Blocking growth hormone to help with severe insulin resistance

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study investigates the effects of pegvisomant, a growth hormone receptor blocker, on individuals with severe insulin resistance due to insulin receptor mutations or partial lipodystrophy. Participants will undergo two hospital stays, where they will receive comprehensive testing, including physical exams, blood tests, and scans to assess their body composition and metabolism. The primary goal is to determine if blocking growth hormone can reduce lipolysis in these patients, potentially improving their insulin sensitivity and metabolic health.

Why it matters

Who can join: the full rules

* INCLUSION CRITERIA:

To be eligible to participate in this study, an individual must meet all the following criteria:

* Either

  * Known pathogenic variant in the insulin receptor gene, either dominant negative or recessive, OR
  * Clinical diagnosis of partial lipodystrophy based on reduction in adipose tissue outside the normal range in selected adipose depots (including, at a minimum, the gluteofemoral depot) with preservation of adipose tissue in other depots.
* Male or female, aged 18-70 years.
* Completed linear growth and puberty.

EXCLUSION CRITERIA:

An individual who meets any of the following criteria will be excluded from participation in this study:

* Use of niacin or other drugs that directly affect lipolysis within 8 weeks prior to enrollment.
* Patients taking anticoagulants (blood thinning medications).
* Use of non-steroidal anti-inflammatory medications (e.g., aspirin, ibuprofen) 2 weeks prior to the biopsy date (in patients who choose to undergo biopsy).
* Changes in medications for diabetes or dyslipidemia within 2 weeks prior to enrollment.
* Pregnancy or lactation.
* For females of reproductive potential: inability or unwillingness to use contraception during study participation and for an additional 1 month after the end of pegvisomant administration.
* For males of reproductive potential: inability or unwillingness to use condoms or other methods to ensure effective contraception with partner during the study and for an additional 1 month after the end of pegvisomant administration.
* Known allergic reactions pegvisomant or any of its components.
* Clinically significant liver disease, evidenced by any of the following:

  * ALT or AST \>3 times the upper limit of normal at screening.
  * Current known liver disease other than steatohepatitis (e.g., autoimmune or viral hepatitis).
  * History of cirrhosis
* Triglycerides \>1500 mg/dL (non-fasting) or \>1000 mg/dL (fasting) at screening.
* In subjects with partial lipodystrophy only, Hemoglobin A1c \>10% at screening.
* Any other medical condition or medication that, in the judgement of the investigator, will increase risk to the subject or impede the measurement of study outcomes.
* Inability of subject to understand or the unwillingness to sign a written informed consent document.

Where it's running

• National Institutes of Health Clinical Center
  Bethesda, Maryland, United States Recruiting

Study contacts

• Principal investigator: Rebecca J Brown, M.D. — National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• Study coordinator: Megan S Startzell, R.N.
• Email: megan.startzell@nih.gov
• Phone: (301) 402-6371

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.