T-IR- Study to Understand the Effects of Testosterone and Estrogen on the Body's Response to the Hormone Insulin

NCT ID: NCT01686828

Last Updated: 2018-05-08

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

53 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-06-30

Study Completion Date

2017-12-31

Brief Summary

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The purpose of this research study is to understand the effects of testosterone and estrogen on the body's response to the hormone insulin.

Detailed Description

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The investigators will examine the effects of testosterone on insulin sensitivity and body composition in men. This study may lend greater insight into the increased risk of diabetes evident in men with low circulating levels of testosterone. Three drugs will be used in this study: acyline, given by injection; testosterone (T) gel that is applied to the skin; and letrozole, which is an oral drug that blocks the conversion of androgens (male hormones) to estrogens (female hormones). Acyline inhibits the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH). When acyline stops the production of these hormones, it blocks the signal from the brain that stimulates the testicles to make testosterone. Adding testosterone to acyline will restore physiologic levels of testosterone in some study participants. One group of men will receive T gel with letrozole, an aromatase inhibitor; these men will have normal levels of testosterone but low levels of estrogen in the blood. This design will enable determination of the respective metabolic effects of testosterone and estrogen.

Conditions

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Insulin Resistance Type 2 Diabetes Mellitus Obesity Androgen Deficiency Metabolic Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Acyline & placebo gel & placebo pill

Acyline (300mcg/kg) + placebo transdermal gel + placebo pill daily

Group Type EXPERIMENTAL

Acyline

Intervention Type DRUG

300 mcg/mL administered subcutaneously (at Day 0, Week 2)

Placebo gel (for Testosterone 1.62% gel)

Intervention Type DRUG

placebo gel manufactured to mimic Testosterone 1.62% gel

Placebo pill (for Letrozole)

Intervention Type DRUG

Oral placebo aromatase inhibitor to mimic Letrozole 5mg/d

Acyline & Testosterone 1.25g & placebo pill

Acyline (300mcg/kg) + Testosterone gel (1.25g) daily + placebo pill daily

Group Type EXPERIMENTAL

Acyline

Intervention Type DRUG

300 mcg/mL administered subcutaneously (at Day 0, Week 2)

Testosterone 1.62% gel

Intervention Type DRUG

Transdermal Testosterone Gel (either 1.25g or 5g/d) for 4 weeks

Placebo pill (for Letrozole)

Intervention Type DRUG

Oral placebo aromatase inhibitor to mimic Letrozole 5mg/d

Acyline & Testosterone 5g & placebo pill

Acyline (300mcg/kg) + Testosterone gel (5g) daily + placebo pill daily

Group Type EXPERIMENTAL

Acyline

Intervention Type DRUG

300 mcg/mL administered subcutaneously (at Day 0, Week 2)

Testosterone 1.62% gel

Intervention Type DRUG

Transdermal Testosterone Gel (either 1.25g or 5g/d) for 4 weeks

Placebo pill (for Letrozole)

Intervention Type DRUG

Oral placebo aromatase inhibitor to mimic Letrozole 5mg/d

Acyline & Testosterone & Letrozole

Acyline (300mcg/kg) + Testosterone gel (5g) daily + letrozole (5mg) daily

Group Type EXPERIMENTAL

Acyline

Intervention Type DRUG

300 mcg/mL administered subcutaneously (at Day 0, Week 2)

Testosterone 1.62% gel

Intervention Type DRUG

Transdermal Testosterone Gel (either 1.25g or 5g/d) for 4 weeks

Letrozole

Intervention Type DRUG

Letrozole oral aromatase inhibitor 5mg daily for 4 weeks

Interventions

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Acyline

300 mcg/mL administered subcutaneously (at Day 0, Week 2)

Intervention Type DRUG

Testosterone 1.62% gel

Transdermal Testosterone Gel (either 1.25g or 5g/d) for 4 weeks

Intervention Type DRUG

Letrozole

Letrozole oral aromatase inhibitor 5mg daily for 4 weeks

Intervention Type DRUG

Placebo gel (for Testosterone 1.62% gel)

placebo gel manufactured to mimic Testosterone 1.62% gel

Intervention Type DRUG

Placebo pill (for Letrozole)

Oral placebo aromatase inhibitor to mimic Letrozole 5mg/d

Intervention Type DRUG

Other Intervention Names

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Androgel Femara

Eligibility Criteria

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Inclusion Criteria

* Prostate-specific antigen (PSA) ≤ 3 ng/mL
* Age 25-55 years
* Ability to understand the study, study procedures and provide informed consent
* Serum total T \> 300 ng/dL
* Normal reproductive history and exam
* International Prostate Symptom Score (IPSS) \< 11

Exclusion Criteria

* A history of prostate cancer including suspicious digital rectal exam (DRE) or history of highgrade prostatic intraepithelial neoplasia (PIN) on prostate biopsy
* Invasive therapy for benign prostatic hyperplasia (BPH) in the past
* History of acute urinary retention in the previous 3 months
* Current or recent past use of androgenic or anti-androgenic drugs, steroids or drugs which interfere with steroid metabolism (within the last 3 months)
* Current use of statins or glucocorticoids
* Severe systemic illness (renal, liver, cardiac, lung disease, cancer, diabetes mellitus) or skin disease
* A history of or current breast cancer
* Known, untreated obstructive sleep apnea
* Hematocrit \> 50 or \< 34
* Hypersensitivity to any of the drugs used in the study
* History of a bleeding disorder or anticoagulation
* Participation in any other drug study within past 90 days
* History of drug or alcohol abuse within the last 12 months
* Weight \> 280 lbs. or BMI ≥ 33
* Desire for fertility in the next 6 months or current pregnant partner
* Sperm concentration \<14 million/ml
* Significant, uncontrolled hypertension (BP \>160/100 mmHg); subjects with well-controlled BP on medical therapy will be eligible to participate
Minimum Eligible Age

25 Years

Maximum Eligible Age

55 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Katya Rubinow

Assistant Professor, Division of Metabolism, Endocrinology and Nutrition

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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William J Bremner, MD, PhD

Role: STUDY_CHAIR

University of Washington

Stephanie T Page, MD, PhD

Role: STUDY_DIRECTOR

University of Washington

Katya Rubinow, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Chao J, Rubinow KB, Kratz M, Amory JK, Matsumoto AM, Page ST. Short-Term Estrogen Withdrawal Increases Adiposity in Healthy Men. J Clin Endocrinol Metab. 2016 Oct;101(10):3724-3731. doi: 10.1210/jc.2016-1482. Epub 2016 Aug 2.

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Other Identifiers

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STUDY00002641

Identifier Type: -

Identifier Source: org_study_id

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