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Trial record 36 of 52 for:    cushing's | Recruiting, Not yet recruiting, Available Studies

Reduction by Pasireotide of the Effluent Volume in High-output Enterostomy in Patients Refractory to Usual Medical Treatment (SOMILEO)

This study is not yet open for participant recruitment.
Verified February 2016 by Hospices Civils de Lyon
Sponsor:
ClinicalTrials.gov Identifier:
NCT02713776
First Posted: March 21, 2016
Last Update Posted: March 21, 2016
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Information provided by (Responsible Party):
Hospices Civils de Lyon
  Purpose

During rectal or complex digestive surgery with multiple digestive resections and anastomosis, the creation of enterostomy is a common procedure. In France, it is estimated that 20000 patients have an ileostomy and 16000 new digestive stomas are formed each year with approximately 30% of enterostomy. Enterostomy might sometimes give high-output not controlled with usual medical treatment (e.g loperamide ± codeine) and exposes the patients to important hydro-electrolytic loss leading to a risk for dehydration, electrolyte abnormalities and acute renal failure. This risk implies parenteral correction which may extend hospital stay and delay home return.

Somatostatin analogues (octreotide, lanreotide and pasireotide) could reduce digestive secretions and decrease digestive peristalsis. Nevertheless, somatostatin analogues are not routinely used for the treatment of patients with high-output enterostomy and their efficacy in the indication (off-label) was only tested in small case series. Pasireotide (SOM230, SIGNIFOR®) is currently indicated for the treatment of patients with Cushing's disease for whom surgery is not an option or for whom surgery has failed.

As the efficacity of pasireotide in patients with high-output enterostomy refractory to usual medical treatment associated with an oral fluid restriction has never been demonstrated before, there is a need to perform a pilot, double-blind, randomized, placebo-controlled trial evaluating its impact on reduction of the effluent volume.


Condition Intervention Phase
Enterostomy Drug: Pasireotide Drug: Placebo Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Reduction by Pasireotide of the Effluent Volume in High-output Enterostomy in Patients Refractory to Usual Medical Treatment : Phase II Multicentric Randomized Double Bland Placebo Controlled Study

Resource links provided by NLM:


Further study details as provided by Hospices Civils de Lyon:

Primary Outcome Measures:
  • Compare the efficacy of pasireotide versus placebo in reduction of high-output [ Time Frame: Evaluated 72 hours after first injection of treatment ]
    Decrease of enterostomy output (ml/24H)within the 72 hours after first injection of treatment


Secondary Outcome Measures:
  • Estimate the success rate of pasireotide and placebo [ Time Frame: 1 week after first injection of treatment ]
    Number of normal renal function patients in both arms with an enterostomy output than 800 millimeters (mL) /24h within a week after first injection of treatment allowing discontinuation of intravenous perfusion.

  • Compare the decrease in the length of hospitalization with pasireotide versus placebo [ Time Frame: 1 month after the end of treatment ]
    Duration of hospitalization in days in both arms

  • Compare the incidence of premature closure of stoma due to high-output with pasireotide versus placebo [ Time Frame: 2 months after enterostomy creation ]
    Rate of premature closure of stoma due to high-output (before 2 months after creation) in both arms

  • Evaluate the economic impact of pasireotide in this indication [ Time Frame: 2 months from the inclusion of the patient in the study ]
    Costs of taking care of patients from French Public Health Insurance perspective in both arms

  • Incidence of treatment - Emergent Adverse Events [ Time Frame: during treatment (4 days), one week, two weeks, three weeks and one month after treatment ]
    Nature, number and grade of adverse events observed throughout the study


