Trial Outcomes & Findings for Endogenous Opioid Activity and Affective State in Insulin Resistant Women (NCT NCT02069379)

NCT ID: NCT02069379

Last Updated: 2018-11-08

Results Overview

Mu-opioid neurotransmission in limbic brain regions at baseline and change from baseline after metformin treatment

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

42 participants

Primary outcome timeframe

Baseline, 20 weeks, 40 weeks

Results posted on

2018-11-08

Participant Flow

Participant milestones

Participant milestones
Measure
Controls
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Insulin Resistant Participants (Placebo First)
Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Insulin Resistant Participants (Metformin First)
Women classified as insulin resistant and randomized to Metformin treatment arm 1st and Placebo treatment arm 2nd
Insulin Resistant (Not Randomized)
Insulin resistant participants not randomized to treatment arms
Baseline Measurements
STARTED
30
4
2
6
Baseline Measurements
Baseline Measurements Taken
30
4
2
6
Baseline Measurements
COMPLETED
27
4
2
4
Baseline Measurements
NOT COMPLETED
3
0
0
2
First Treatment Arm
STARTED
0
4
2
0
First Treatment Arm
COMPLETED
0
3
1
0
First Treatment Arm
NOT COMPLETED
0
1
1
0
Washout Period (4 Weeks)
STARTED
0
3
1
0
Washout Period (4 Weeks)
COMPLETED
0
1
1
0
Washout Period (4 Weeks)
NOT COMPLETED
0
2
0
0
Second Treatment Arm
STARTED
0
1
1
0
Second Treatment Arm
COMPLETED
0
1
0
0
Second Treatment Arm
NOT COMPLETED
0
0
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Controls
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Insulin Resistant Participants (Placebo First)
Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Insulin Resistant Participants (Metformin First)
Women classified as insulin resistant and randomized to Metformin treatment arm 1st and Placebo treatment arm 2nd
Insulin Resistant (Not Randomized)
Insulin resistant participants not randomized to treatment arms
Baseline Measurements
Lost to Follow-up
1
0
0
0
Baseline Measurements
Ineligible based on initial assessments
2
0
0
2
First Treatment Arm
Lost to Follow-up
0
1
1
0
Washout Period (4 Weeks)
Lost to Follow-up
0
1
0
0
Washout Period (4 Weeks)
Unrelated event
0
1
0
0
Second Treatment Arm
Lost to Follow-up
0
0
1
0

Baseline Characteristics

Endogenous Opioid Activity and Affective State in Insulin Resistant Women

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Controls
n=30 Participants
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Insulin Resistant Participants
n=12 Participants
Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Total
n=42 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
30 Participants
n=5 Participants
12 Participants
n=7 Participants
42 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Female
30 Participants
n=5 Participants
12 Participants
n=7 Participants
42 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
30 Participants
n=5 Participants
12 Participants
n=7 Participants
42 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=5 Participants
2 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
White
13 Participants
n=5 Participants
7 Participants
n=7 Participants
20 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Region of Enrollment
United States
30 participants
n=5 Participants
12 participants
n=7 Participants
42 participants
n=5 Participants
Glucose
80.29 mg/dL
STANDARD_DEVIATION 5.33 • n=5 Participants
84.67 mg/dL
STANDARD_DEVIATION 9.99 • n=7 Participants
81.60 mg/dL
STANDARD_DEVIATION 7.21 • n=5 Participants
Plasma Insulin Levels
10.18 mIU/L
STANDARD_DEVIATION 1.99 • n=5 Participants
18.61 mIU/L
STANDARD_DEVIATION 3.36 • n=7 Participants
12.71 mIU/L
STANDARD_DEVIATION 4.61 • n=5 Participants
HOMA Insulin Resistance (IR)
2.01 HOMA IR
STANDARD_DEVIATION 0.42 • n=5 Participants
3.94 HOMA IR
STANDARD_DEVIATION 1.11 • n=7 Participants
2.56 HOMA IR
STANDARD_DEVIATION 1.12 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline, 20 weeks, 40 weeks

Population: PET scanners available were replaced for other institutional reasons which resulted in image production so incompatible as to be not comparable. Therefore PET image data files were unable to be analyzed due to inconsistencies with imaging techniques.

Mu-opioid neurotransmission in limbic brain regions at baseline and change from baseline after metformin treatment

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Baseline, 20 weeks, 40 weeks

Population: PET scanners available were replaced for other institutional reasons which resulted in image production so incompatible as to be not comparable. Therefore PET image data files were unable to be analyzed due to inconsistencies with imaging techniques.

Mu-opioid neurotransmission in limbic brain regions at baseline and change from baseline after metformin treatment

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Baseline, 20 weeks, 40 weeks

Population: PET scanners available were replaced for other institutional reasons which resulted in image production so incompatible as to be not comparable. Therefore PET image data files were unable to be analyzed due to inconsistencies with imaging techniques.

Mu-opioid neurotransmission in limbic regions at baseline and change from baseline after metformin treatment

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Baseline, 20 weeks, 40 weeks

Population: PET scanners available were replaced for other institutional reasons which resulted in image production so incompatible as to be not comparable. Therefore PET image data files were unable to be analyzed due to inconsistencies with imaging techniques.

Mu-opioid neurotransmission in limbic brain regions at baseline and change from baseline after metformin treatment

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline

Population: All women assessed at baseline, prior to treatment arm randomization, so all insulin resistant women are analyzed as a single group. On the Control side, one woman's data for affective state is unavailable.

