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The Effects of Two Brands of Hydrocortisone Injected Intramuscularly Into Deltoid and Thigh Muscles

Primary Purpose

Addison's Disease

Status
Recruiting
Phase
Phase 4
Locations
United Kingdom
Study Type
Interventional
Intervention
Solu-Cortef 100 MG Injection
Hydrocortisone 100mg/ml
Sponsored by
The London Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Addison's Disease

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18-70 inclusive
  2. Written informed consent provided, prior to any study related assessments/procedure being conducted.
  3. Men & Women with a BMI between 18-30kg/m2
  4. Addison's disease or Bilateral Adrenalectomised patients with pre-hydrocortisone cortisol level below 100nmol/L and ACTH greater than 50ng/L on screening visit
  5. All patients must be stabilised on hydrocortisone with no change in dosage for 6 months, other than transient increases for concurrent illness.
  6. Able to self-inject into deltoid and thigh muscles following teaching at recruitment.
  7. Female patients of child-bearing potential must be willing to use an acceptable method of birth control/abstinence from the time consent is signed until 6 weeks after treatment is discontinued. Acceptable methods include: physical barrier (male or female condom, contraceptive sponges, diaphragms and cervical caps),-contraceptive pill or patch, spermicidal method alongside a physical barrier or an intrauterine device (IUD). Abstinence is also acceptable if it falls in line with the patient's usual lifestyle however it must be complete abstinence and not either; periodic, ovulation timed, symptothermal or withdrawal based. Those patients that utilise hormonal contraceptives must have used the same method for at least three months before additional barrier contraception (as described above). Patients of non-child-bearing potential are defined as having 12 month amenorrhoea or are surgically sterile.

Exclusion Criteria:

  1. Patient on oestrogen based or mixed oral contraceptives unless willing to use alternate effective method of contraception
  2. Patient on any forms of oral steroids other than hydrocortisone.
  3. Any patient with secondary adrenal failure
  4. Patients with a diagnosis of any disease or condition listed in Hydrocortisone 100mg/ml and Solu-Cortef®'s SmPC as being contraindicated or precautionary for use
  5. Patient with concurrent illness in the week preceding screening/study visit.
  6. Patient must not have had an adrenal crisis in the week before screening
  7. Patient with Nelson's syndrome.
  8. Participating in another IMP investigation
  9. Patient who is unable or unwilling to comply with the protocol.
  10. Patient taking any medications/substances that are known to interact with hydrocortisone e.g. CYP3A4 inhibitors
  11. Pregnant or breastfeeding patients
  12. Patient has any other disease or condition that, in the opinion of the investigator, might compromise patient safety or interfere with the results of the trial

Sites / Locations

  • The London ClinicRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Solu-Cortef® in deltoid muscle

Solu-Cortef® in thigh muscle

Hydrocortisone 100mg/ml in deltoid muscle

Hydrocortisone 100mg/ml in thigh muscle

Arm Description

Solu-Cortef® in deltoid muscle

Solu-Cortef® in thigh muscle

Hydrocortisone 100mg/ml in deltoid muscle

Hydrocortisone 100mg/ml in thigh muscle

Outcomes

Primary Outcome Measures

State of Hypocortisolaemia when injected into deltoid muscle or thigh muscle
Measure of Peak Serum Cortisol

Secondary Outcome Measures

Pain perception following use of difference sizes of needles (1inch orange needle versus 1.25inch blue needle), muscle groups (deltoid versus thigh) and hydrocortisone preparations (Solu-Cortef® versus Hydrocortisone 100mg/ml)
Verbal Numerical Rating Scale for Pain from 0 (no pain) to 10 (worst pain) Size of needle Injection site used Hydrocortisone preparation
Hydrocortisone absorption
Measured by Injection site circumference measured in Centimeters and BMI (weight in kilograms, height in meters) BMI combined to view Area under curve and Time to peak concentration
Ability to Self-Inject
Measure by assessment of the following: Hypocortisolaemia symptoms Leftover IMP in ampoules (Quanitity of IMP measure in ml to calculate remaining mg of IMP) Time taken to inject
Subjective health status/impact on quality of life
AddiQol score (AddiQol Health-related quality of life in Addison's disease) total score 30 Ability to self-inject

Full Information

First Posted
March 29, 2022
Last Updated
April 22, 2022
Sponsor
The London Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT05350020
Brief Title
The Effects of Two Brands of Hydrocortisone Injected Intramuscularly Into Deltoid and Thigh Muscles
Official Title
An Open Label Pilot Study to Investigate the Effects of Two Preparations of Hydrocortisone (Hydrocortisone 100mg/ml and Solu-Cortef) Injected Intramuscularly Into the Deltoid and Upper Thigh Muscle During the State of Hypocortisolaemia
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 14, 2022 (Actual)
Primary Completion Date
March 2023 (Anticipated)
Study Completion Date
August 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The London Clinic

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The study will be looking at the cortisol profiles of hypocortisolaemic patients following 100mg injections of two hydrocortisone preparations (Solu-Cortef® & Hydrocortisone 100mg/ml). The investigators plan to use two methods of intramuscular injection to administer the preparations, one using a 1inch orange needle into the deltoid muscle and the other using a 1.25inch blue needle into the thigh muscle.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Addison's Disease

