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Growth Hormone and/or Rosiglitazone for HIV-Associated Increased Abdominal Fat and Insulin Resistance
This study is ongoing, but not recruiting participants.
Sponsored by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Information provided by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
ClinicalTrials.gov Identifier: NCT00130286
  Purpose

The purpose of the study is to determine if the combination of recombinant human growth hormone plus rosiglitazone (an insulin-sensitizing drug) is safe and more effective than either drug alone (or no active therapy) for the treatment of fat accumulation in people with HIV infection and insulin resistance.


Condition Intervention Phase
HIV-Associated Lipodystrophy Syndrome
Insulin Resistance
HIV Infections
Metabolic Syndrome X
Body Weight Changes
Drug: Recombinant Human Growth Hormone
Drug: Rosiglitazone
Drug: Recombinant Human Growth Hormone and Rosiglitazone
Drug: Placebo human growth hormone and placebo rosiglitazone
Phase I
Phase II

MedlinePlus related topics: AIDS Metabolic Syndrome
Drug Information available for: Insulin Rosiglitazone Rosiglitazone Maleate Somatotropin Somatropin
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Factorial Assignment, Safety/Efficacy Study
Official Title: Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Recombinant Human Growth Hormone and/or Rosiglitazone in the Treatment of Human Immunodeficiency Virus-Associated Visceral Adiposity and Insulin Resistance

Further study details as provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

Primary Outcome Measures:
  • Change in insulin sensitivity [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change in body fat (total and regional; visceral and subcutaneous) [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  • Other body composition and metabolic endpoints [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 80
Study Start Date: March 2005
Estimated Study Completion Date: April 2009
Estimated Primary Completion Date: April 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental Drug: Recombinant Human Growth Hormone and Rosiglitazone
3mg subcutaneous injection of the Human Growth Hormone daily plus 4 mg Rosiglitazone tablet twice daily x 12 weeks (double-blind phase)
2: Experimental Drug: Recombinant Human Growth Hormone
3 mg subcutaneous injection daily for 12 weeks (double-blind phase)
3: Experimental Drug: Rosiglitazone
4 mg tablet twice a day x 12 weeks (double-blind phase)
4: Placebo Comparator Drug: Placebo human growth hormone and placebo rosiglitazone
Placebo subcutaneous injections daily plus placebo pills twice daily for 12 weeks (double-blind phase)

Detailed Description:

A number of people with HIV infection who gain weight in the abdomen (sometimes called lipodystrophy) also have a high level of the sugar-controlling hormone called insulin. These people need to produce this extra insulin to help keep their blood sugar normal. This is called "insulin resistance."

Studies have shown that growth hormone (also called "Serostim") can decrease abdominal fat, but it can also worsen the insulin resistance. Rosiglitazone (also called "Avandia") is used to treat insulin resistance in people who have diabetes, so we want to see if taking growth hormone and rosiglitazone together will be better for treating the fat accumulation part of lipodystrophy than either drug alone or no active therapy.

The study is 24 weeks long, divided into two 12-week parts.

The first part of the study is double-blind, meaning that neither participants nor the study staff will know which drugs participants are on. Participants will be assigned randomly (like flipping a coin) to one of four groups:

  1. Growth hormone (one injection, daily) PLUS rosiglitazone (one tablet, twice daily).
  2. Growth hormone PLUS rosiglitazone placebo ("sugar pill").
  3. Growth hormone placebo (plain water injection) PLUS rosiglitazone.
  4. Growth hormone placebo PLUS rosiglitazone placebo.

Everyone in the study will need to be hospitalized overnight for special tests at the beginning of the study and at week 12.

