outcome, such as growth hormone, oxandrolone, propranolol, insulin, ketoconazole, inhospital exercise and home exercise.

Condition	Intervention	Phase
Burns	Procedure: Stable Isotope Infusion Study Procedure: Collection of blood and tissues Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Drug: Humatrope Drug: Ketoconazole Drug: Oxandrolone Drug: Propranolol Drug: Oxandrolone and propranolol combined Drug: Humatrope and propranolol combined Drug: Placebo Behavioral: Exercise--Hospital supervised intensive exercise program Behavioral: Home exercise program	Phase II Phase III

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Uncontrolled, Parallel Assignment, Safety/Efficacy Study
Official Title:	Assessment of the Treatment of the Severely Burned With Anabolic Agents on Clinical Outcomes, Recovery and Rehabilitation

Resource links provided by NLM:

MedlinePlus related topics: Anabolic Steroids Burns Exercise and Physical Fitness Rehabilitation

Drug Information available for: Oxandrolone Testosterone Propionate Methyltestosterone Testosterone Nandrolone phenpropionate Somatropin Metoprolol Metoprolol Tartrate Ketoconazole Fungarest Itraconazole Fluconazole Metoprolol succinate Metoprolol fumarate Oxymesterone Testosterone enanthate Propranolol hydrochloride Nandrolone decanoate Nandrolone Propranolol Dexpropranolol Testosterone undecanoate Somatotropin

U.S. FDA Resources

Further study details as provided by The University of Texas, Galveston:

Primary Outcome Measures:

Outcome assessments will include measures of muscle wasting, weakness, immunosuppression chronic bone loss and decreased growth with increases in metabolic, hemodynamic, inflammatory and scarring responses. [ Time Frame: Admission to burn unit to 95% wound healing ] [ Designated as safety issue: No ]

Estimated Enrollment:	500
Study Start Date:	January 1998
Estimated Study Completion Date:	September 2010
Estimated Primary Completion Date:	September 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental Humatrope SQ 0.05-0.2 mg/kg/day for 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Humatrope Humatrope (Growth Hormone) dose:0.05mg - 0.2mg/kg/day SQ daily for 2 years post burn injury.
2: Experimental Ketoconazole PO given twice a day throughout hospitalization until 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Ketoconazole Ketoconazole administration (or other glucocorticoid blocker--itraconazole or fluconazole) PO daily for 2 years post burn injury
3: Experimental Oxandrolone PO given daily throughout hospitalization until 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Oxandrolone oxandrolone (or other anabolic steroid-testosterone or nandrolone) daily for 2 years post burn injury
4: Experimental Propranolol PO given daily throughout hospitalization until 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Propranolol Propranolol (or other beta adrenergic blocker--metoprolol, inderol), PO administration daily for 2 years post burn injury.
5: Experimental Oxandrolone and propranolol PO to be given daily until 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Oxandrolone and propranolol combined Daily administration of oxandrolone and propranolol to be given for 2 years post burn injury.
6: Experimental Humatrope SQ and Propranolol PO to be given daily 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Humatrope and propranolol combined Humatrope (growth hormone) and propranolol administration daily for 2 years post burn injury.
7: Placebo Comparator Placebo PO to be given until 2 years post burn	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Drug: Placebo placebo to be given once a day for two years post burn injury.
8: Experimental Exercise--hospital supervised intensive exercise program	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Behavioral: Exercise--Hospital supervised intensive exercise program intensive exercise program supervised by trained personnel in the hospital environment for twelve week program.
9: Experimental Exercise--home exercise program	Procedure: Stable Isotope Infusion Study 1-8 hour stable isotope infusion study to be done following each surgery. Tagged isotopes to assess uptake into blood and tissues. Procedure: Collection of blood and tissues Blood draw with each stable isotope infusion study and weekly Tissue biopsy: skin, fat, muscle at stable isotope infusion study Procedure: Radiology testing: DEXA, K+ counter, ultrasound, MRI Testing to be done following every stable isotope infusion study to measure muscle, fat and bone tissues. Behavioral: Home exercise program Home intensive exercise program: training occurs in hospital then patient sent home to continue exercise program for 12 weeks at home.