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
8 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Solu-Cortef® in deltoid muscle
Arm Type
Experimental
Arm Description
Solu-Cortef® in deltoid muscle
Arm Title
Solu-Cortef® in thigh muscle
Arm Type
Experimental
Arm Description
Solu-Cortef® in thigh muscle
Arm Title
Hydrocortisone 100mg/ml in deltoid muscle
Arm Type
Experimental
Arm Description
Hydrocortisone 100mg/ml in deltoid muscle
Arm Title
Hydrocortisone 100mg/ml in thigh muscle
Arm Type
Experimental
Arm Description
Hydrocortisone 100mg/ml in thigh muscle
Intervention Type
Drug
Intervention Name(s)
Solu-Cortef 100 MG Injection
Intervention Description
Licensed medicine used in clinical practice. Preparations will be used unmodified in this trial withinmarketing authorisations.
Intervention Type
Drug
Intervention Name(s)
Hydrocortisone 100mg/ml
Intervention Description
Licensed medicine used in clinical practice. Preparations will be used unmodified in this trial within marketing authorisations.
Primary Outcome Measure Information:
Title
State of Hypocortisolaemia when injected into deltoid muscle or thigh muscle
Description
Measure of Peak Serum Cortisol
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Pain perception following use of difference sizes of needles (1inch orange needle versus 1.25inch blue needle), muscle groups (deltoid versus thigh) and hydrocortisone preparations (Solu-Cortef® versus Hydrocortisone 100mg/ml)
Description
Verbal Numerical Rating Scale for Pain from 0 (no pain) to 10 (worst pain) Size of needle Injection site used Hydrocortisone preparation
Time Frame
4 Weeks
Title
Hydrocortisone absorption
Description
Measured by Injection site circumference measured in Centimeters and BMI (weight in kilograms, height in meters) BMI combined to view Area under curve and Time to peak concentration
Time Frame
4 Weeks
Title
Ability to Self-Inject
Description
Measure by assessment of the following: Hypocortisolaemia symptoms Leftover IMP in ampoules (Quanitity of IMP measure in ml to calculate remaining mg of IMP) Time taken to inject
Time Frame
4 Weeks
Title
Subjective health status/impact on quality of life
Description
AddiQol score (AddiQol Health-related quality of life in Addison's disease) total score 30 Ability to self-inject
Time Frame
5 Weeks

10. Eligibility

Sex
All
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-70 inclusive Written informed consent provided, prior to any study related assessments/procedure being conducted. Men & Women with a BMI between 18-30kg/m2 Addison's disease or Bilateral Adrenalectomised patients with pre-hydrocortisone cortisol level below 100nmol/L and ACTH greater than 50ng/L on screening visit All patients must be stabilised on hydrocortisone with no change in dosage for 6 months, other than transient increases for concurrent illness. Able to self-inject into deltoid and thigh muscles following teaching at recruitment. Female patients of child-bearing potential must be willing to use an acceptable method of birth control/abstinence from the time consent is signed until 6 weeks after treatment is discontinued. Acceptable methods include: physical barrier (male or female condom, contraceptive sponges, diaphragms and cervical caps),-contraceptive pill or patch, spermicidal method alongside a physical barrier or an intrauterine device (IUD). Abstinence is also acceptable if it falls in line with the patient's usual lifestyle however it must be complete abstinence and not either; periodic, ovulation timed, symptothermal or withdrawal based. Those patients that utilise hormonal contraceptives must have used the same method for at least three months before additional barrier contraception (as described above). Patients of non-child-bearing potential are defined as having 12 month amenorrhoea or are surgically sterile. Exclusion Criteria: Patient on oestrogen based or mixed oral contraceptives unless willing to use alternate effective method of contraception Patient on any forms of oral steroids other than hydrocortisone. Any patient with secondary adrenal failure Patients with a diagnosis of any disease or condition listed in Hydrocortisone 100mg/ml and Solu-Cortef®'s SmPC as being contraindicated or precautionary for use Patient with concurrent illness in the week preceding screening/study visit. Patient must not have had an adrenal crisis in the week before screening Patient with Nelson's syndrome. Participating in another IMP investigation Patient who is unable or unwilling to comply with the protocol. Patient taking any medications/substances that are known to interact with hydrocortisone e.g. CYP3A4 inhibitors Pregnant or breastfeeding patients Patient has any other disease or condition that, in the opinion of the investigator, might compromise patient safety or interfere with the results of the trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christine Topham
Phone
0203 219 3570
Email
clinicalresearch@thelondonclinic.co.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Phillip Yeoh
Phone
0207 953 4444
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pierre Bouloux
Organizational Affiliation
Endocrinology Consultant
Official's Role
Principal Investigator
Facility Information:
Facility Name
The London Clinic
City
London
ZIP/Postal Code
W1G 6HL
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Phillip Yeoh

12. IPD Sharing Statement

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The Effects of Two Brands of Hydrocortisone Injected Intramuscularly Into Deltoid and Thigh Muscles

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