Growth Hormone and/or Rosiglitazone for HIV-Associated Increased Abdominal Fat and Insulin Resistance
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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: Rosiglitazone Drug: Recombinant human growth hormone + rosiglitazone |
Phase 1 Phase 2 |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Factorial Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
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 |
- Change in insulin sensitivity [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- 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 ]
Enrollment: | 77 |
Study Start Date: | March 2005 |
Study Completion Date: | August 2010 |
Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: rhGH + rosi
Recombinant human growth hormone + rosiglitazone
|
Drug: Rosiglitazone
4 mg tablet twice a day x 12 weeks (double-blind phase)
Drug: Recombinant human growth hormone + rosiglitazone
Recombinant human growth hormone or placebo 3 mg s.c. x 12 weeks (double-blind phase)
|
Experimental: rhGH placebo + rosi
Placebo for recombinant human growth hormone + rosiglitazone
|
Drug: Rosiglitazone
4 mg tablet twice a day x 12 weeks (double-blind phase)
Drug: Recombinant human growth hormone + rosiglitazone
Recombinant human growth hormone or placebo 3 mg s.c. x 12 weeks (double-blind phase)
|
Experimental: rhGH + rosi placebo
Recombinant human growth hormone + placebo for rosiglitazone
|
Drug: Rosiglitazone
4 mg tablet twice a day x 12 weeks (double-blind phase)
Drug: Recombinant human growth hormone + rosiglitazone
Recombinant human growth hormone or placebo 3 mg s.c. x 12 weeks (double-blind phase)
|
Placebo Comparator: Double placebo
Placebo for recombinant human growth hormone + placebo for rosiglitazone
|
Drug: Rosiglitazone
4 mg tablet twice a day x 12 weeks (double-blind phase)
Drug: Recombinant human growth hormone + rosiglitazone
Recombinant human growth hormone or placebo 3 mg s.c. x 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:
- Growth hormone (one injection, daily) PLUS rosiglitazone (one tablet, twice daily).
- Growth hormone PLUS rosiglitazone placebo ("sugar pill").
- Growth hormone placebo (plain water injection) PLUS rosiglitazone.
- 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).
![](https://webarchive.library.unt.edu/web/20130309095141im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Ages Eligible for Study: | 18 Years to 65 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
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)
![](https://webarchive.library.unt.edu/web/20130309095141im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
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 |
Principal Investigator: | Marshall J Glesby, MD, PhD | Weill Medical College of Cornell University |
![](https://webarchive.library.unt.edu/web/20130309095141im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
No publications provided
Responsible Party: | Marshall Jay Glesby, MD, PhD, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University |
ClinicalTrials.gov Identifier: | NCT00130286 History of Changes |
Other Study ID Numbers: | 65515, R01DK065515 |
Study First Received: | August 12, 2005 |
Last Updated: | June 28, 2012 |
Health Authority: | United States: Federal Government |
Keywords provided by Weill Medical College of Cornell University:
Lipodystrophy HIV Growth hormone Rosiglitazone Visceral fat |
Metabolic syndrome Treatment Experienced Visceral fat accumulation fat accumulation HIV-Associated Metabolic Syndrome |
Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome HIV Infections Body Weight Body Weight Changes Insulin Resistance Lipodystrophy Metabolic Syndrome X HIV-Associated Lipodystrophy Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Slow Virus Diseases |
Immunologic Deficiency Syndromes Immune System Diseases Signs and Symptoms Hyperinsulinism Glucose Metabolism Disorders Metabolic Diseases Skin Diseases, Metabolic Skin Diseases Lipid Metabolism Disorders Hormones Rosiglitazone Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Hypoglycemic Agents |
ClinicalTrials.gov processed this record on March 07, 2013