The second part of the study is open-label, meaning that participants and the study staff will know which drugs participants are receiving. All volunteers will receive both active drugs:

  • Growth hormone (one 2 mg injection, every other day) PLUS rosiglitazone (one 4 mg tablet, twice daily).
  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • HIV-infected
  • On stable Food and Drug Administration (FDA)-approved antiretrovirals for at least 8 weeks
  • Excess abdominal fat based on waist and hip measurements done at the screening visit. [waist greater than 34.7 inches (men) or 29.6 inches (women) and waist to hip ratio greater than 0.95 (men) or 0.9 (women)]
  • Evidence of insulin resistance (based on fasting glucose and insulin levels done at screening)
  • Triglycerides less than 750 mg/dL

Exclusion Criteria:

  • Pregnancy
  • Active AIDS-defining infection or other acute illness, within 30 days of entry.
  • Active cancer (except for localized Kaposi's sarcoma) or active brain tumor
  • Any diagnosis of pancreatitis, carpal tunnel syndrome, diabetes, angina, coronary artery disease, or disorder associated with fluid retention (examples: cirrhosis, congestive heart failure)
  • Untreated or uncontrolled high blood pressure, within 30 days of entry.
  • Within 12 weeks of study entry, use of the following:

    • Obesity (fat-reducing) drugs.
    • Anti-diabetic or insulin-sensitizing drugs (examples: rosiglitazone, pioglitazone, or metformin).
    • Systemic glucocorticoids (example: prednisone).
    • Growth hormone or any medication for AIDS-associated wasting.
    • Systemic chemotherapy, interferon, or radiation therapy.
    • Androgenic agents [examples: nandrolone, oxandrolone (Oxandrin) (testosterone replacement therapy is permitted if started more than 30 days before entry)]
    • Appetite stimulants (Marinol, Megace, Periactin).
  • Use of cholesterol lowering drugs, unless started more than 12 weeks before entry
  • Inability to have a magnetic resonance imaging (MRI) scan performed (examples: cardiac pacemaker, intracranial aneurysm clips)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00130286

Locations
United States, New York
Cornell HIV Clinical Trials Unit, Weill Medical College of Cornell University
New York, New York, United States, 10021
St. Luke's-Roosevelt Hospital Center
New York, New York, United States, 10025
Columbia University College of Physicians and Surgeons
New York, New York, United States, 10032
AIDS Community Research Initiative of America (ACRIA)
New York, New York, United States, 10018
Sponsors and Collaborators
Investigators
Principal Investigator: Marshall J Glesby, MD, PhD Weill Medical College of Cornell University
  More Information

Responsible Party: Weill Cornell Medical College ( Marshall J Glesby, MD, PHD/Principal Investigator )
Study ID Numbers: 65515
Study First Received: August 12, 2005
Last Updated: October 7, 2008
ClinicalTrials.gov Identifier: NCT00130286  
Health Authority: United States: Federal Government

Keywords provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):
Lipodystrophy
HIV
Growth hormone
Rosiglitazone
Visceral fat
Metabolic syndrome
Treatment Experienced
Visceral fat accumulation
fat accumulation
HIV-Associated Metabolic Syndrome

Study placed in the following topic categories:
Sexually Transmitted Diseases, Viral
Insulin
Body Weight
Signs and Symptoms
Hyperinsulinism
Lipodystrophy
Body Weight Changes
Syndrome X
Retroviridae Infections
Rosiglitazone
Abdominal obesity metabolic syndrome
Obesity
Metabolic Syndrome X
Metabolic Diseases
Skin Diseases
Acquired Immunodeficiency Syndrome
Immunologic Deficiency Syndromes
Virus Diseases
HIV-Associated Lipodystrophy Syndrome
HIV Infections
Sexually Transmitted Diseases
Insulin Resistance
Glucose Metabolism Disorders
Metabolic disorder
Lipid Metabolism Disorders

Additional relevant MeSH terms:
RNA Virus Infections
Hypoglycemic Agents
Pathologic Processes
Disease
Slow Virus Diseases
Immune System Diseases
Skin Diseases, Metabolic
Syndrome
Physiological Effects of Drugs
Lentivirus Infections
Infection
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009