NCT01063569

Brief Summary

Addison's disease is a rare condition which in most cases is caused by autoimmune destruction of the adrenals, leading to deficiency of cortisol, aldosterone and adrenal androgens. Unrecognized the disease is life threatening, but with proper treatment patients can live near normal lives. The conventional glucocorticoid replacement therapy renders the cortisol levels unphysiological, which may cause symptoms and long-term complications. Glucocorticoid replacement therapy is technically feasible by continuous subcutaneous hydrocortisone infusion (CSHI), and can mimic the normal diurnal cortisol rhythm. This study aims to further evaluate CSHI treatment in terms of metabolic effects, effects on health-related quality-of-life and sleep in an 8 months randomised open label clinical trial with crossover design.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
33

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Feb 2010

Typical duration for phase_2

Geographic Reach
2 countries

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 26, 2010

Completed
6 days until next milestone

Study Start

First participant enrolled

February 1, 2010

Completed
4 days until next milestone

First Posted

Study publicly available on registry

February 5, 2010

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2012

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2012

Completed
Last Updated

March 20, 2013

Status Verified

March 1, 2013

Enrollment Period

2.8 years

First QC Date

January 26, 2010

Last Update Submit

March 19, 2013

Conditions

Keywords

Addison's diseaseGlucocorticoid treatmentContinuous subcutaneous hydrocortisone infusionCSHIQuality of LifeSleep

Outcome Measures

Primary Outcomes (1)

  • Morning (08-09) plasma ACTH

    Time 0, months 2, 3, 5, 7 and 8

Secondary Outcomes (5)

  • Health-Related Quality of Life; evaluated by SF-36 vitality scores and AddiQoL scores

    At time 0 and months 2,3,5,7 and 8

  • Sleep; evaluated by Pittsburgh Sleep Quality Index (PSQI), and 7-days' Actigraph registration combined with self-reported sleep diary

    PSQI: 0 and months 2,3,5,7 and 8; Actigraph/sleep diary: months 2 and 7

  • 24h cortisol profiles in serum and saliva

    months 2 and 7

  • S-glucose, 24 h profile

    months 2 and 7

  • Insulin sensitivity assessed by euglycemic clamp

    Months 2 and 7

Study Arms (2)

Oral hydrocortisone

ACTIVE COMPARATOR
Drug: Cortef (hydrocortisone)

Continous subcutaneous hydrocortisone infusion

EXPERIMENTAL
Drug: Solu-Cortef (hydrocortisone)

Interventions

Continuous Subcutaneous Hydrocortisone infusion via insulin pump. Doses adjusted to body surface area.

Also known as: Solu-Cortef
Continous subcutaneous hydrocortisone infusion

Oral treatment 3 times a day. Weight adjusted doses.

Also known as: Cortef 5 mg
Oral hydrocortisone

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with verified Addison's disease on stable treatment.

You may not qualify if:

  • Insulin treated Diabetes Mellitus, cardiovascular disease,malignant disease, pregnancy.
  • Treatment with glucocorticoids or drugs that interfere with cortisol metabolism (antiepileptics, rifampicin, St. John's wart).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Haukeland University Hospital

Bergen, 5021, Norway

Location

Karolinska Institutet

Stockholm, Sweden

Location

Uppsala University

Uppsala, Sweden

Location

MeSH Terms

Conditions

Addison Disease

Interventions

hydrocortisone hemisuccinateHydrocortisone

Condition Hierarchy (Ancestors)

Adrenal InsufficiencyAdrenal Gland DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System Diseases

Intervention Hierarchy (Ancestors)

PregnenedionesPregnenesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds11-HydroxycorticosteroidsHydroxycorticosteroidsAdrenal Cortex HormonesHormonesHormones, Hormone Substitutes, and Hormone Antagonists17-Hydroxycorticosteroids

Study Officials

  • Kristian Løvås, MD,PhD

    Haukeland University Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 26, 2010

First Posted

February 5, 2010

Study Start

February 1, 2010

Primary Completion

December 1, 2012

Study Completion

December 1, 2012

Last Updated

March 20, 2013

Record last verified: 2013-03

Locations