Effects of rhIGF-1 on Bone Metabolism in Adolescent Girls With Anorexia Nervosa (814)
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Purpose
Adolescents and young adults with anorexia nervosa (AN) are at high risk for low bone mineral density at a time when healthy adolescents are rapidly accruing bone, with implications for peak bone mass and fracture risk in later life. They are also deficient in insulin-like growth factor 1 (IGF-1), the bone trophic factor made in the liver in response to growth hormone (GH), despite elevated levels of growth hormone. It is possible that deficiency of insulin-like growth factor 1, a hormone very important for the maintenance of skeletal integrity, may contribute to the severe osteopenia seen in anorexia nervosa. The physiologic effects of recombinant human insulin-like growth factor 1 (rhIGF-1) treatment in adolescents and young adults with anorexia nervosa have not been studied. The goal of this proposal is to investigate the effects of recombinant human insulin-like growth factor 1 on bone density and bone microarchitecture in adolescent girls and young adult women with anorexia nervosa over a 6 month period. We hypothesize that adolescent and young adult anorexia nervosa patients, being insulin-like growth factor 1 deficient, will respond to exogenously administered recombinant human insulin-like growth factor 1 with elevations in biochemical indices of bone turnover and an increase in bone density and improvement in bone structure, or maintain bone density (in contrast to the decrease in bone density expected in adolescent girls and women with anorexia nervosa who are not treated).
| Condition | Intervention | Phase |
|---|---|---|
|
Disorder of Bone Density and Structure, Unspecified |
Drug: Recombinant human insulin like growth factor-1 (rhIGF-1) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effects of Recombinant Human Insulin Like Growth Factor-1 (rhIGF-1) on Bone Metabolism in Adolescent Girls With Anorexia Nervosa |
- Change in Spine Bone Density (g/cm^2) [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: No ]Change in spine bone density over 6 months (6month data- baseline data). Bone density at the spine was assessed using dual energy x-ray absorptiometry at baseline and 6 months and the change in bone density over these 6 months was calculated.
| Enrollment: | 28 |
| Study Start Date: | July 2008 |
| Study Completion Date: | October 2011 |
| Primary Completion Date: | October 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Anorexia Nervosa Females |
Drug: Recombinant human insulin like growth factor-1 (rhIGF-1)
Twice daily
Other Name: Tercica
|
Eligibility| Ages Eligible for Study: | 12 Years to 26 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Meet criteria for anorexia nervosa (AN) as described in the Diagnostic and Statistical Manual of Mental Disorders
Exclusion Criteria:
- Pregnant or nursing
- Hematocrit < 30%, K < 3 mmol/L
- Any illness (other than AN) known to affect bone and mineral metabolism such as diabetes, untreated hypo- or hyperthyroidism, or hyperparathyroidism
- History of use of any medicine, such as corticosteroids, known to affect bone density. Subjects who are on estrogen will still be eligible to participate in the study because our data in adult women with AN do not indicate deleterious effects of estrogen in patients receiving rhIGF-
Contacts and Locations| United States, Massachusetts | |
| Massachusetts General Hospital | |
| Boston, Massachusetts, United States, 02114 | |
| Principal Investigator: | Madhusmita Misra, MD | MD |
More Information
No publications provided
| Responsible Party: | Madhusmita Misra, Asssociate Professor of Pediatrics, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT00720122 History of Changes |
| Other Study ID Numbers: | MassGH, CDER |
| Study First Received: | July 18, 2008 |
| Results First Received: | January 27, 2012 |
| Last Updated: | February 28, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Massachusetts General Hospital:
|
Bone density Bone turnover markers rhIGF-1 Bone structure Anorexia nervosa |
Additional relevant MeSH terms:
|
Anorexia Anorexia Nervosa Bone Diseases Signs and Symptoms, Digestive Signs and Symptoms Eating Disorders Mental Disorders Musculoskeletal Diseases |
Mitogens Insulin Mitosis Modulators Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Hypoglycemic Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 22, 2013