Detailed Description:

The UTMB project improves outcomes for severely burned children by instituting and evaluating two modifications to traditional rehabilitation: (1) an intensive rehabilitation program including active resistance exercise; (2) long term administration of anabolic agents.

Effectiveness is assessed by comparison with functional outcomes achieved in traditional outpatient rehabilitation programs. Results indicate improvement in strength, endurance and bone density with these modifications. The project also maintains a longitudinal database that includes measures of cardiopulmonary function, growth and maturation, bone density, range of motion, and psychosocial adjustment.

Eligibility

Ages Eligible for Study:	up to 65 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Burn 40% TBSA or greater
Ages 0-65 yrs
Negative pregnancy test
Informed consent

Exclusion Criteria:

Untreated malignancy, known history of AIDS, ARC, HIV
Recent history of myocardial infarction (6 wks)
Tuberculosis, arthritis, cirrhosis, hyperlipidemia, bone or endocrine diseases, autoimmune diseases
Chronic glucocorticoid or non steroidal anti inflammatory drug therapy
Diabetes mellitus prior to burn injury
Renal insufficiency (defined by creatinine >3.0 mg/dl)
Hepatic disease (bilirubin > 3.0 mg/dl)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00675714

Contacts

Contact: David N Herndon, MD	409-770-6731	dherndon@utmb.edu
Contact: Deb A Benjamin, MSN	409-770-6731 ext 6740	dbenjami@utmb.edu

Locations

United States, Texas
University of Texas Medical Branch	Recruiting
Galveston, Texas, United States, 77551
Contact: David N Herndon, MD 409-770-6731 dherndon@utmb.edu
Contact: Deb A Benjamin, MSN 409-770-6731 dbenjami@utmb.edu
Principal Investigator: David N Herndon, MD
Sub-Investigator: Oscar E Suman, PhD
Sub-Investigator: Marc G Jeschke, MD, PhD

Sponsors and Collaborators

The University of Texas, Galveston

U.S. Department of Education

National Institutes of Health (NIH)

Shriners Hospitals for Children

Investigators

Study Director:

David N Herndon, MD

University of Texas

More Information

Additional Information:

University of Texas web page to describe funded program This link exits the ClinicalTrials.gov site

burn care web site includes information on funded grant project This link exits the ClinicalTrials.gov site

Publications:

Alloju SM, Herndon DN, McEntire SJ, Suman OE. Assessment of muscle function in severely burned children. Burns. 2008 Jun;34(4):452-9. Epub 2008 Feb 20.

Responsible Party:	The University of Texas Medical Branch ( David Herndon, MD / Principal Investigator )
Study ID Numbers:	04-157, NIDRR H133A020102, NIH P50 GM60338, SHC #8760
Study First Received:	December 26, 2007
Last Updated:	December 10, 2009
ClinicalTrials.gov Identifier:	NCT00675714 History of Changes
Health Authority:	United States: Food and Drug Administration

Keywords provided by The University of Texas, Galveston:

anabolic agents
exercise

Additional relevant MeSH terms:

Anti-Infective Agents
Antiprotozoal Agents
Vasodilator Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Adrenergic Agents
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Itraconazole
Hormones
Oxandrolone
Nandrolone
Antiparasitic Agents
Propranolol

Antifungal Agents
Therapeutic Uses
Nandrolone decanoate
Adrenergic beta-Antagonists
Anti-Arrhythmia Agents
Fluconazole
Sympatholytics
Nandrolone phenpropionate
Antineoplastic Agents, Hormonal
Cardiovascular Agents
Methyltestosterone
Antihypertensive Agents
Metoprolol
Ketoconazole
Pharmacologic Actions

ClinicalTrials.gov processed this record on February 08, 2010