Value of 25 Mcg Cortrosyn Stimulation Test (25CST)
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Purpose
The diagnosis of secondary AI is vital to prevent catastrophic events in patients. An optimal test should have a very low margin of error with high sensitivity and specificity, be easy and safe to administer, and have distinct cut off values. Both 1 ug and 250 ug doses have their limitations. Based on our experience over the past six years, we hypothesize that 25 ug ACTH stimulation test may eliminate some of the shortcomings of the LDST (1 ug) and SDST (250 ug). This is supported by our preliminary data and the study by Oelkers et al, which looked at ACTH levels following various doses of cortrosyn injections.
Therefore we propose a head to head comparison of 25 ug, 250 ug and 1 ug dose using ITT as gold standard.
| Condition | Intervention |
|---|---|
|
Adrenal Insufficiency |
Procedure: ACTH stimulation test Procedure: 250 ug ACTH stimulation test Procedure: 25 ug Cortrosyn stimulation test Procedure: Insulin tolerance test Procedure: 1 ug cortrosyn test |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | The Value of 25 Mcg Cortrosyn Stimulation Test to Assess Adult HPA Axis |
- Peak cortisol values [ Time Frame: 4 hours ] [ Designated as safety issue: No ]
- ACTH level [ Time Frame: 6 hours ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | June 2012 |
| Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1ug cortrosyn dose stimulation test
Subjects will undergo an ACTH stimulation test using a dose of 1 ug cotrosyn
|
Procedure: ACTH stimulation test
1 ug cortrosyn dose
Procedure: 1 ug cortrosyn test
Subjects will undergo an ACTH test using a 1 ug dose cortrosyn
|
|
Active Comparator: 250 ug cortrosyn dose stimulation test
Subjects will undergo an ACTH stimulation test using 250 ug cortrosyn dose
|
Procedure: 250 ug ACTH stimulation test
ACTH stimulation test will be done using 250 ug cortrosyn dose
|
|
Experimental: 25 ug cortrosyn stimulation test
Subjects will undergo an ACTH stimulation test using a 25 ug cortosyn dose
|
Procedure: 25 ug Cortrosyn stimulation test
ACTH stimulation test using a 25 ug cortrosyn dose
|
|
Active Comparator: Insulin tolerance test
Subjects will undergo an Insulin Tolerance Test
|
Procedure: Insulin tolerance test
subjects will undergo an insulin tolerance test
|
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- hypothalamic-pituitary-adrenal disorders
Exclusion Criteria:
- under 18 or older than 65 years of age
Contacts and Locations| Contact: Amir Hamrahian, MD | 216-445-8538 | hamraha@ccf.org |
| Contact: Seenia Peechakara, MD | 216-445-5411 | peechas@ccf.org |
| United States, Ohio | |
| Cleveland Clinic Department of Endocrinology | Recruiting |
| Cleveland, Ohio, United States, 44195 | |
| Contact: Amir Hamrahian, MD 216-445-8538 hamraha@ccf.org | |
| Contact: Seenia Peechakara, MD 216-445-5411 peechas@ccf.org | |
| Principal Investigator: Amir Hamrahian, MD | |
| Sub-Investigator: Seenia Peechakara, MD | |
More Information
No publications provided
| Responsible Party: | The Cleveland Clinic |
| ClinicalTrials.gov Identifier: | NCT01428336 History of Changes |
| Other Study ID Numbers: | 1945 |
| Study First Received: | September 1, 2011 |
| Last Updated: | March 26, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Adrenal Insufficiency Addison Disease Adrenal Gland Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases Adrenocorticotropic Hormone |
Cosyntropin Insulin Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Hypoglycemic Agents |
ClinicalTrials.gov processed this record on May 16, 2013