Estimated Enrollment: 78
Study Start Date: April 2016
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: October 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Pasireotide
Pasireotide 0.9 mg by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of pasireotide Long Acting Release (LAR) 60mg on Day 4 morning.
Drug: Pasireotide
Pasireotide 0.9 mg by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of pasireotide Long Acting Release (LAR) 60mg on Day 4 morning.
Other Name: Pasireotide 0.9 mg (SIGNIFOR®) and Pasireotide 60mg Long Acting Release (LAR)
Placebo Comparator: Placebo
Placebo by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of placebo on Day 4 morning.
Drug: Placebo
Placebo by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of placebo on Day 4 morning.
Other Name: Placebo of pasireotide 0.9 mg by subcutaneous injection twice a day during 3 days and 1 intramuscular injection of pasireotide LAR (Long Acting Release) 60mg on Day 4

  Eligibility

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male and Female patients ≥ 18 years old ;
  • Patients who underwent an intestinal surgery with enterostomy repair in the three weeks preceding the inclusion ;
  • Patients with high-output ileostomy or jejunostomy > 1000 ml/24h ;
  • Patients with failure of treatment combining oral fluid restriction and loperamide (up to 8 capsules/24h) +/- codeine syrup (10 mg x 3/24h) during 5 days ;
  • Patients who gave its written informed consent to participate to the study ;
  • Patients affiliated to a social insurance regime.

Exclusion Criteria:

  • Male and Female patients < 18 years old ;
  • Patients who did not give its written informed consent to participate to the study ;
  • Patients who received somatostatin analogues during the month before inclusion ;
  • Patients with symptomatic cholelithiasis or acute or chronic pancreatitis ;
  • Patients with uncontrolled diabetes (with HbA1c (glycated hemoglobin) > 8%) ;
  • Patients who are hypothyroid and not on adequate replacement therapy ;
  • Patients who have congestive heart failure (NYHA (New York Heart Association) Class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, advanced heart block or a history of clinically significant bradycardia or acute myocardial infarction within the 6 months preceding randomization ;
  • Patients with history of syncope or family history of idiopathic sudden death ;
  • Patients with screening or baseline (predose) : QT interval corrected for heart rate using Fridericia's correction (QTcF) QTcF > 450 msec (male), QTcF > 460 msec (female) (QT interval corrected for heart rate using Fridericia's correction) ;
  • Patients with not corrected hypokalaemia and/or hypomagnesaemia ;
  • Patients with liver disease such as cirrhosis, chronic active hepatitis, or chronic persistent hepatitis, or patients with alanine transaminase/aspartate transaminase (ALT/AST) > 2 x Upper Limit of Normal (ULN), serum bilirubin > 2 x ULN ;
  • Patients with Child-Pugh C cirrhosis ;
  • Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control ;
  • Patients with active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix) ;
  • Patients with abnormal coagulation (PT and/or APTT elevated by 30% above normal limits) or patients receiving anticoagulants that affect PT (prothrombin time) or activated partial thromboplastin time (APTT) ;
  • Patients with known hypersensitivity to somatostatin analogues or any other component of the pasireotide LAR ;
  • Patients under guardianship ;
  • Patients nonaffiliated to a social insurance regime.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02713776


Contacts
Contact: Eddy COTTE, Professor 4 78 862 371 ext +33 eddy.cotte@chu-lyon.fr
Contact: Laurent VILLENEUVE 4 78 864 536 ext +33 laurent.villeneuve@chu-lyon.fr

Sponsors and Collaborators
Hospices Civils de Lyon
Investigators
Principal Investigator: Eddy COTTE, Professor Hospices Civils de Lyon - Centre Hospitalier Lyon Sud
  More Information

Responsible Party: Hospices Civils de Lyon
ClinicalTrials.gov Identifier: NCT02713776     History of Changes
Other Study ID Numbers: 2014_880
First Submitted: February 29, 2016
First Posted: March 21, 2016
Last Update Posted: March 21, 2016
Last Verified: February 2016

Keywords provided by Hospices Civils de Lyon:
High-Output Enterostomy
Pasireotide
Somatostatin Analogues

Additional relevant MeSH terms:
Pasireotide
Somatostatin
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs