The Circadian Rhythm in CusHing SyndrOme in Active Phase and dUring RemiSsion (TheHOURS)

NCT ID: NCT03343470

Last Updated: 2022-11-23

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

Total Enrollment

15 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-11-08

Study Completion Date

2023-12-30

Brief Summary

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This is an observational, open, prospective multi-centre study designed to evaluate melatonin and cortisol circadian rhythm, immunological profile and anthropometric parameters in Cushing Syndrome patients during active Remission state.

Detailed Description

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Cushing Syndrome is a severe condition caused by prolonged exposure to high levels of glucocorticoids.

This is a disease with high morbidity and mortality due to metabolic, cardiovascular, coagulative, psychiatric complications of hypercortisolism.

The loss of circadian secretion of cortisol is one of the most sensitive and specific diagnostic features of Cushing's Syndrome that normalizes during remission. The evaluation of the circadian rhythm of cortisol is one of the diagnostic tests recommended by the guidelines to evaluate the state of the disease's activity.

Studies in literature have shown several correlations between states of hypercortisolism and circadian secretion of melatonin, displaying reduced melatonin secretion throughout the day and the suppression of circadian rhythm of cortisol. However, the dynamics of the normalization of melatonin circadian rhythm during remission from Cushing syndrome are unclear.

Therefore, the aim of our study is to evaluate the changes in circadian secretion of melatonin in Cushing's syndrome during active disease and during remission (3 and 6 months), according to the rational scientific influence of endogenous hypercortisolism on the function of the pineal gland. In addition, the changes in circadian secretion of cortisol, of mononuclear cells of the blood (PBMC) and of anthropometric-metabolic parameters, will be analyzed.

Conditions

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Cushing Syndrome

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Cushing Syndrome (active phase)

Patients displaying biochemical and clinical features of active Cushing's syndrome

No interventions assigned to this group

Cushing Syndrome (during remission)

Patients at 3-6 months from remission with cortisol levels in the normal range

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Cushing Syndrome during active phase

Exclusion Criteria

* Malignancy
* Alcoholism or drug addiction
* Psychiatric disorders
* Clinical or laboratory signs of significant cardiovascular, hepatobiliary disease
* Clinically significant renal dysfunction
* Pregnancy
* Any medication with agents which could interfere with glucocorticoid kinetics and melatonin secretion
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Federico II University

OTHER

Sponsor Role collaborator

University of Palermo

OTHER

Sponsor Role collaborator

University of Florence

OTHER

Sponsor Role collaborator

Ospedali Riuniti Ancona

OTHER

Sponsor Role collaborator

University of Padova

OTHER

Sponsor Role collaborator

University of Roma La Sapienza

OTHER

Sponsor Role lead

Responsible Party

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Andrea M. Isidori

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea M Isidori, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Dept. Experimental Medicine

Locations

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Department of Experimental Medicine

Rome, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Andrea M Isidori, MD, PhD

Role: CONTACT

+390649970540

Facility Contacts

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Andrea M Isidori, MD, PhD

Role: primary

+390649970540

References

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Tomova A, Kumanov P, Robeva R, Manchev S, Konakchieva R. Melatonin secretion and non-specific immune responses are differentially expressed in corticotropin-dependent and corticotropin-independent Cushing's syndrome. Med Sci Monit. 2008 Jun;14(6):CR327-332.

Reference Type RESULT
PMID: 18509277 (View on PubMed)

Pivonello R, De Leo M, Cozzolino A, Colao A. The Treatment of Cushing's Disease. Endocr Rev. 2015 Aug;36(4):385-486. doi: 10.1210/er.2013-1048. Epub 2015 Jun 11.

Reference Type RESULT
PMID: 26067718 (View on PubMed)

Piovesan A, Terzolo M, Borretta G, Torta M, Buniva T, Osella G, Paccotti P, Angeli A. Circadian profile of serum melatonin in Cushing's disease and acromegaly. Chronobiol Int. 1990;7(3):259-61. doi: 10.3109/07420529009056984.

Reference Type RESULT
PMID: 2268888 (View on PubMed)

Fevre-Montange M, Tourniaire J, Estour B, Bajard L. 24 hour melatonin secretory pattern in Cushing's syndrome. Clin Endocrinol (Oxf). 1983 Aug;19(2):175-81. doi: 10.1111/j.1365-2265.1983.tb02979.x.

Reference Type RESULT
PMID: 6684004 (View on PubMed)

Angeli A, Gatti G, Sartori ML, Masera RG. Chronobiological aspects of the neuroendocrine-immune network. Regulation of human natural killer (NK) cell activity as a model. Chronobiologia. 1992 Jul-Dec;19(3-4):93-110. No abstract available.

Reference Type RESULT
PMID: 1478121 (View on PubMed)

Other Identifiers

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Adrenal_2

Identifier Type: -

Identifier Source: org_study_id

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