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Trial registered on ANZCTR
Registration number
ACTRN12612000540819
Ethics application status
Approved
Date submitted
16/05/2012
Date registered
22/05/2012
Date last updated
22/05/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of low dose steroids on blood glucose and risk of heart disease
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Scientific title
Effect of therapeutic glucocorticoids on insulin sensitivity, cardiovascular risk and energy metabolism in patients with inflammatory arthritis
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Secondary ID [1]
280489
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Insulin sensitivity
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cardiovascular risk
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energy metabolism
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inflammatory arthritis
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Condition category
Condition code
Cardiovascular
286728
286728
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0
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Coronary heart disease
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Metabolic and Endocrine
286729
286729
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0
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Diabetes
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Inflammatory and Immune System
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0
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Rheumatoid arthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Group 1: The effect of oral low dose prednisolone on arterial stiffness (assessed by pulse wave analysis from radial artery using Sphygmocor device), sympathetic nervous system activity ( assessed using a task force haemodynamic monitor), energy metabolism (using indirect calorimetry,assessing brown fat activity using FLIR T425 infrared camera) and carbohydrate metabolism (by serial glucose, insulin and C peptide ), in patients aged more than 30years with inflammatory rheumatologic disease will be studied before and after a seven day course of oral prednisolone (mean dose of arm 2). The tests will be done before and 1 to 2.5hours after a mixed meal (10 Kcal/Kg) on the day studied (involves two visits, total duration of 5hours on study day).
Group 2: The effect of oral low dose prednisolone(4 to 10mg/day) on arterial stiffness, sympathetic nervous system activity, energy and carbohydrate metabolism in patients aged more than 30years with inflammatory rheumatologic disease on oral prednisolone for more than 6 months will be studied before and 1 to 2.5 hours after a mixed meal( 10Kcal/Kg). (involves single visit,total duration of 5hours on study day).
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Intervention code [1]
284857
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Treatment: Drugs
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Comparator / control treatment
The study include two designs:
Longitudinal study :Subects with inflammatory rheumatological disease who have not received prednisolone for more than 6 months (Group1) will be studied before and after seven day course of prednisolone (mean dose of Group2).
Cross-sectional study: Baseline data from Group 1 will be compared to that of matched subjects on 4-10mg/day of prednisolone for more than 6 months (Group 2) for inflammatory rhematologic disease
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in postprandial reduction in Augmentation index
( assessed by pulse wave analysis form radial artery using sphygmocor device) with glucocorticoids.
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Assessment method [1]
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Timepoint [1]
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Longitudinal study (acute study):baseline and after seven day course of prednisolone (dose= mean dose of group2).
Cross-sectional study: baseline.
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Secondary outcome [1]
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Effect of glucocorticoid treatment on postprandial changes in sympathetic nervous system activity (assessed by taskforce haemodynamic monitor)
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Assessment method [1]
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Timepoint [1]
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Longitudinal study (acute study):baseline and after seven day course of prednisolone (dose= mean dose of group2).
Cross-sectional study: baseline.
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Secondary outcome [2]
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Effect of glucocorticoid treatment on postprandial changes in endothelial function (assessed by peripheral arterial tonometry using Endo-PAT 2000).
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Assessment method [2]
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Timepoint [2]
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Longitudinal study (acute study): baseline and after seven day course of prednisolone (dose= mean dose of group2).
Cross-sectional study: baseline.
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Secondary outcome [3]
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Effect of glucocorticoid treatment on postprandial changes in energy metabolism and brown tissue activity ( assessed by indirect calorimetry and infrared thermography using FLIR T425 infrared camera).
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Assessment method [3]
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Timepoint [3]
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Longitudinal study (acute study): baseline and after seven day course of prednisolone (dose= mean dose of group2).
Cross-sectional study: baseline.
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Secondary outcome [4]
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Effect of glucocorticoid treatment on insulin sensitivity
( assessed by serial glucose, insulin and C peptide estimation after a mixed meal test).
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Assessment method [4]
297449
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Timepoint [4]
297449
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Longitudinal study (acute study): baseline and after seven day course of prednisolone (dose= mean dose of group2).
Cross-sectional study: baseline.
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Secondary outcome [5]
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Effect of glucocorticoid treatment on body composition (assessed by DEXA).
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Assessment method [5]
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Timepoint [5]
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baseline
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Eligibility
Key inclusion criteria
Group 1 : Has inflammatory rhematologic disease
No prednisolone for >6 months
Age >30years
Group 2 : Has inflammatory rhematologic disease
Taking prednisolone 4 to 10 mg/day for >6months
Age >30years
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Minimum age
30
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Taking oral hypoglycemic agents, insulin or beta blockers
Atrial fibrillation
Inability to provide written informed consent
History of claustrophobia
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
In the acute study data from participants in Group1 will be compared before and after seven day course of prednisolone.
In the chronic study data from participants in Group2 who are on prednisolone for more than 6 months will be comapared with baseline data of Group1.
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Phase
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/06/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
36
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Foundation Daw Park
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Address [1]
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Daws Road,
Daw Park, 5041
SA
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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Diabetes Australia Research Trust
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Address [2]
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GPO Box 3156
Canberra ACT, 2601
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Country [2]
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Australia
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Primary sponsor type
Individual
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Name
Morton Burt
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Address
Staff Specialist,
Southern Adelaide Diabetes and Endocrine Services,
Repatriation General Hospital,
Daws Road,
Daw Park, SA, 5041
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
284116
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Southern Adelaide Diabetes and Endocrine Services
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Address [1]
284116
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Repatriation General Hospital,
Daws Road,
Daw Park, SA , 5041
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Country [1]
284116
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287265
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
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Flinders Medical Centre, The Flats G5- Rooms 3 and 4, Flinders Drive, Bedford Park, SA- 5042.
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Ethics committee country [1]
287265
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Australia
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Date submitted for ethics approval [1]
287265
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Approval date [1]
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24/04/2012
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Ethics approval number [1]
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11/12/2012
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Summary
Brief summary
Glucocorticoids are potent anti inflammatory agents that are used to treat a wide range of inflammatory and rheumatologic conditions. Most patients require a relatively low dose of glucocorticoid for disease control, with one study reporting a mean prednisolone dose of 8mg/day which is approximately 2 to 3 times the physiological glucocorticoid production. The purpose of this study is to investigate : whether typical therapeutic steroid doses increase the risk of a heart attack. whether high blood sugars after a meal are related to risk of heart attack. a novel mechanism by which steroids might increase fat mass through reducing brown fat activity.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Anjana Radhakutty
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Address
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Endocrine Registrar
Southern Adelaide Diabetes and Endocrine Services,
Daws Road,
Daw Park -5041
SA
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Country
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Australia
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Phone
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+61 08 82751094
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Fax
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+61 08 82751215
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Email
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[email protected]
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Contact person for scientific queries
Name
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Anjana Radhakutty
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Address
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Endocrine Registrar
Southern Adelaide Diabetes and Endocrine Services,
Daws Road,
Daw Park -5041
SA
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Country
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Australia
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Phone
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+61 08 82751094
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Fax
8354
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+61 08 82751215
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Email
8354
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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