Phase II Study With ITF2984 in Acromegalic Patients (POC)
Primary Purpose
Acromegaly
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Octreotide
ITF2984 500 mcg
ITF2984 1000 mcg
ITF2984 2000 mcg
Sponsored by
About this trial
This is an interventional treatment trial for Acromegaly focused on measuring de novo or partial responder to somatostatin analogues
Eligibility Criteria
Inclusion Criteria:
- Signed written informed consent.
- Patients with active acromegaly due to a pituitary adenoma. Active acromegaly should be confirmed by 2h five point mean GH level higher than 5 mcg/liter, lack of suppression of GH nadir to less than 1 mcg/liter after oral glucose tolerance test, and elevated IGF-1 for age and sex-matched controls.
- Patients aged between 18 to 80 years old inclusive.
- Patients treated with previous surgery and/or medical therapy or previously untreated (de novo). For patients who had previously received medical therapy for acromegaly a washout periods before study entry of 3 months for long-acting formulation of somatostatin analogs and 2 weeks for octreotide sc must be foreseen. Partial responder means a significant decrease (>50%), without achievement of control of GH and/or IGF-1 levels and/or >20 % tumor shrinkage after at least 6 months of SRL therapy.
- Patients with GH level and IGF-1 level for age and sex-matched controls out of range at baseline (GH at baseline > 2.5mcg/l).
Exclusion Criteria:
- Patients undergone pituitary surgery within the prior 6 months.
- Patients who have received pituitary radiotherapy (within last 10 years).
- Patients with additional active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix)
- Patients with compression of the optic chiasm causing any visual field defect.
- Patients who require a surgical intervention for relief of any sign or symptom associated with tumor compression.
- Patients with uncontrolled diabetes defined as having a fasting glucose > 150 mg/dL (8.3 mmol/L) or HbA1c ≥ 8% (Patients can be rescreened after diabetes is brought under adequate control).
- Patients who have had a significant cardiovascular disease in the three months prior to inclusion such as congestive heart failure (NYHA [New York Heart Association] class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, sustained clinically significant bradycardia, advanced heart block, or with a history of acute myocardial infarction.
- A marked baseline prolongation of QT/QTc interval i.e. a mean QT/QTc >450ms after 3 consecutive measurements at least 5 minutes apart.
- Patients with abnormal coaugulation, Prothrombin time (PT), activated partial thromboplastin time (PTT) elevated by 30% above normal limits.
- Symptomatic cholelithiasis, gallstone or chronic liver disease.
- Patients who have a history or presence at the moment of the screening visit of pancreatitis.
- Clinically significant GI, renal or hepatic disease (in the opinion of investigator).
- AST and/or ALT>2ULN.
- Severely reduced renal function (serum creatinine >2.0 mg/dl or 176µmol/L)
- Active HBV and/or active HCV infection.
- Patients who have a history of alcohol or drug abuse in the six-month period prior to the enrollment visit.
- Known hypothyroidism or hypocortisolism not adequately treated with a stable dose of thyroid or steroid hormone replacement therapy for at least the previous 3 months.
- Known hypersensitivity to any of the study medications, or components thereof or a history of drug or other allergy that in the opinion of the Investigator contraindicates their participation.
- Female patients who are pregnant or lactating, and female patient who are of childbearing potential or male patient with female partners of childbearing potential who do not accept the contraception requirements reported in the protocol.
- Patients who have participated in any clinical investigation with an Investigational drug within 3 months before study entry.
- Current or recent (< 2 months) therapy with pegvisomant or cabergoline.
