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Triptorelin for Ovary Protection in Childhood Onset Lupus

Primary Purpose

Systemic Lupus Erythematosus

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Triptorelin pamoate
Triptorelin Pamoate
Triptorelin Pamoate
Triptorelin Pamoate
placebo
Sponsored by
Children's Hospital Medical Center, Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Systemic Lupus Erythematosus focused on measuring SLE, Lupus, Ovarian damage, Menopause

Eligibility Criteria

9 Years - 21 Years (Child, Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Females under the age of 21 and non-pregnant Tanner stage of 2 or above as determined by physical examination of breast stage Diagnosis with SLE using the updated American College of Rheumatology (ACR) Classification Criteria for SLE 1 Severe SLE requiring cyclophosphamide therapy Bone mineral density z-score > - 2.0 Must be using a medically acceptable form of birth control during the study and must not be pregnant at the screening visit No clinically significant abnormal findings other than those consistent with the diagnosis of childhood-onset SLE (cSLE) on the physical examination, medical history or clinical laboratory results during screening Currently on any combination of medication but must not have been treated with more than one dose of cyclophosphamide or other gonadotoxic medications in the past Voluntary consent or, if under the age of consent, assent to participate in this study with permission by a legal guardian Exclusion Criteria: Male patients of any age Female patients with a Tanner stage of 1 Positive blood pregnancy test at screening or taking oral or injectable birth-control medications Prior exposure to more than one dose of gonadotoxic medications including cyclophosphamide History of allergic or adverse response to triptorelin Diagnosed with hypogonadism prior to cyclophosphamide exposure Acutely life-threatening disease activity that prohibits inclusion in a clinical trial History of clinically significant gastrointestinal tract, renal, hepatic, endocrine, oncologic, pulmonary (asthma accepted), or cardiovascular disease; or a history of tuberculosis, epilepsy, diabetes, depression, psychosis, or any other non-cSLE condition, which in the opinion of the physician, would jeopardize the safety of the subject or impact the validity of the study results Patient age 18 years of younger with severe depression as defined by a CDI (Children's Depression Inventory) score of > 23 or a patient age 19 to 21 years with severe depression as defined by a BDI (Beck's Depression Inventory) score > 29 Patient admits to suicidal thoughts at screening visit Bone mineral density lower than z = -2.0.

Sites / Locations

  • Children's Hospital of Los Angeles
  • Children's Memorial Hospital
  • Hackensack University Medical Center
  • Morgan Stanley Children's Hospital of New York
  • Cincinnati Children's Hospital Medical Center
  • Columbus Children's Hospital
  • Children's Hospital of Oklahoma
  • Seattle Children's Hospital
  • Children's Hospital of Wisconsin
  • University of Sao Paulo

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Triptorelin T1

Triptorelin T2

Triptorelin T3

Triptorelin T4

Placebo

Arm Description

Triptorelin Pamoate 25 μg/kg body weight

Triptorelin Pamoate 50 μg/kg body weight

Triptorelin Pamoate 75 μg/kg body weight T3

Triptorelin Pamoate 100 μg/kg body weight T4

Normal Saline

Outcomes

Primary Outcome Measures

Dose of Triptorelin for Ovarian Suppression
Dose escalation was initiated If COS was not maintained with the 1st dose of study drug. Subsequent doses were increased by 25% or at least 20μg/kg dose. This procedure of dose increases by 25% or at least 20μg/kg dose was repeated until COS was maintained. Absolute max dose 7.8mg. Triptorelin (T1-T4) groups were pooled for analysis.

Secondary Outcome Measures

Length of Time of Triptorelin Treatment to Achieve Ovarian Suppression
Time to ovarian suppression, based on suppressed LH levels, after the initial dose of triptorelin. Due to the dose escalation during the study, Triptorelin (T1-T4) groups were pooled for analysis.

Full Information

First Posted
July 26, 2005
Last Updated
December 8, 2020
Sponsor
Children's Hospital Medical Center, Cincinnati
Collaborators
Watson Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00124514
Brief Title
Triptorelin for Ovary Protection in Childhood Onset Lupus
Official Title
Triptorelin for Ovary Protection in Childhood Onset Lupus
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
June 2003 (undefined)
Primary Completion Date
March 2014 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Children's Hospital Medical Center, Cincinnati
Collaborators
Watson Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to test the safety of triptorelin when used for the protection of the ovaries (pair of female reproductive organs) during cyclophosphamide therapy for systemic lupus erythematosus (SLE; lupus) and to see what effects (good or bad) it has on patients. The study will be done with female patients who have been diagnosed with systemic lupus erythematosus, are younger than 21 years of age, and require intravenous cyclophosphamide to control the disease. Each patient will be in the study for approximately 23 months, until 4 months after the intravenous cyclophosphamide treatment has been completed. This study is currently being conducted at 3 sites across the United States and Brazil (Los Angeles, Cincinnati and San Paulo Brazil). A total of 50 patients will participate in this study. Each patient will be randomized (assigned) to one of 5 groups. Randomization means that patients are put into a group completely by chance. It is like flipping a coin. Neither the patient nor the study staff knows what group the patient is in. The patient has a 20% chance of being placed in any group. This is a dose escalation study, each patient will receive the first dose of the study drug (T1 - T4, placebo). If a patient has complete ovarian suppression on day 27 after the initial injection of study drug, then she will remain on this weight-adjusted dose of study drug throughout the study. The dose will be increased up for a weight gain of 5kg or greater. The dose will not be adjusted downward for a weight loss. If COS was not maintained with the 1st dose of study drug, then the subsequently injected 2nd dose will be increased by 25% or at least 20 microgram/kg/dose. The maximal dose of 150 microgram/kg/dose will not be exceeded. The absolute maximum dose is 20 mg. Funding Source: FDA OOPD and Watson Pharmaceuticals
Detailed Description
Lupus is an autoimmune disease that may harm all organs in the body and especially affects the kidney, brain, skin and lungs. Cyclophosphamide is a very effective medication to treat lupus, but it can damage the ovaries (pair of reproductive organs). Only female lupus patients may participate in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Systemic Lupus Erythematosus
Keywords
SLE, Lupus, Ovarian damage, Menopause

