COrticosteroid in Congenital Adrenal Hyperplasia

NCT ID: NCT02552251

Last Updated: 2015-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-31

Brief Summary

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Congenital adrenal hyperplasia (CAH) results from a deficiency of a key enzyme in the biosynthesis of cortisol, mainly 21-hydroxylase, resulting in its classic form a neonatal salt loss syndrome and / or a virilization syndrome in girls. The treatment of the disorder in adulthood involves administering steroidal compounds with the aim to substitute the gluco- and mineralocorticoid deficit on the one hand, and effectively curb the adrenal hyperplasia and adrenal androgen pathway in girls . The terms of glucocorticoid treatment are not clearly codified and are based on several steroidal compounds and various protocols. The advantages in terms of adrenal suppression and disadvantages - including bone and metabolic - different treatments have not been clearly established in the literature. The main objective of this study is to compare among adults with HCS in its classical form the impact on hormonal parameters adrenal suppression glucocorticoid of 3 types of treatment administered to equivalent dose and according to the usual procedures. The secondary objective is to compare in the same patients the impact of different drugs and treatments on several metabolic bone parameters. The study will include 40 adult patients bearing a HCS in its classical form and will include 3 treatment sequences of eight weeks each, during which they will be administered sequentially in random order at random and according to the known equivalences hydrocortisone, prednisone (CORTANCYL) and dexamethasone (DECTANCYL).

Randomization will be stratified based on previous DMARDs in the investigation that may be different for different patients, knowing that France hydrocortisone and dexamethasone are used mainly for the treatment of congenital adrenal hyperplasia. The judging criteria will be: i) the criteria of adrenal hormone suppression: plasma levels of testosterone, androstenedione, 17 OHP, ACTH and diurnal variations of the 17 OH progesterone salivary ii) the criteria of the metabolic impact of glucocorticoids: plasma glucose levels , blood lipids, and insulin sensitivity index HOMA-R calculated from glucose and insulin, iii) the criteria of bone impact of glucocorticoids: plasma for CTX bone resorption and bone alkaline phosphatase P1NP for bone formation iv) the living quality criteria evaluated by the PGWB Questionnaire (Psychological General Well-Being). The duration of the study period will be 24 months.

Detailed Description

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Conditions

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Congenital Adrenal Hyperplasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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A: hydrocortisone

hydrocortisone equivalent to physiological doses for each patient Strategy: administration of glucocorticoids during sequences of eight weeks

Group Type EXPERIMENTAL

Hormonal balance measurements

Intervention Type BIOLOGICAL

metabolic balance measurements

Intervention Type BIOLOGICAL

bone balance measurements

Intervention Type BIOLOGICAL

quality of life assessment

Intervention Type BEHAVIORAL

B :dexamethasone (DECTANCYL)

dexamethasone equivalent to physiological doses for each patient Strategy: administration of glucocorticoids during sequences of eight weeks

Group Type EXPERIMENTAL

Hormonal balance measurements

Intervention Type BIOLOGICAL

metabolic balance measurements

Intervention Type BIOLOGICAL

bone balance measurements

Intervention Type BIOLOGICAL

quality of life assessment

Intervention Type BEHAVIORAL

C : prednisone (CORTANCYL)

prednisone equivalent to physiological doses for each patient Strategy: administration of glucocorticoids during sequences of eight weeks

Group Type EXPERIMENTAL

Hormonal balance measurements

Intervention Type BIOLOGICAL

metabolic balance measurements

Intervention Type BIOLOGICAL

bone balance measurements

Intervention Type BIOLOGICAL

quality of life assessment

Intervention Type BEHAVIORAL

Interventions

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Hormonal balance measurements

Intervention Type BIOLOGICAL

metabolic balance measurements

Intervention Type BIOLOGICAL

bone balance measurements

Intervention Type BIOLOGICAL

quality of life assessment

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Pubescent women over 18 in genital activity (premenopausal)
* Suffering from congenital adrenal hyperplasia in its classical form with salt loss or pure virilizing
* Patients who have presented signs of congenital adrenal hyperplasia in its classical form (salt wasting syndrome and / or neonatal masculinization) with elevation of 17 OH progesterone with diagnosis of enzyme block 21 hydroxylase.
* Patients currently treated by: 1 or 2 Oral compound glucocorticoid as replacement and suppressive therapy + 1 mineralocorticoid if necessary with effective control of substitution + possibly by estrogen-progestin pill.

Exclusion Criteria

* Liver disease, kidney, bone, diabetes, severe dyslipidemia, pregnancy
* Postmenopausal women, age over 55 years
* Concomitant therapy: glucocorticoids supra-physiological doses for other indications, bisphosphonates, vitamin D, oral antidiabetic agents or insulin, lipid lowering agents (eg inflammatory disease, asthma, systemic disease ... ..).
* participation of the subject to another biomedical research protocol for this study
* Inability to submit to medical monitoring study for geographical, social or psychological.
* Severe calorie diet planned or carried out during the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Caen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Service Endocrinologie et Maladies Métaboliques

Caen, , France

Site Status RECRUITING

Countries

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France

Facility Contacts

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Yves REZNIK, MD, PhD

Role: primary

02.31.06.45.86

Other Identifiers

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11-059

Identifier Type: -

Identifier Source: org_study_id

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