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Dexamethasone Treatment of Congenital Adrenal Hyperplasia

Boston Children's Hospital logo

Boston Children's Hospital

Status and phase

Completed
Phase 2

Conditions

Adrenal Hyperplasia, Congenital

Treatments

Drug: Hydrocortisone
Drug: dexamethasone

Study type

Interventional

Funder types

Other

Identifiers

NCT00621985
08-01-0025

Details and patient eligibility

About

The purpose of this study is to determine if dexamethasone given at night is a more effective treatment for congenital adrenal hyperplasia in young children than standard three times per day hydrocortisone. Our hypothesis is that nocturnal dexamethasone will lead to more efficient suppression of the hypothalamic-pituitary-adrenal axis. We performed a cross-over trial comparing hormonal control during two 24-hour hospitalizations, one on hydrocortisone and one on nocturnal dexamethasone.

Full description

This is a Phase II clinical trial, intended to estimate the effect of instituting Dexamethasone therapy in comparison to prior standard therapy. Each subject provides his own baseline data. There is no control group. Patients with CAH who meet inclusion criteria will be admitted to the clinical research center for two 24 hour hospitalizations. Adrenal hormone profiles will be measured during each hospitalization. The patient will take his or her baseline hydrocortisone regimen during one hospitalization and a new regimen consisting of a single daily nocturnal dose of Dexamethasone during the second hospitalization.

Enrollment

5 patients

Sex

All

Ages

2 to 9 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Classic salt-wasting 21-hydroxylase deficient congenital adrenal hyperplasia
  • Pre-pubertal children with bone ages below 8 years

Exclusion criteria

  • Age less than 2 years
  • Patients with additional medical conditions necessitating glucocorticoid therapy.
  • Patients on phenytoin, barbiturates, and rifampin as these medications accelerate the metabolism of glucocorticoids.
  • Patients on ketoconazole as this medication increases the bioavailability of glucocorticoids.

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Crossover Assignment

Masking

None (Open label)

5 participants in 1 patient group

Experimental
Experimental group
Description:
Experimental therapy with nocturnal dexamethasone.
Treatment:
Drug: Hydrocortisone
Drug: dexamethasone

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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