Ignite Creation Date:
2024-05-06 @ 10:09 AM
Last Modification Date:
2024-10-26 @ 12:25 PM
Study NCT ID:
NCT03174171
Status:
COMPLETED
Last Update Posted:
2019-01-09
First Post:
2017-05-24
Brief Title:
Open-label Study on Treatment of Primary Aldosteronism With Everolimus
Sponsor:
University Hospital Basel Switzerland
Organization:
University Hospital Basel Switzerland
Study Overview
Official Title:
Open-label Study on Treatment of Primary Aldosteronism With Everolimus
Status:
COMPLETED
Status Verified Date:
2019-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The overall objective is to evaluate everolimus as an aldosterone-lowering drug in the treatment of primary hyperaldosteronism
Detailed Description:
The purpose of this study is to evaluate everolimus as an aldosterone-lowering drug in treatment of primary aldosteronism
Primary aldosteronism is defined as a group of disorders in which aldosterone production is inappropriately high and relatively autonomous from regulation by the renin-angiotensin-aldosterone system It often presents with increased blood pressure and constitutes the most common cause of endocrine hypertension It is associated with an increased risk of cardiovascular complications structural and functional renal abnormalities and metabolic syndrome The goal of primary aldosteronism treatment is to prevent mortality and morbidity associated with hypertension hypokalemia and direct aldosterone-associated organ damage
Treatment depends on the underlying cause of primary aldosteronism In general patients with aldosterone-producing adenoma and unilateral adrenal hyperplasia are recommended to have adrenalectomy while patients with bilateral adrenal hyperplasia and those not willing to obtain surgery are offered targeted treatment with mineralocorticoid receptor antagonists However the use of mineralocorticoid receptor antagonist is related to side effects that include breast tenderness gynecomastia sexual dysfunction and menstrual irregularities
The primary purpose of this proof-of-concept study is to evaluate whether inhibition of adrenocortical mammilian target of rapamycin mTOR signalling with everolimus decreases circulating aldosterone levels The study also aims to determine whether potential changes in aldosterone levels result solely from a direct effect of everolimus on the adrenal gland or could be caused by changes in aldosterone metabolism andor levels of canonical regulators of adrenal function ACTH AngII The secondary purpose of this study is to test whether everolimus treatment ameliorates hypertension improves cardiac function and to better understand molecular mechanisms leading to the development of primary aldosteronism
Participants will receive Everolimus 075mg bid orally for a duration of 14 days Blood pressure measurements haemodynamic measurements blood tests 24h urine collection and saline Infusion tests will be conducted in order to compare changes in blood pressure cardiac and kidney function aldosterone and steroid hormone metabolite levels activity of the renin-angiotensin-aldosterone system before and after treatment
In patients undergoing adrenalectomy adrenocortical cells will be isolated and primary adrenocortical cell cultures will be established from excised adrenal glands Cultured cells will be treated with mTOR inhibitors and their proliferation and steroidogenic potential will be assessed Cells treated with mTOR inhibitors will be subjected to transcriptomic proteomic and phosphoproteomic analyses that will allow identification of mTOR signaling effectors in the adrenal cortex and to better understand molecular mechanisms leading to the development of primary aldosteronism
Primary aldosteronism is defined as a group of disorders in which aldosterone production is inappropriately high and relatively autonomous from regulation by the renin-angiotensin-aldosterone system It often presents with increased blood pressure and constitutes the most common cause of endocrine hypertension It is associated with an increased risk of cardiovascular complications structural and functional renal abnormalities and metabolic syndrome The goal of primary aldosteronism treatment is to prevent mortality and morbidity associated with hypertension hypokalemia and direct aldosterone-associated organ damage
Treatment depends on the underlying cause of primary aldosteronism In general patients with aldosterone-producing adenoma and unilateral adrenal hyperplasia are recommended to have adrenalectomy while patients with bilateral adrenal hyperplasia and those not willing to obtain surgery are offered targeted treatment with mineralocorticoid receptor antagonists However the use of mineralocorticoid receptor antagonist is related to side effects that include breast tenderness gynecomastia sexual dysfunction and menstrual irregularities
The primary purpose of this proof-of-concept study is to evaluate whether inhibition of adrenocortical mammilian target of rapamycin mTOR signalling with everolimus decreases circulating aldosterone levels The study also aims to determine whether potential changes in aldosterone levels result solely from a direct effect of everolimus on the adrenal gland or could be caused by changes in aldosterone metabolism andor levels of canonical regulators of adrenal function ACTH AngII The secondary purpose of this study is to test whether everolimus treatment ameliorates hypertension improves cardiac function and to better understand molecular mechanisms leading to the development of primary aldosteronism
Participants will receive Everolimus 075mg bid orally for a duration of 14 days Blood pressure measurements haemodynamic measurements blood tests 24h urine collection and saline Infusion tests will be conducted in order to compare changes in blood pressure cardiac and kidney function aldosterone and steroid hormone metabolite levels activity of the renin-angiotensin-aldosterone system before and after treatment
In patients undergoing adrenalectomy adrenocortical cells will be isolated and primary adrenocortical cell cultures will be established from excised adrenal glands Cultured cells will be treated with mTOR inhibitors and their proliferation and steroidogenic potential will be assessed Cells treated with mTOR inhibitors will be subjected to transcriptomic proteomic and phosphoproteomic analyses that will allow identification of mTOR signaling effectors in the adrenal cortex and to better understand molecular mechanisms leading to the development of primary aldosteronism
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None