Sites / Locations
- St. Anne University Hospital
- University Hospital Hradec Kralove
- Université Hôpital Bicêtre
- Hôpital de la TIMONE
- Az MH Honvédkórház
- Semmelweis University
- University of Pecs
- University of Szeged
- Presidio Ospedaliero di Montichiari
- Policlinico G. Martino
- Fondazione Policlinico IRCCS
- IRCCS Ospedale San Raffaele
- Università Federico II
- Università di Pisa
- San Giovanni Battista Molinette
- Leiden University Medical Center
- Erasmus Medisch Centrum
- University Children's Hospital of Cracow
- Klinika Endokrynologii Centrum Medycznego Kształcenia Podyplomowego
- Samodzielny Publiczny Szpital Kliniczny
- Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie II
- Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie I
- Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie VI
- Clinical Center of Serbia
- Clinical center of Nis
- Complejo Hospitalario Universitario de Santiago de Compostela
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Active Comparator
Experimental
Experimental
Experimental
Arm Label
Octreotide
ITF2984 500 mcg
ITF2984 1000 mcg
ITF2984 2000 mcg
Arm Description
Octreotide 100 mcg sc three times daily (t.i.d) for 4 weeks
ITF2984 500 mcg sc twice a day (b.i.d) for 4 weeks
ITF2984 1000 mcg sc b.i.d for 4 weeks
ITF2984 2000 mcg sc b.i.d for 4 weeks
Outcomes
Primary Outcome Measures
effect of treatment on GH and IGF-1
To investigate the effect of treatment on GH and IGF-1 concentrations
Secondary Outcome Measures
reduction in (random) GH < 1.0 mcg/l and/or normalization of IGF-1
To investigate the biochemical response, defined as a reduction in (random) GH < 1.0 mcg/l and/or normalization of IGF-1.
reduction of GH to no more than 2.5 mcg/l and/or normalization of IGF-1
To investigate the biochemical response, defined as a reduction of GH to no more than 2.5 mcg/l and/or normalization of IGF-1.
signs and symptoms of acromegaly
To evaluate variation of signs and symptoms of acromegaly at the end of each month of treatment in comparison with basal status.
PK profile of ITF2984 and Octreotide
To investigate the pharmacokinetic (PK) profile of ITF2984 and Octreotide
dose-response effect of ITF2984 on GH and IGF1 circulating levels
To compare the effects on GH and IGF1 circulating levels of different doses of ITF2984
effects of ITF2984 vs Octreotide on GH and IGF1 circulating levels
To compare the effects on GH and IGF1 circulating levels of ITF2984 and Octreotide
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02111044
Brief Title
Phase II Study With ITF2984 in Acromegalic Patients
Acronym
POC
Official Title
A Randomized, Multicenter, Phase II Study to Investigate Efficacy and Safety of ITF2984 in Acromegalic Patients
Study Type
Interventional
2. Study Status
Record Verification Date
June 2016
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
February 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Italfarmaco
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to investigate in acromegalic patients the effect of different doses of ITF2984 on GH and IGF-1 concentrations and to investigate safety and tolerability of three different doses of ITF2984.
Detailed Description
The study will enroll patients with active acromegaly, de novo or partial responder to previous treatment with somatostatin analogues. For patients who had previously received medical therapy for acromegaly a washout periods before study entry of 3 months for long-acting formulation of somatostatin analogs, 2 weeks for octreotide sc, 2 months for pegvisomant and/or cabergoline must be foreseen.
Each patient will be randomized and wll remain in the study for about 6 months, and they will attend a visit every two weeks.
The patients will be treated for 4 months in a total, in particular every month of treatment will be followed by a washout period of 2 weeks.