Compare positive affective state between controls and insulin resistant women. Positive and Negative Affect Schedule - positive affective state. Scores can range from 10-50, with higher scores representing more positive affective state (better outcome)

Outcome measures

Outcome measures
Measure
Controls
n=26 Participants
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Metformin
n=12 Participants
16 weeks treatment with metformin (insulin sensitizing treatment) Metformin: Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Placebo
Placebo comparator to metformin treatment Placebo: Placebo capsules prepared identically to Metformin capsules
Positive and Negative Affect Schedule - Positive Affective State
28.23 units on a scale
Standard Deviation 8.29
21.83 units on a scale
Standard Deviation 8.84

SECONDARY outcome

Timeframe: Baseline

Population: All women assessed at baseline, prior to treatment arm randomization, so all insulin resistant women analyzed as a single group. One woman's baseline affective score is not available.

Measure of overall negative affective state at baseline in controls and insulin resistant women. Positive and Negative Affect Schedule - negative affective state. Scores can range from 10-50, with higher scores representing more negative affective state (worse outcome)

Outcome measures

Outcome measures
Measure
Controls
n=26 Participants
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Metformin
n=12 Participants
16 weeks treatment with metformin (insulin sensitizing treatment) Metformin: Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Placebo
Placebo comparator to metformin treatment Placebo: Placebo capsules prepared identically to Metformin capsules
Positive and Negative Affect Schedule - Negative Affective State
11.46 units on a scale
Standard Deviation 1.68
12.83 units on a scale
Standard Deviation 6.74

SECONDARY outcome

Timeframe: Baseline

Population: All women assessed at baseline, prior to treatment arm randomization, so all insulin resistant women analyzed as a single group; one woman on the control side's data is not available

Measure of overall negative mood at baseline in controls and insulin resistant women; Profile of Mood States are standardized to a relative score where a higher score is a worse mood state. Standardized cores generally ranged from - 11 to 52.

Outcome measures

Outcome measures
Measure
Controls
n=26 Participants
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Metformin
n=12 Participants
16 weeks treatment with metformin (insulin sensitizing treatment) Metformin: Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Placebo
Placebo comparator to metformin treatment Placebo: Placebo capsules prepared identically to Metformin capsules
Profile of Mood States - Overall Negative Mood
3.15 units on a scale
Standard Deviation 10.60
14.42 units on a scale
Standard Deviation 20.35

SECONDARY outcome

Timeframe: Baseline

Population: All women assessed at baseline, prior to treatment arm randomization, so all insulin resistant women analyzed as a single group. The data for one woman in the control group is unavailable. Note: women with BDI scores of greater than 20 were excluded from the study by definition and therefore could not be in either arm.

Measure of depression symptoms at baseline in controls and insulin resistant women. The Beck Depression Index runs on a scale from 0 to 63 where low scores mean less depression and high scores mean greater depression. Clinically, scores of 14 or higher are considered mild depression; 20 is moderate and 29 is severe.

Outcome measures

Outcome measures
Measure
Controls
n=26 Participants
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Metformin
n=12 Participants
16 weeks treatment with metformin (insulin sensitizing treatment) Metformin: Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Placebo
Placebo comparator to metformin treatment Placebo: Placebo capsules prepared identically to Metformin capsules
Beck Depression Index
2.93 units on a scale
Standard Deviation 4.36
7.00 units on a scale
Standard Deviation 9.96

Adverse Events

Controls

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Placebo (First Assignment & Washout or Second Assignment)

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Metformin (First Assignment & Washout or Second Assignment)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Insulin-resistant Women Not Randomized

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Controls
n=30 participants at risk
metabolically healthy controls will participate in baseline assessments only, and will not be randomized to the placebo and metformin treatment arms.
Placebo (First Assignment & Washout or Second Assignment)
n=5 participants at risk
Placebo comparator to metformin treatment Placebo: Placebo capsules prepared identically to Metformin capsules
Metformin (First Assignment & Washout or Second Assignment)
n=3 participants at risk
16 weeks treatment with metformin (insulin sensitizing treatment) Metformin: Women classified as insulin resistant will participate in both a placebo and a metformin treatment arm, each lasting about 16 weeks. Women will be randomized to order of treatment arms.
Insulin-resistant Women Not Randomized
n=6 participants at risk
These participants, like controls, did not continue beyond baseline and were not assigned any metformin or placebo.
Gastrointestinal disorders
Nausea?
3.3%
1/30 • Number of events 1 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/5 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/3 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/6 • Adverse event data were collected for up to 40 weeks of study participation.
Renal and urinary disorders
Elevated potassium levels
3.3%
1/30 • Number of events 1 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/5 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/3 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/6 • Adverse event data were collected for up to 40 weeks of study participation.
Nervous system disorders
Self-reported seizure
0.00%
0/30 • Adverse event data were collected for up to 40 weeks of study participation.
20.0%
1/5 • Number of events 1 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/3 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/6 • Adverse event data were collected for up to 40 weeks of study participation.
Nervous system disorders
Brain lesion detected
0.00%
0/30 • Adverse event data were collected for up to 40 weeks of study participation.
20.0%
1/5 • Number of events 1 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/3 • Adverse event data were collected for up to 40 weeks of study participation.
0.00%
0/6 • Adverse event data were collected for up to 40 weeks of study participation.

Additional Information

Alison Berent-Spillson

University of Michigan

Phone: (734) 936-4400

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place