Phase 3
N=122
Comparison of Chronocort® With Standard Glucocorticoid Therapy in Patients With Congenital Adrenal Hyperplasia
Congenital Adrenal Hyperplasia
Bottom Line
View on ClinicalTrials.gov: NCT02716818 ↗Enrolled (actual)
122
Serious AEs
9.8%
Results posted
Sep 2019
Primary outcome: Primary: Change From Baseline to 24 Weeks of the Mean of the 24-hour Standard Deviation Score (SDS) Profile for 17-OHP — -0.403; -0.172 Z-score — p==0.5521
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Chronocort® (Drug); standard glucocorticoid therapy (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Neurocrine UK Limited
- Primary completion
- Jul 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline to 24 Weeks of the Mean of the 24-hour Standard Deviation Score (SDS) Profile for 17-OHP |
-0.403; -0.172 | =0.5521 |
| SECONDARY Change From Baseline to 24 Weeks of the Mean of the 24-hour Standard Deviation Score (SDS) Profile for A4 |
0.113; -0.041 | =0.7405 |
| SECONDARY 17-OHP and A4 by Individual Baseline Treatment Strata. |
-0.248; -0.061; -0.245; -0.431; -0.320; -0.565 | =0.8186 |
| SECONDARY Number of Participants With 17-OHP and A4 Levels in the Optimal Range at 9:00 at Week 24 Visit |
30; 25; 30; 30 | =0.9877 |
| SECONDARY Changes Relative to Standard Glucocorticoid Therapy in Body Composition (DEXA - Fat Mass and Lean Mass) |
-0.575; 0.445; 0.640; 0.234 | =0.156 |
| SECONDARY Changes Relative to Standard Glucocorticoid Therapy in Body Composition (DEXA - Bone Mineral Density) - Measured at All Sites Except Germany. |
-0.001; -0.008 | =0.2614 |
Summary
This study is a parallel arm, randomised, open-label study, including dose titration and admissions for four overnight stays for 24-hour endocrine profiles. It will compare the efficacy, safety and tolerability of Chronocort® with standard glucocorticoid replacement therapy in the treatment of congenital adrenal hyperplasia (CAH) over a treatment period of 6 months. Dose titration decisions in both treatment groups will be made by a central independent physician, blinded to the treatment arm, using information generated from the 24-hour endocrine profiles. Each treatment arm will be subject to the same titration rules throughout the study, ensuring that opportunities for optimisation and control of androgens are the same in both groups.
Eligibility Criteria
Inclusion Criteria
- Known CAH due to 21-hydroxylase deficiency (classic CAH) diagnosed in childhood with documented (at any time) elevated 17-OHP and/or A4 and currently treated with hydrocortisone, prednisone, prednisolone or dexamethasone (or a combination of the aforementioned glucocorticoids) on a stable glucocorticoid therapy for a minimum of 6 months.
- Provision of signed written informed consent.
- Non-pregnant, non-lactating females who are post menopausal, naturally or surgically sterile, or of childbearing potential with a negative urinary pregnancy test and using a medically acceptable method of contraception.
- Plasma renin activity (PRA) less than 1.5 times the upper limit of normal (ULN) at screening or within 3 months prior to screening, except in subjects who have been diagnosed with hypertension where the renin is not being used to monitor fludrocortisone replacement.
- Plasma renin activity (PRA) less than 1.5 times the upper limit of normal (ULN) at screening or within 3 months prior to screening, except in subjects who have been diagnosed with hypertension where the renin is not being used to monitor fludrocortisone replacement.
Exclusion Criteria
- Co-morbid condition requiring daily administration of a medication (or consumption of any material) that interferes with the metabolism of glucocorticoids.
- Clinical or biochemical evidence of hepatic or renal disease. Creatinine over twice the ULN or elevated liver function tests (ALT or AST >2 times the ULN).
- Subjects on regular daily inhaled, topical, nasal or oral steroids for any indication other than CAH.
- Subjects with any other significant medical or psychiatric conditions that in the opinion of the investigator would preclude participation in the trial.
- History of malignancy (other than basal cell carcinoma successfully treated >6 months prior to entry into the study).
- Participation in another clinical trial of an investigational or licensed drug or device within the 3 months prior to inclusion in this study.
- Subjects with a history of bilateral adrenalectomy.
- Subjects having previously been exposed to Chronocort®.
- Subjects unable to comply with the requirements of the protocol.
Data sourced from ClinicalTrials.gov (NCT02716818). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.