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Safety and Efficacy Trial of Serostim® in the Treatment of Subjects With Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)

Primary Purpose

Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS), Human Immunodeficiency Virus Infections

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Serostim®
Placebo
Sponsored by
EMD Serono
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS) focused on measuring Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS), Human Immunodeficiency Virus Infections, recombinant human growth hormone (r-hGH), Serostim®, Placebo

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: • Have an Human Immunodeficiency Virus (HIV) infection documented either by viral load as measured by polymerase chain reaction (PCR) amplification; or by the presence of HIV antibodies with confirmation by one of the following: Western blot Immunofluorescence assay Branched Deoxyribonucleic Acid (bDNA) signal amplification The presence of p24 antigen These tests may have been performed at any time in the past, but the results must be available for review by the Serono monitor prior to randomization Have evidence of excess abdominal adipose deposition when measured using the following cut points: Men: Waist circumference greater than 88.2 centimeter (cm) and waist/hip ratio greater than or equal to 0.95 Women: Waist circumference greater than 75.3 cm and waist/hip ratio greater than or equal to 0.9 (23) Be taking antiretroviral medication(s) which is (are) approved or is (are) available under a treatment investigational new drug (IND). The regimen must have remained stable for the 30 days prior to study entry. Subjects must also have agreed not to discontinue or to change their regimen for the duration of the study except as judged medically necessary Have parameter values less than the following limits: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and amylase less than or equal to 3 times the upper limit of normal (Screening) Fasting triglycerides less than or equal to 1,000 milligram per deciliter (mg/dL) (Screening) Fasting glucose less than 110 mg/dL (Screening) Two hour (120 minute) glucose less than 140 mg/dL (following an oral glucose load at Screening) Weigh greater than or equal to 36 kilogram (kg) (79.3 pound) Be between 18 and 60 years of age unless local law dictates different limits Be able and willing to comply with the protocol for the duration of the study Have given written informed consent If female, be post-menopausal or surgically sterilized (that is, have undergone tubal ligation or hysterectomy), or is Using a contraceptive method such as a hormonal contraceptive, intra uterine device, diaphragm with spermicide, or condom with spermicide, for the duration of the study Not pregnant or breast feeding Exclusion Criteria: Have an active acquired immune deficiency syndrome (AIDS)-defining Opportunistic Infection (OI) as defined by the Center for Disease Control; or have had an untreated or suspected serious systemic infection, or persistent fever greater than or equal to 101 degree Fahrenheit (°F) (38.3 degree Celsius) during the 30 days prior to study entry Have any active malignancy, except for localized cutaneous Karposi's sarcoma (fewer than 10 lesions, none of which are larger than 2 cm, and not on active therapy) Have a central nervous system (CNS) mass or active CNS process associated with neurological findings Have unstable or untreated hypertension, defined as greater than or equal to 140/90 millimeter of mercury (mmHg) at the time of the Screening Visit, and/or has initiated or changed antihypertensive therapy in the 30 days prior to Day 1 Have an acute critical illness treated in an intensive care unit, for example, due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure Have any condition, which interferes with informed consent or protocol compliance including, but not limited to, active substance abuse and/or dementia Is unable to comply with the concomitant therapy restrictions Have ever been diagnosed with any of the following conditions: Pancreatitis Carpal tunnel syndrome (unless resolved by surgical release) Diabetes mellitus Angina pectoris Coronary artery disease Any disorder associated with moderate to severe edema (for example, cirrhosis, nephrotic syndrome, congestive heart failure, lymphedema) Allergy or hypersensitivity to growth hormone

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    Serostim® 4 mg daily

    Serostim® 4 mg alternate days

    Placebo

    Arm Description

    Outcomes

    Primary Outcome Measures

    Change from Baseline in absolute area of visceral adipose tissue quantified by Computerized Tomography (CT) scan at Week 12
    Change from Baseline in the ratio of trunk fat to limb fat quantified by Dual-Energy X-Ray Absorptiometry (DXA) scan at Week 12

    Secondary Outcome Measures

    Change from Baseline in composite sum of the visceral adipose tissue and the ratio of trunk fat to limb fat at Week 12
    Dorsal fat area in the transverse plane, as measured by Computerized Tomography (CT) Scan
    Weight measured on a calibrated scale
    Absolute values of maximal chest, waist, and hip circumference
    Waist/hip ratio
    Absolute value of dorsocervical fat
    Absolute value of total body fat as quantified by DXA scan
    Absolute value of trunk and Limb fat quantified by DXA scan
    Absolute value of Lean body mass as quantified by DXA scan
    Absolute concentration of serum insulin and glucose
    Absolute concentration of fasting serum triglyceride, total cholesterol, Low density lipoprotein (LDL), High density lipoprotein (HDL) and very low density lipoprotein (VLDL)
    High density lipoprotein (HDL)/Low density lipoprotein (LDL) ratio
    Change from Baseline in Serial Photography Parameters of chest and abdomen at Week 12 and 24
    Health related Quality of life

