Healthy Males Clinical Trial
Official title:
Mechanisms of Control of the Intratesticular Hormonal Milieu in Man
The purpose of this research study is to determine how much male hormone, testosterone, is
necessary to maintain sperm production in the testis. This knowledge will be used to help in
the development of a safe male hormonal contraception.
Specific Aims:
1. to determine if ketoconazole plus acyline will suppress intratesticular
testosterone(ITT) to a greater degree than acyline alone.
2. to determine if dutasteride plus acyline will suppress intratesticular
dihydrotestosterone (IT-DHT) to a greater degree than acyline alone.
3. to determine if anastrazole plus acyline will suppress intratesticular estradiol(IT-E2)
to a greater degree than acyline alone.
Five drugs will be used in this study: acyline, testosterone gel, ketoconazole, dutasteride,
and anastrazole.
Acyline suppresses luteinizing hormone (LH) and follicle stimulating hormone (FSH), which
are hormones made by the pituitary gland in the brain, thus blocking the signal from the
brain that causes the testes to make testosterone. Therefore, acyline blocks testosterone
production. Men may experience some side effects from the low levels of testosterone caused
by acyline. Acyline is an experimental drug. Over 125 men have received acyline from our
lab. Acyline will be given by injection, and injections are formulated by subject's weight
and may be given in multiple injections.
Testosterone gel is given to replace testosterone level back to the normal range.
Testosterone gel is approved for use in men with low testosterone levels.
Ketoconazole suppresses testosterone production as well. Ketoconazole works in the adrenal
glands to prevent testosterone production. It is approved by the U.S. FDA for treatment of
fungal infections but for this study the use is considered investigational.
Dutasteride blocks metabolism of testosterone into dihydrotestosterone (DHT). It is approved
by the FDA for treatment of benign enlargement of the prostate gland, but the use is
considered investigational in this study. Also, the dose is 5 times higher than the FDA
approved dose.
Anastrazole blocks metabolism of testosterone into estradiol. It is approved by the FDA for
treatment of breast cancer but its use is considered investigational in this study.
Participation will last approximately 2 months. The study involves a minimum of 7 visits.
Clinic visits at Screening, Day 3 and Day 10 will take about 1-1.5 hours each. On Day 3 & 10
a fine needle aspiration of one testis will be performed. The Day 1 visit will take
approximately 45 minutes. The Day 7 visit will take about 15 minutes. The Day 17 and Day 40
visits will take approximately 30 minutes each. Over the course of the study, which includes
7 separate blood draws, approximately 12 ounces (one and a half cups) of blood will be
drawn. The acyline will be given by injection. The testosterone or placebo gel is applied to
the skin on the chest, upper arms, and upper back. The ketoconazole, dutasteride,
anastrazole, or placebo medication will be taken by mouth.
Subjects randomly assigned to Group 3 will have a Cosyntropin Stimulation Test performed at
the day 10 visit to evaluate the function of adrenal glands.
This is NOT a trial of a male contraceptive, and the study medications will not prevent
pregnancy. Subjects must use an acceptable form of birth control.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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