Brief Title
Acromegaly Combination Treatment Study
Official Title
Comparison of Combination Low-Dose SRL + Daily Pegvisomant Therapy, Low-Dose SRL + Weekly Pegvisomant Therapy, and High-Dose SRL + Weekly Pegvisomant Therapy
Brief Summary
In this study the investigators will evaluate whether combination low dose somatostatin receptor ligand (SRL) and weekly or daily Pegvisomant will attain equivalent control of serum IGF-1 levels at a lower cost, compared to combination high dose SRL and weekly Pegvisomant. Lower doses of therapy will greatly reduce cost of acromegaly therapy.
Detailed Description
Subjects will be stratified based on prior response to SRL therapy and then randomized to one of three treatment arms. The study will begin when the combination of octreotide LAR or lanreotide and pegvisomant is first administered. Study visits will occur every 4 weeks from the start of the study. However, for subjects who cannot make every study visit due to distance, the study team will facilitate monthly blood draws at their local Quest laboratory facility. After the 24 weeks of combination therapy, subjects with a controlled IGF-1 will then start Pegvisomant monotherapy at the same dose and schedule that they attained normalization in combination therapy. IGF-1 levels, liver function test, and blood glucose will be performed monthly. An MRI will be performed at the conclusion of the study.
Study Type
Interventional
Primary Outcome
Equivalent Control
Condition
Acromegaly
Intervention
Pegvisomant
Study Arms / Comparison Groups
High dose SRL + weekly Pegvisomant
Description: High dose of SRL monthly Octreotide LAR 30mg Lanreotide 120mg Weekly Pegviosmant (40-120mg/week)
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
51
Start Date
January 2012
Completion Date
June 2022
Primary Completion Date
December 2021
Eligibility Criteria
Inclusion Criteria: - Newly diagnosed patients with acromegaly who have not had surgery or medical therapy - Acromegaly patients who are at least 3 months post surgery, who are/are not receiving adjuvant medical therapy - Acromegaly patients on SRL monotherapy with normal or elevated IGF-1 levels - Acromegaly patients on Pegvisomant monotherapy with normal or elevated IGF-1 levels. - Acromegaly patients who have received SRL and dopamine agonist therapy, after a 6 week washout period of the dopamine agonist. - Acromegaly patients on combination therapy with maximum doses of SRL and Pegvisomant (daily or weekly - Normal liver function tests before randomization to treatment - The patient has had appropriate dynamic testing of the pituitary axis and, if applicable, is receiving appropriate hormone replacement therapy. Exclusion Criteria: - The patient harbors a macroadenoma with visual field defects due to chiasmatic compression - The patient has clinically significant hepatic abnormalities and/or aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) above 3 times the upper limit of normal at the baseline visit. - The patient had pituitary surgery within 3 months prior to study entry - The patient had radiotherapy within 12 months prior to study entry - The patient has abnormal CBC and chemistry panel at the baseline visit, any other medical condition(s) or laboratory findings that, in the opinion of the investigator, might jeopardize the patient's safety. - The patient has a known hypersensitivity to any of the test materials or related compounds. - The patient has a history of, or known current problems with alcohol or drug abuse. - The patient has any mental condition rendering the patient unable to understand the nature, scope, and possible consequences of the study, and/or evidence of an uncooperative attitude.
Gender
All
Ages
18 Years - 85 Years
Accepts Healthy Volunteers
No
Contacts
Shlomo Melmed, MD, 424-315-4489, [email protected]
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT01538966
Organization ID
Pro26424
Secondary IDs
WS2036536
Responsible Party
Principal Investigator
Study Sponsor
Cedars-Sinai Medical Center
Study Sponsor
Shlomo Melmed, MD, Principal Investigator, Cedars-Sinai Medical Center
Verification Date
September 2020