At each month of treatment the patients will receive one of the four treatment as reported below:
Octreotide 100 mcg sc three times daily (t.i.d) for 4 weeks, ITF2984 500 mcg sc twice a day (b.i.d) for 4 weeks, ITF2984 1000 mcg sc b.i.d for 4 weeks, ITF2984 2000 mcg sc b.i.d for 4 weeks. Patients will be randomized using a 4 way crossover design to receive ITF2984 or octreotide at each treatment month. Each patient will receive all of the four treatments overseen in this study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acromegaly
Keywords
de novo or partial responder to somatostatin analogues
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
48 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Octreotide
Arm Type
Active Comparator
Arm Description
Octreotide 100 mcg sc three times daily (t.i.d) for 4 weeks
Arm Title
ITF2984 500 mcg
Arm Type
Experimental
Arm Description
ITF2984 500 mcg sc twice a day (b.i.d) for 4 weeks
Arm Title
ITF2984 1000 mcg
Arm Type
Experimental
Arm Description
ITF2984 1000 mcg sc b.i.d for 4 weeks
Arm Title
ITF2984 2000 mcg
Arm Type
Experimental
Arm Description
ITF2984 2000 mcg sc b.i.d for 4 weeks
Intervention Type
Drug
Intervention Name(s)
Octreotide
Other Intervention Name(s)
somatostatin analog
Intervention Description
octreotide 100 mcg sc t.i.d. for 4 weeks
Intervention Type
Drug
Intervention Name(s)
ITF2984 500 mcg
Other Intervention Name(s)
somatostatin analog
Intervention Description
ITF2984 500 mcg sc b.i.d for 4 weeks
Intervention Type
Drug
Intervention Name(s)
ITF2984 1000 mcg
Other Intervention Name(s)
somatostatin analog
Intervention Description
ITF2984 1000 mcg sc b.i.d for 4 weeks
Intervention Type
Drug
Intervention Name(s)
ITF2984 2000 mcg
Other Intervention Name(s)
somatostatin analog
Intervention Description
ITF2984 2000 mcg sc b.i.d for 4 weeks
Primary Outcome Measure Information:
Title
effect of treatment on GH and IGF-1
Description
To investigate the effect of treatment on GH and IGF-1 concentrations
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
reduction in (random) GH < 1.0 mcg/l and/or normalization of IGF-1
Description
To investigate the biochemical response, defined as a reduction in (random) GH < 1.0 mcg/l and/or normalization of IGF-1.
Time Frame
4 weeks
Title
reduction of GH to no more than 2.5 mcg/l and/or normalization of IGF-1
Description
To investigate the biochemical response, defined as a reduction of GH to no more than 2.5 mcg/l and/or normalization of IGF-1.
Time Frame
4 weeks
Title
signs and symptoms of acromegaly
Description
To evaluate variation of signs and symptoms of acromegaly at the end of each month of treatment in comparison with basal status.
Time Frame
4 weeks
Title
PK profile of ITF2984 and Octreotide
Description
To investigate the pharmacokinetic (PK) profile of ITF2984 and Octreotide
Time Frame
4 weeks
Title
dose-response effect of ITF2984 on GH and IGF1 circulating levels
Description
To compare the effects on GH and IGF1 circulating levels of different doses of ITF2984
Time Frame
4 weeks
Title
effects of ITF2984 vs Octreotide on GH and IGF1 circulating levels
Description
To compare the effects on GH and IGF1 circulating levels of ITF2984 and Octreotide
Time Frame
4 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed written informed consent.
Patients with active acromegaly due to a pituitary adenoma. Active acromegaly should be confirmed by 2h five point mean GH level higher than 5 mcg/liter, lack of suppression of GH nadir to less than 1 mcg/liter after oral glucose tolerance test, and elevated IGF-1 for age and sex-matched controls.
Patients aged between 18 to 80 years old inclusive.
Patients treated with previous surgery and/or medical therapy or previously untreated (de novo). For patients who had previously received medical therapy for acromegaly a washout periods before study entry of 3 months for long-acting formulation of somatostatin analogs and 2 weeks for octreotide sc must be foreseen. Partial responder means a significant decrease (>50%), without achievement of control of GH and/or IGF-1 levels and/or >20 % tumor shrinkage after at least 6 months of SRL therapy.
Patients with GH level and IGF-1 level for age and sex-matched controls out of range at baseline (GH at baseline > 2.5mcg/l).
Exclusion Criteria:
Patients undergone pituitary surgery within the prior 6 months.
Patients who have received pituitary radiotherapy (within last 10 years).
Patients with additional active malignant disease within the last five years (with the exception of basal cell carcinoma or carcinoma in situ of the cervix)
Patients with compression of the optic chiasm causing any visual field defect.
Patients who require a surgical intervention for relief of any sign or symptom associated with tumor compression.
Patients with uncontrolled diabetes defined as having a fasting glucose > 150 mg/dL (8.3 mmol/L) or HbA1c ≥ 8% (Patients can be rescreened after diabetes is brought under adequate control).
