Diabetes Clinical Trial
Official title:
Observational, Cross-sectional, Longitudinal, Multi-center, Diagnostic Study to Evaluate the Influence of Acromegaly on Glucose Tolerance and to Evaluate the Changes of Impaired Glucose Tolerance During Standard Treatment of Acromegaly.
Observational, Cross-sectional, longitudinal, multi-center, diagnostic study
Cross-sectional part of the study: To evaluate the influence of acromegaly on glucose
tolerance
Longitudinal part of the study: To evaluate the changes of impaired glucose tolerance during
standard treatment of acromegaly. Adult patients with established acromegaly
Cross-sectional part of the study: 150 patients
Longitudinal part of the study: 58 patients
TRIAL DESIGN Observational, cross-sectional (patients with normal glucose tolerance).
longitudinal (patients with impaired glucose tolerance), multi-center, diagnostic study.
After checking the inclusion and exclusion criteria for the cross-sectional part of the
study patients will be included for anamnesis according to Flow Chart Visit -1 (Screening
Visit). After checking the glucose tolerance and the insulin resistance by HOMA-IR, the
patients will be classified to the group with normal glucose tolerance defined as:
- fasting plasma glucose < 110 mg/dl and/or 2-hour plasma glucose after an OGTT < 140
mg/dl or to the group with impaired glucose tolerance defined as:
- fasting plasma glucose ≥ 110 mg/dl (IFG) and/or 2-hour plasma glucose after an
OGTT ≥ 140 mg/dl (IGT). For the HOMA-IR the cut off is 1.5.
For patients with normal glucose tolerance the study will end after Screening Visit (V -1).
After patient recruitment of the cross-sectional part is completed an interim analysis is
planned to verify that all criteria for the longitudinal study part are achieved. The
longitudinal part should start not later than one year after the last patient was examined
in the cross-sectional part. For patients with impaired glucose tolerance the inclusion and
exclusion criteria for the longitudinal part of the study will be checked (Baseline, Visit
0). If a patient might be included into the longitudinal part of the study a 12 months
observation with 4 further visits will follow.
Primary Objective and Endpoint
Cross-sectional part of the study:
To evaluate a correlation between IGF-I and glucose tolerance in acromegalic patients. The
inclusion should be performed in 2 stratification groups.
Following two groups are defined:
1. 1/3 of patients with a controlled IGF-I (controlled means IGF-I in age and sex-related
normal reference range.
2. 2/3 of patients with an uncontrolled IGF-I (uncontrolled means IGF-I not in age and sex
related normal reference range.
Longitudinal part of the study:
To evaluate changes of impaired glucose tolerance by different standard treatment options in
acromegaly.
For the analysis of the different treatment options patients will be stratified into 5
treatment groups. Decision will be made according to next planned therapeutic intervention
at Screening Visit (V -1):
1. Surgery
2. Treatment with somatostatin analoga (with or without combination of dopamine agonists)
3. Treatment with growth hormone receptor antagonist
4. Treatment with somatostatin analoga in combination with growth hormone receptor
antagonist
5. Others (e.g. radiation, dopamine agonist monotherapy, no intervention)
;
Observational Model: Case-Only, Time Perspective: Cross-Sectional
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