    Full Information

    First Posted
    February 16, 2006
    Last Updated
    March 24, 2014
    Sponsor
    EMD Serono
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00294164
    Brief Title
    Safety and Efficacy Trial of Serostim® in the Treatment of Subjects With Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)
    Official Title
    Phase 2/3, Multicenter, Double-blind, Randomized, Placebo-controlled, Parallel-group, Dose-finding, Safety and Efficacy Trial of Subcutaneously Administered Serostim® (Mammalian Cell-derived Recombinant Human Growth Hormone, r-hGH) in the Treatment of Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    March 2001 (undefined)
    Primary Completion Date
    May 2002 (Actual)
    Study Completion Date
    May 2002 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    EMD Serono

    4. Oversight

    5. Study Description

    Brief Summary
    This study is a Phase 2/3, multicenter, double-blind, randomized, parallel-group, placebo-controlled, dose-finding trial of Serostim® (mammalian cell-derived recombinant human growth hormone, r-hGH) versus placebo in subjects with human immunodeficiency virus-associated adipose tissue redistribution syndrome (HARS). The primary study objective is to determine whether Serostim® treatment reduces adipose tissue maldistribution more effectively than placebo. The primary co-endpoints are derived from measures of visceral adipose tissue assessed by computerized tomography (CT) and the ratio of trunk; and limb fat assessed by dual-energy X-Ray absorptiometry (DXA) scans. Anthropometric measures, physical exams, quality of life assessments, serial photographs, and various laboratory measures will be used to address secondary objectives. These secondary objectives relate to the impact of Serostim® on Physician and subject assessments of change in body shape, health-related quality of life, attitude towards medication compliance, metabolic markers, fat redistribution, and safety. On Day 1, eligible subjects will be randomized in a 1:1:1 ratio to receive daily Serostim®, Serostim® and placebo given on alternate days, or daily placebo. Serostim® doses will be based on body weight, with a maximum dose of 4 milligram (mg). Therapy will continue for 12 weeks. Treatment will then be altered and the new treatment will be continued through Week 24. Interim Study Visits will be required at Weeks 2 and 4 (Treatment Period 1) and at Weeks 14 and 16 (Treatment Period 2). Subjects will be offered to be enrolled into a maintenance Protocol (Study 23056) at Week 24.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS), Human Immunodeficiency Virus Infections
    Keywords
    Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS), Human Immunodeficiency Virus Infections, recombinant human growth hormone (r-hGH), Serostim®, Placebo

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2, Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    245 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Serostim® 4 mg daily
    Arm Type
    Experimental
    Arm Title
    Serostim® 4 mg alternate days
    Arm Type
    Experimental
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Serostim®
    Other Intervention Name(s)
    Recombinant human growth hormone (r-hGH)
    Intervention Description
    Serostim® will be administered subcutaneously (daily or given on alternate days with matched placebo), at a dose based on body weight measured at Baseline, with a maximum daily dose of 4 mg up to Week 24.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Matching placebo will be administered subcutaneously (daily or given on alternate days with Serostim®), up to Week 24.
    Primary Outcome Measure Information:
    Title
    Change from Baseline in absolute area of visceral adipose tissue quantified by Computerized Tomography (CT) scan at Week 12
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in the ratio of trunk fat to limb fat quantified by Dual-Energy X-Ray Absorptiometry (DXA) scan at Week 12
    Time Frame
    Baseline and Week 12
    Secondary Outcome Measure Information:
    Title
    Change from Baseline in composite sum of the visceral adipose tissue and the ratio of trunk fat to limb fat at Week 12
    Time Frame
    Baseline and Week 12
    Title
    Dorsal fat area in the transverse plane, as measured by Computerized Tomography (CT) Scan
    Time Frame
    Baseline, Week 12 and 24
    Title
    Weight measured on a calibrated scale
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute values of maximal chest, waist, and hip circumference
    Time Frame
    Baseline, Week 12 and 24
    Title
    Waist/hip ratio
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute value of dorsocervical fat
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute value of total body fat as quantified by DXA scan
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute value of trunk and Limb fat quantified by DXA scan
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute value of Lean body mass as quantified by DXA scan
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute concentration of serum insulin and glucose
    Time Frame
    Baseline, Week 12 and 24
    Title
    Absolute concentration of fasting serum triglyceride, total cholesterol, Low density lipoprotein (LDL), High density lipoprotein (HDL) and very low density lipoprotein (VLDL)
    Time Frame
    Baseline, Week 12 and 24
    Title
    High density lipoprotein (HDL)/Low density lipoprotein (LDL) ratio
    Time Frame
    Baseline, Week 12 and 24
    Title
    Change from Baseline in Serial Photography Parameters of chest and abdomen at Week 12 and 24
    Time Frame
    Baseline, Week 12 and 24
    Title
    Health related Quality of life
    Time Frame
    Baseline, Week 4, 12 and 24