Patients who have had a significant cardiovascular disease in the three months prior to inclusion such as congestive heart failure (NYHA [New York Heart Association] class III or IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, sustained clinically significant bradycardia, advanced heart block, or with a history of acute myocardial infarction.
A marked baseline prolongation of QT/QTc interval i.e. a mean QT/QTc >450ms after 3 consecutive measurements at least 5 minutes apart.
Patients with abnormal coaugulation, Prothrombin time (PT), activated partial thromboplastin time (PTT) elevated by 30% above normal limits.
Symptomatic cholelithiasis, gallstone or chronic liver disease.
Patients who have a history or presence at the moment of the screening visit of pancreatitis.
Clinically significant GI, renal or hepatic disease (in the opinion of investigator).
AST and/or ALT>2ULN.
Severely reduced renal function (serum creatinine >2.0 mg/dl or 176µmol/L)
Active HBV and/or active HCV infection.
Patients who have a history of alcohol or drug abuse in the six-month period prior to the enrollment visit.
Known hypothyroidism or hypocortisolism not adequately treated with a stable dose of thyroid or steroid hormone replacement therapy for at least the previous 3 months.
Known hypersensitivity to any of the study medications, or components thereof or a history of drug or other allergy that in the opinion of the Investigator contraindicates their participation.
Female patients who are pregnant or lactating, and female patient who are of childbearing potential or male patient with female partners of childbearing potential who do not accept the contraception requirements reported in the protocol.
Patients who have participated in any clinical investigation with an Investigational drug within 3 months before study entry.
Current or recent (< 2 months) therapy with pegvisomant or cabergoline.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paolo Bettica, MD
Organizational Affiliation
Italfarmaco
Official's Role
Study Director
Facility Information:
Facility Name
St. Anne University Hospital
City
Brno
Country
Czech Republic
Facility Name
University Hospital Hradec Kralove
City
Hradec Kralove
Country
Czech Republic
Facility Name
Université Hôpital Bicêtre
City
Le Kremlin-Bicêtre
Country
France
Facility Name
Hôpital de la TIMONE
City
Marseille
Country
France
Facility Name
Az MH Honvédkórház
City
Budapest
Country
Hungary
Facility Name
Semmelweis University
City
Budapest
Country
Hungary
Facility Name
University of Pecs
City
Pecs
Country
Hungary
Facility Name
University of Szeged
City
Szeged
Country
Hungary
Facility Name
Presidio Ospedaliero di Montichiari
City
Brescia
Country
Italy
Facility Name
Policlinico G. Martino
City
Messina
Country
Italy
Facility Name
Fondazione Policlinico IRCCS
City
Milano
Country
Italy
Facility Name
IRCCS Ospedale San Raffaele
City
Milano
Country
Italy
Facility Name
Università Federico II
City
Napoli
Country
Italy
Facility Name
Università di Pisa
City
Pisa
Country
Italy
Facility Name
San Giovanni Battista Molinette
City
Torino
Country
Italy
Facility Name
Leiden University Medical Center
City
Leiden
Country
Netherlands
Facility Name
Erasmus Medisch Centrum
City
Rotterdam
Country
Netherlands
Facility Name
University Children's Hospital of Cracow
City
Cracow
Country
Poland
Facility Name
Klinika Endokrynologii Centrum Medycznego Kształcenia Podyplomowego
City
Warsaw
Country
Poland
Facility Name
Samodzielny Publiczny Szpital Kliniczny
City
Wrocław
Country
Poland
Facility Name
Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie II
City
Bucharest
Country
Romania
Facility Name
Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie I
City
Bucharest
Country
Romania
Facility Name
Institutul de Endocrinologie C.I.Parhon, Sectia clinica de endocrinologie VI
City
Bucharest
Country
Romania
Facility Name
Clinical Center of Serbia
City
Belgrade
Country
Serbia
Facility Name
Clinical center of Nis
City
Nis
Country
Serbia
Facility Name
Complejo Hospitalario Universitario de Santiago de Compostela
City
Santiago de Compostela
Country
Spain
12. IPD Sharing Statement
Learn more about this trial
Phase II Study With ITF2984 in Acromegalic Patients
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