Dehydroepiandrosterone (DHEA) replacement in patients with secondary adrenal insufficiency (hypopituitarism)

ISRCTN ISRCTN14203656
DOI https://doi.org/10.1186/ISRCTN14203656
Secondary identifying numbers N0158124149
Submission date
30/09/2004
Registration date
30/09/2004
Last edited
25/03/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Not provided at time of registration

Contact information

Dr M Akber
Scientific

North Staffs Hospital Trust
Ward 60
City General
Stoke-on-Trent
ST4 6QG
United Kingdom

Study information

Study designDouble-blind placebo-controlled crossover study with a prearranged randomisation schedule
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Home
Study typeTreatment
Scientific titleDehydroepiandrosterone (DHEA) replacement in patients with secondary adrenal insufficiency (hypopituitarism)
Study hypothesisTo evaluate the benefits of dehydroepiandrosterone (DHEA) replacement in terms of improvement in quality of life as compared to placebo in patients with secondary adrenal insufficiency and to assess its influence on serum lipids, insulin resistance and endothelial function.
Ethics approval(s)Not provided at time of registration
ConditionNutritional, Metabolic, Endocrine: Adrenal insufficiency
InterventionFor the first 4 months each patient would receive either 50 mg of DHEA administered orally or a placebo tablet of identical appearance. Following a washout period of one month the form of therapy would be switched and would be continued for a further period of 4 months.

Allocation details would only be known to an independent statistician and would remain coded until the trial is completed. Patients would be asked to attend the metabolic unit following overnight fast at 0, 4, 5 and 9 months. Pre-menopausal patients would be assessed during the follicular phase of the menstrual cycle. Any side effects would be noted and weight, body mass index (BMI) and blood pressure (BP). Quality of Life (QoL) Questionnaires would be completed and blood samples would be collected for biochemical and hormonal assays and biochemical markers of endothelial function. Short insulin tolerance test would be used as a measure of peripheral insulin sensitivity. After an overnight fast - 0.1 unit/kg body weight of soluble insulin would be injected at 0 minute and blood glucose would be measured at 0, 3, 6, 9, 12 and 15 minutes. The rate of fall of blood glucose, which indicates the endogenous glucose disposal rate, would be calculated from the linear regression of all values between 3 and 15 minutes and the rate of fall in percept per minute would be taken as an index of insulin sensitivity. In addition, biophysical markers of endothelial function would be measured by high resolution ultrasonography and would include carotid intima-media thickness and flow mediated dilatation of the brachial artery. For the latter, flow and diameter of the right brachial artery would be initially measured at rest. A tourniquet would be applied on the forearm and inflated to 250 mm of Hg for 5 minutes and the above measurements on the brachial artery would be repeated following the release of the tourniquet. The change in the diameter would be expressed as a percentage of the baseline diameter. Mean baseline values for each parameter would be compared to the mean post treatment values for placebo and for DHEA arms of the treatment and statistical significance would be assessed using the Student-t test or the Mann Whitney U test, depending on whether the variables are normally disrupted or not. 5% level of significance would be used.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)dehydroepiandrosterone (DHEA)
Primary outcome measure1. Body mass index
2. Blood pressure (BP)
3. Quality of life (QoL) assessment
4. Hormone, Biochemical and Endothelial markers (detail give above)
5. Insulin tolerance test
6. Ultrasonographic assessment of endothelial function by checking carotid intima-media thickness
7. Flow mediated dilatation of the brachial artery
Secondary outcome measuresNot provided at time of registration
Overall study start date01/12/2002
Overall study end date01/10/2003

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants20
Participant inclusion criteria1. 20 patients between the age of 20 and 60 years
2. With adrenal insufficiency secondary to panhypopituitarism of varying aetiology
3. Of at least one years duration enrolled from outpatient clinics of City General Hospital
4. They would be adequately replaced with regards to corticosteroid, thyroxine and sex steroid deficiency with unchanged replacement dose over the preceding 3 months
5. None of the patients would receive growth hormone replacement therapy
6. Patients with significant co-morbidity, those with hormone dependent conditions like breast cancer, pregnant women are excluded
7. Written consent would be obtained from all patients
Participant exclusion criteriaNot provided at time of registration
Recruitment start date01/12/2002
Recruitment end date01/10/2003

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

North Staffs Hospital Trust
Stoke-on-Trent
ST4 6QG
United Kingdom

Sponsor information

Department of Health
Government

Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom

Website http://www.dh.gov.uk/Home/fs/en

Funders

Funder type

Government

North Staffordshire Research and Development Consortium (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

25/03/2020: No publications found, all search options exhausted, study status unverified.