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: • Have an Human Immunodeficiency Virus (HIV) infection documented either by viral load as measured by polymerase chain reaction (PCR) amplification; or by the presence of HIV antibodies with confirmation by one of the following: Western blot Immunofluorescence assay Branched Deoxyribonucleic Acid (bDNA) signal amplification The presence of p24 antigen These tests may have been performed at any time in the past, but the results must be available for review by the Serono monitor prior to randomization Have evidence of excess abdominal adipose deposition when measured using the following cut points: Men: Waist circumference greater than 88.2 centimeter (cm) and waist/hip ratio greater than or equal to 0.95 Women: Waist circumference greater than 75.3 cm and waist/hip ratio greater than or equal to 0.9 (23) Be taking antiretroviral medication(s) which is (are) approved or is (are) available under a treatment investigational new drug (IND). The regimen must have remained stable for the 30 days prior to study entry. Subjects must also have agreed not to discontinue or to change their regimen for the duration of the study except as judged medically necessary Have parameter values less than the following limits: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and amylase less than or equal to 3 times the upper limit of normal (Screening) Fasting triglycerides less than or equal to 1,000 milligram per deciliter (mg/dL) (Screening) Fasting glucose less than 110 mg/dL (Screening) Two hour (120 minute) glucose less than 140 mg/dL (following an oral glucose load at Screening) Weigh greater than or equal to 36 kilogram (kg) (79.3 pound) Be between 18 and 60 years of age unless local law dictates different limits Be able and willing to comply with the protocol for the duration of the study Have given written informed consent If female, be post-menopausal or surgically sterilized (that is, have undergone tubal ligation or hysterectomy), or is Using a contraceptive method such as a hormonal contraceptive, intra uterine device, diaphragm with spermicide, or condom with spermicide, for the duration of the study Not pregnant or breast feeding Exclusion Criteria: Have an active acquired immune deficiency syndrome (AIDS)-defining Opportunistic Infection (OI) as defined by the Center for Disease Control; or have had an untreated or suspected serious systemic infection, or persistent fever greater than or equal to 101 degree Fahrenheit (°F) (38.3 degree Celsius) during the 30 days prior to study entry Have any active malignancy, except for localized cutaneous Karposi's sarcoma (fewer than 10 lesions, none of which are larger than 2 cm, and not on active therapy) Have a central nervous system (CNS) mass or active CNS process associated with neurological findings Have unstable or untreated hypertension, defined as greater than or equal to 140/90 millimeter of mercury (mmHg) at the time of the Screening Visit, and/or has initiated or changed antihypertensive therapy in the 30 days prior to Day 1 Have an acute critical illness treated in an intensive care unit, for example, due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure Have any condition, which interferes with informed consent or protocol compliance including, but not limited to, active substance abuse and/or dementia Is unable to comply with the concomitant therapy restrictions Have ever been diagnosed with any of the following conditions: Pancreatitis Carpal tunnel syndrome (unless resolved by surgical release) Diabetes mellitus Angina pectoris Coronary artery disease Any disorder associated with moderate to severe edema (for example, cirrhosis, nephrotic syndrome, congestive heart failure, lymphedema) Allergy or hypersensitivity to growth hormone
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Ellen Brady, M.D. MPH
    Organizational Affiliation
    EMD Serono
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    15076238
    Citation
    Kotler DP, Muurahainen N, Grunfeld C, Wanke C, Thompson M, Saag M, Bock D, Simons G, Gertner JM; Serostim in Adipose Redistribution Syndrome Study Group. Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients. J Acquir Immune Defic Syndr. 2004 Mar 1;35(3):239-52. doi: 10.1097/00126334-200403010-00004. Erratum In: J Acquir Immune Defic Syndr. 2006 Nov 1;43(3):381.
    Results Reference
    result
    Links:
    URL
    http://www.jaids.com/pt/re/jaids/abstract.00126334-200403010-00004.htm
    Description
    Published in J Acquir Immune Defic Syndr 35; 239-252: 2004
    URL
    http://www.serostim.com
    Description
    Full FDA approved prescribing information can be found here

    Learn more about this trial

    Safety and Efficacy Trial of Serostim® in the Treatment of Subjects With Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)

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