Administration of Clomiphene: Short and Long Term Metabolism in an Anti-Doping Setting

NCT ID: NCT03028532

Last Updated: 2020-01-30

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

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-13

Study Completion Date

2018-10-15

Brief Summary

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Clomiphene (Clomid) is a drug FDA approved to treat female infertility, however, it is often used by men in an off-label setting to both treat male infertility and in a multitude of sports disciplines to increase performance.

Study Objectives:

* Determine detection windows for clomiphene and its metabolites in urine following a medium-term administration
* Understand the effect of clomiphene administration on luteinizing hormone (LH), follicle-stimulating hormone (FSH), and serum testosterone (T) concentrations in a longitudinal manner
* Identify changes in current steroidal module of Athlete Biological Passport

Detailed Description

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Clomiphene, pharmaceutically prepared as clomiphene citrate, is a selective estrogen receptor modulator (SERM) with a therapeutic indication to treat female infertility. Though FDA-approved only for use in women, clomiphene is often prescribed off-label to males to treat male infertility and secondary hypogonadism due to its ability to increase serum testosterone levels. Numerous clinical studies have documented both the effectiveness for these indications and safety of clomiphene administration in males. Increasing the concentration of circulating testosterone can have additional effects, including the enhancement of performance in sports. As such, clomiphene is already abused by athletes in several sporting disciplines, including mixed martial arts, cycling, and bodybuilding. Therefore, clomiphene is a prohibited substance under the World Anti-Doping Agency code . Though the parent compound and metabolites of clomiphene are directly detectable in routine anti-doping screening, the urinary detection window and the effect of clomiphene administration on other anti-doping markers are unknown and thus the foci of this study.

Conditions

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Sports Drug Abuse Abuse of Steroids or Hormones

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Clomid

All participants will be receiving Clomid and will follow the same study procedures.

Group Type EXPERIMENTAL

Clomid

Intervention Type DRUG

Participants will self-administer Clomid (50mg oral tablet) once daily for 30 consecutive days

Interventions

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Clomid

Participants will self-administer Clomid (50mg oral tablet) once daily for 30 consecutive days

Intervention Type DRUG

Other Intervention Names

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Clomiphene Clomifene

Eligibility Criteria

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Inclusion Criteria

\- Active males who engage in regular exercise between the ages of 18 and 40 on the day of enrollment

• For this study, regular exercise is defined as: physical activity resulting in an increased heart rate for at least 30 minutes per day, 4-5 days per week.

Exclusion Criteria

* Individuals outside of the described age range on the day of enrollment
* Individuals who are in a Registered Testing Pool for anti-doping purposes, or individuals who for any reason could be subject to doping control testing
* Individuals who are unwilling or unable to provide blood or urine samples
* Individuals who do not actively exercise
* Individuals with any history of cancer, cardiovascular disease, endocrine abnormalities, infertility, hypoandrogenism, renal disease, hepatic disease, neurologic disease, or any psychiatric history
* Individuals who have previously used anabolic steroids, selective estrogen receptor modulators (SERMs), selective androgen receptor modulators (SARMs), or who are currently using any substances included on the WADA Prohibited List
* History of venous thromboembolic disease (i.e. deep vein thrombosis or pulmonary embolism)
* History of untreated cataracts
* History of intracranial lesions such as pituitary tumors
* Transaminase elevation greater than 3 times the upper limit of normal (ULN)
* Moderate or heavy alcohol intake
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Sports Medicine Research and Testing Laboratory

INDUSTRY

Sponsor Role collaborator

Partnership for Clean Competition

OTHER

Sponsor Role collaborator

Stuart Willick

OTHER

Sponsor Role lead

Responsible Party

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Stuart Willick

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Stuart Willick, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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Heidi Jo Hansen

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Guay AT, Jacobson J, Perez JB, Hodge MB, Velasquez E. Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit? Int J Impot Res. 2003 Jun;15(3):156-65. doi: 10.1038/sj.ijir.3900981.

Reference Type BACKGROUND
PMID: 12904801 (View on PubMed)

Katz DJ, Nabulsi O, Tal R, Mulhall JP. Outcomes of clomiphene citrate treatment in young hypogonadal men. BJU Int. 2012 Aug;110(4):573-8. doi: 10.1111/j.1464-410X.2011.10702.x. Epub 2011 Nov 1.

Reference Type BACKGROUND
PMID: 22044663 (View on PubMed)

Niederberger C. Re: outcomes of clomiphene citrate treatment in young hypogonadal men. J Urol. 2013 Mar;189(3):1039. doi: 10.1016/j.juro.2012.11.143. Epub 2013 Jan 22. No abstract available.

Reference Type BACKGROUND
PMID: 23394666 (View on PubMed)

Taylor F, Levine L. Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacy and treatment cost. J Sex Med. 2010 Jan;7(1 Pt 1):269-76. doi: 10.1111/j.1743-6109.2009.01454.x. Epub 2009 Aug 17.

Reference Type BACKGROUND
PMID: 19694928 (View on PubMed)

Chandrapal JC, Nielson S, Patel DP, Zhang C, Presson AP, Brant WO, Myers JB, Hotaling JM. Characterising the safety of clomiphene citrate in male patients through prostate-specific antigen, haematocrit, and testosterone levels. BJU Int. 2016 Dec;118(6):994-1000. doi: 10.1111/bju.13546. Epub 2016 Jun 24.

Reference Type BACKGROUND
PMID: 27226135 (View on PubMed)

Helo S, Mahon J, Ellen J, Wiehle R, Fontenot G, Hsu K, Feustel P, Welliver C, McCullough A. Serum levels of enclomiphene and zuclomiphene in men with hypogonadism on long-term clomiphene citrate treatment. BJU Int. 2017 Jan;119(1):171-176. doi: 10.1111/bju.13625. Epub 2016 Sep 11.

Reference Type BACKGROUND
PMID: 27511863 (View on PubMed)

Moskovic DJ, Katz DJ, Akhavan A, Park K, Mulhall JP. Clomiphene citrate is safe and effective for long-term management of hypogonadism. BJU Int. 2012 Nov;110(10):1524-8. doi: 10.1111/j.1464-410X.2012.10968.x. Epub 2012 Mar 28.

Reference Type BACKGROUND
PMID: 22458540 (View on PubMed)

Patel DP, Brant WO, Myers JB, Presson AP, Johnstone EB, Dorais JA, Aston KI, Carrell DT, Hotaling JM. The safety and efficacy of clomiphene citrate in hypoandrogenic and subfertile men. Int J Impot Res. 2015 Nov-Dec;27(6):221-4. doi: 10.1038/ijir.2015.21. Epub 2015 Aug 20.

Reference Type BACKGROUND
PMID: 26289907 (View on PubMed)

Roth LW, Ryan AR, Meacham RB. Clomiphene citrate in the management of male infertility. Semin Reprod Med. 2013 Jul;31(4):245-50. doi: 10.1055/s-0033-1345271. Epub 2013 Jun 17.

Reference Type BACKGROUND
PMID: 23775379 (View on PubMed)

Miller GD, Moore C, Nair V, Hill B, Willick SE, Rogol AD, Eichner D. Hypothalamic-Pituitary-Testicular Axis Effects and Urinary Detection Following Clomiphene Administration in Males. J Clin Endocrinol Metab. 2019 Mar 1;104(3):906-914. doi: 10.1210/jc.2018-01159.

Reference Type DERIVED
PMID: 30295816 (View on PubMed)

Other Identifiers

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97194

Identifier Type: -

Identifier Source: org_study_id

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