Prader-Willi Syndrome Clinical Trial
Official title:
Investigation of the Developmental, Nutritional and Hormonal Regulation of Ghrelin in Children and Young Adults With Prader-Willi Syndrome (PWS): Octreotide Intervention Sub-study
The purpose of this study is to investigate over a 6 month period the effect of octreotide therapy on food intake, sense of hunger, body weight, body composition, efficiency of burning calories, biomarkers of weight regulation and growth hormone markers in children and young Adults with Prader-Willi Syndrome(PWS).
Obesity continues to be a prevalent health concern affecting every race of the American
population. According to data from the World Health Organization, 54% of U.S. adults are
overweight (body mass index (BMI) >25 kg/m2 ) and 22% are obese (BMI >30 kg/m2) (1). In
addition, 25% of U.S. children are overweight or obese (1). Studies show that obese children
are likely to become obese adults (2-5). Also, recent studies report significant years of
life lost due to the impact of being an obese adult (6, 7). Thus, insights into the
pathogenesis of childhood obesity and preventative measures are needed to combat the
inevitable increase in worldwide incidence of obesity and its associated co-morbidities.
Recent studies have identified a new gastroenteric hormone, ghrelin, as a long-term
regulator of energy balance in humans (12). Ghrelin is a 28 amino acid acylated peptide
which is an endogenous ligand of the growth hormone secretagogue receptor (GHS-R), a
hypothalamic G-protein-coupled receptor (13). Enteroendocrine cells (X/A-like cells) of the
stomach are the major site of ghrelin synthesis, although a minor proportion of ghrelin
synthesis occurs in other sites such as the hypothalamus, pituitary, duodenum, jejunum and
lung (14) (15, 16).
The hypothesis that hyperghrelinemia causes some of the features of PWS predicts that this
disorder will be ameliorated (partially or completely) by lowering ghrelin levels. We have
recently shown that the somatostatin agonist, octreotide, suppresses ghrelin levels in
humans. If octreotide remains effective in longer term studies, the drug may become an
adjuvant therapy, in addition to growth hormone, to control the insatiable appetite and
morbid obesity seen in this condition.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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