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
31 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Triptorelin T1
Arm Type
Experimental
Arm Description
Triptorelin Pamoate 25 μg/kg body weight
Arm Title
Triptorelin T2
Arm Type
Experimental
Arm Description
Triptorelin Pamoate 50 μg/kg body weight
Arm Title
Triptorelin T3
Arm Type
Experimental
Arm Description
Triptorelin Pamoate 75 μg/kg body weight T3
Arm Title
Triptorelin T4
Arm Type
Experimental
Arm Description
Triptorelin Pamoate 100 μg/kg body weight T4
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Normal Saline
Intervention Type
Drug
Intervention Name(s)
Triptorelin pamoate
Other Intervention Name(s)
Trelstar Depot
Intervention Description
IM injection given monthly
Intervention Type
Drug
Intervention Name(s)
Triptorelin Pamoate
Other Intervention Name(s)
Trelstar Depot
Intervention Description
IM injection given monthly
Intervention Type
Drug
Intervention Name(s)
Triptorelin Pamoate
Other Intervention Name(s)
Trelstar Depot
Intervention Description
IM injection given monthly
Intervention Type
Drug
Intervention Name(s)
Triptorelin Pamoate
Other Intervention Name(s)
Trelstar Depot
Intervention Description
IM injection given monthly
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
placebo 0.9% normal saline
Intervention Description
placebo 0.9% normal saline IM injection
Primary Outcome Measure Information:
Title
Dose of Triptorelin for Ovarian Suppression
Description
Dose escalation was initiated If COS was not maintained with the 1st dose of study drug. Subsequent doses were increased by 25% or at least 20μg/kg dose. This procedure of dose increases by 25% or at least 20μg/kg dose was repeated until COS was maintained. Absolute max dose 7.8mg. Triptorelin (T1-T4) groups were pooled for analysis.
Time Frame
baseline to week 24
Secondary Outcome Measure Information:
Title
Length of Time of Triptorelin Treatment to Achieve Ovarian Suppression
Description
Time to ovarian suppression, based on suppressed LH levels, after the initial dose of triptorelin. Due to the dose escalation during the study, Triptorelin (T1-T4) groups were pooled for analysis.
Time Frame
baseline to week 24

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
9 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Females under the age of 21 and non-pregnant Tanner stage of 2 or above as determined by physical examination of breast stage Diagnosis with SLE using the updated American College of Rheumatology (ACR) Classification Criteria for SLE 1 Severe SLE requiring cyclophosphamide therapy Bone mineral density z-score > - 2.0 Must be using a medically acceptable form of birth control during the study and must not be pregnant at the screening visit No clinically significant abnormal findings other than those consistent with the diagnosis of childhood-onset SLE (cSLE) on the physical examination, medical history or clinical laboratory results during screening Currently on any combination of medication but must not have been treated with more than one dose of cyclophosphamide or other gonadotoxic medications in the past Voluntary consent or, if under the age of consent, assent to participate in this study with permission by a legal guardian Exclusion Criteria: Male patients of any age Female patients with a Tanner stage of 1 Positive blood pregnancy test at screening or taking oral or injectable birth-control medications Prior exposure to more than one dose of gonadotoxic medications including cyclophosphamide History of allergic or adverse response to triptorelin Diagnosed with hypogonadism prior to cyclophosphamide exposure Acutely life-threatening disease activity that prohibits inclusion in a clinical trial History of clinically significant gastrointestinal tract, renal, hepatic, endocrine, oncologic, pulmonary (asthma accepted), or cardiovascular disease; or a history of tuberculosis, epilepsy, diabetes, depression, psychosis, or any other non-cSLE condition, which in the opinion of the physician, would jeopardize the safety of the subject or impact the validity of the study results Patient age 18 years of younger with severe depression as defined by a CDI (Children's Depression Inventory) score of > 23 or a patient age 19 to 21 years with severe depression as defined by a BDI (Beck's Depression Inventory) score > 29 Patient admits to suicidal thoughts at screening visit Bone mineral density lower than z = -2.0.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hermine I Brunner, M.D. M.Sc.
Organizational Affiliation
Children's Hospital Medical Center, Cincinnati
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's Hospital of Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Children's Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60614
Country
United States
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Morgan Stanley Children's Hospital of New York
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Columbus Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205
Country
United States
Facility Name
Children's Hospital of Oklahoma
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Seattle Children's Hospital
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Children's Hospital of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
University of Sao Paulo
City
São Paulo
Country
Brazil

12. IPD Sharing Statement

Citations:
PubMed Identifier
25676588
Citation
Brunner HI, Silva CA, Reiff A, Higgins GC, Imundo L, Williams CB, Wallace CA, Aikawa NE, Nelson S, Klein-Gitelman MS, Rose SR. Randomized, double-blind, dose-escalation trial of triptorelin for ovary protection in childhood-onset systemic lupus erythematosus. Arthritis Rheumatol. 2015 May;67(5):1377-85. doi: 10.1002/art.39024.
Results Reference
derived

Learn more about this trial

Triptorelin for Ovary Protection in Childhood Onset Lupus

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