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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05178537
Other study ID # BICAAS01
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date January 1, 2022
Est. completion date December 1, 2025

Study information

Verified date January 2024
Source Odense University Hospital
Contact Jan Frystyk, Professor
Phone 65411807
Email jan.frystyk@rsyd.dk
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Overarching aim of project Performance and image enhancing drugs (PIEDs) are pharmacological agents acquired illicitly to improve physical strength and endurance as well as to obtain a leaner and more muscular appearance. Androgenic anabolic steroids (AAS) are the most frequently used PIED and include testosterone and its synthetic derivatives. However, PIEDs also include other hormones, e.g. growth hormone (GH), insulin-like growth factor I (IGF-I), glucocorticoids, insulin and thyroxin. Originally, the use of PIEDs was predominately restricted to elite athletes. However, today most users of PIEDs are recreational athletes. In USA, the prevalence of recreational PIED users (three million) exceeds the prevalence of type 1 diabetes. This appears to be the same in Denmark, where the estimated prevalence of recreational users of PIEDs is 44,000, compared to approximately 30,000 patients with type 1 diabetes. The access to AAS is easy due to the unregulated and illicit sale on the internet. Furthermore, PIED use is common in the young population with possible detrimental effects on future health and well-being. PIEDs are linked to premature death and a wide spectrum of somatic and psychological disorders. However, clinical data on the use of PIEDs is currently limited. Randomized trials of PIEDs are unethical as this would require administration of potentially harmful supra-physiological doses of hormones and this is the rationale behind our proposal to perform an observational study. With this project the investigators propose to a) Perform a cross-sectional nationwide study of current and former users of PIEDs (N=1200), focusing on AAS. In particular, the investigators will pay attention to: 1. Preclinical cardiovascular disease 2. Psychological well-being, aggression and quality of life 3. Biomarkers of ageing 4. Body composition and muscle strength b) Establish a nationwide biobank containing blood, urine and hair samples from current and former users of PIEDs.


Description:

Performance and image enhancing drugs (PIEDs) are pharmacological agents acquired illicitly to improve physical strength and endurance as well as to obtain a leaner and more muscular appearance. Androgenic anabolic steroids (AAS) are the most frequently used PIED and include testosterone and its synthetic derivatives. However, PIEDs also include other hormones, e.g. growth hormone (GH), insulin-like growth factor I (IGF-I), glucocorticoids, insulin and thyroxin. Originally, the use of PIEDs was predominately restricted to elite athletes. However, today most users of PIEDs are recreational athletes. In USA, the prevalence of recreational PIED users (three million) exceeds the prevalence of type 1 diabetes. This appears to be the same in Denmark, where the estimated prevalence of recreational users of PIEDs is 44,000, compared to approximately 30,000 patients with type 1 diabetes. The access to AAS is easy due to the unregulated and illicit sale on the internet. Furthermore, PIED use is common in the young population with possible detrimental effects on future health and well-being. PIEDs are linked to premature death and a wide spectrum of somatic and psychological disorders. However, clinical data on the use of PIEDs is currently limited. Randomized trials of PIEDs are unethical as this would require administration of potentially harmful supra-physiological doses of hormones and this is the rationale behind our proposal to perform an observational study. With this project the investigators propose to a) Perform a cross-sectional nationwide study of current and former users of PIEDs (N=1200), focusing on AAS. In particular, the investigators will pay attention to: 1. Preclinical cardiovascular disease 2. Psychological well-being, aggression and quality of life 3. Biomarkers of ageing 4. Body composition and muscle strength b) Establish a nationwide biobank containing blood, urine and hair samples from current and former users of PIEDs. Study population Inclusion criteria • Recreational athletes (≥18 years of age) with current or former use of PIEDs, including AAS for ≥ 3 months Exclusion criteria • Severe psychiatric or somatic diseases which makes it impossible to give informed consent or comply with the investigatory program Estimated number of participants over 3 years are N=1200. Participants are recruited using social media groups, newspapers, posters in fitness centers and at general practitioners. Recruitment is performed in collaboration with Anti Doping Denmark. Investigations Patient reported outcomes (PRO) Bio impedance Muscle strength measurement Clinical examination Medical history and socioeconomic status Blood and urine samples Ultrasound of the carotid artery and aorta Echocardiography and ECG CHANGE IN PRIMARY ENDPOINT Amendment - modification of the description of the primary end-point: January 16, 2024. This clinical study is descriptive: It aims to describe the cardiovascular and mental health status of recreational athletes using anabolic androgenic steroids. As such, no strict statistical power calculations were performed. Originally, the primary endpoint was ultrasound-detected calcifications of aorta using a 3.5 mHz transducer. However, due to body size of the anabolic androgenic steroid using participants, the results have appeared not to be reliable. This became evident after the pilot study, which has included 120 recreational athletes. Consequently, the primary endpoint was modified to ultrasound-determined plaques of the carotid and the femoral arteries; i.e. North and South of the abdominal aorta.


Recruitment information / eligibility

Status Recruiting
Enrollment 1200
Est. completion date December 1, 2025
Est. primary completion date December 1, 2025
Accepts healthy volunteers
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Recreational athletes (=18 years of age) with current or former use of PIEDs, including AAS for = 3 months Exclusion Criteria: - none

Study Design


Intervention

Other:
AAS users
no intervention

Locations

Country Name City State
Denmark Jan Frystyk Odense

Sponsors (1)

Lead Sponsor Collaborator
Jan Frystyk

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Primary Ultrasound aorta calcifications 1 day (Only one timepoint as the study is cross sectional)
Primary Ultrasound of the carotid arteries and the femoral arteries calcifications 1 day (Only one timepoint as the study is cross sectional)
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