Anabolic Therapies: New Hope for Treating Secondary Disabilities of SCI

Official Title: “Testosterone Replacement Therapy in Chronic Spinal Cord Injury”

It has long been recognized that co-morbidities associated with the multiple metabolic syndrome (MMS), such as adverse body composition, insulin resistance and autonomic nervous system impairment, may lead to significant increase in cardiovascular morbidity and mortality. It is unclear whether the co-morbidities evident in this population are due directly to their immobility or are the result of unfavorable changes in their underlying hormonal milieu. The purpose of this study is to determine the effect of testosterone replacement therapy in hypogonadal males on:

body composition, i.e. lean tissue and fat mass, glucose tolerance, resting energy expenditure, autonomic-cardiovascular integrity, muscular strength, psychological assessment

This study is 24 months in duration. Men who have consented to pre-screening serum testosterone draw and are found to have total testosterone levels averaging 4 ng/ml will start testosterone replacement therapy after a 6-month baseline period. Once treatment begins subjects will place a testosterone replacement patch (5mg/day) on various sites of the body daily. Subjects will visit the lab after 2,6, 12, and 18 months of therapy for testing; however they will stop taking the patch at the 12 month visit. If needed, a steroid cream will be provided to the subjects should any skin irritations occur. If the patch causes persistent skin irritations, despite use of the steroid cream, then a testosterone gel may be used. Detailed instructions and precautions using the gel are outlined in the consent form and will be reviewed with the subject.

Those men who have consented to pre-screening serum testosterone and are found to have normal levels of total testosterone (> 4ng/ml) are eligible to participate as a control subject for the full 24-month period of the study. These subjects visit the lab at baseline (BL), 12 and 24 months for the same testing as those in the treatment group.

Intervention(s) in this Clinical Trial

• Drug: Testosterone Replacement Therapy Patch 5mg daily
  • Testosterone Replacement Therapy Patch 5mg daily

Arms, Groups and Cohorts in this Clinical Trial

• Other: 1

Primary Measures

• Changes to body composition, metabolism, strength and cardiovascular autonomic control
  • Time Frame: 12/31/2013
    Safety Issue?: No

Inclusion Criteria:

• Males 18-60 years of age
• Chronic SCI
• Normal PSA levels and rectal exam
• No known cardiovascular disease
• 40 subjects with hypogonadism [low serum total testosterone (Total > 4 ng/ml)]
• 10 subjects with eugonadism (Total > 4ng/ml)]

Exclusion Criteria:

• Females
• Known coronary heart and/or artery disease, diabetes mellitus
• Previous or current cancer
• Current or previous anabolic steroid use
• Acute inter-current illness
• Abnormal liver function test (>1.5 times normal values) at baseline
• PSA above normal
• Abnormal DRE at baseline suggestive of malignancy
• Current alcohol or drug abuse
• Significant psychological disorders

Gender Eligibility for this Clinical Trial: Male

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: 60 Years

Are Healthy Volunteers Accepted for this Clinical Trial?: Accepts Healthy Volunteers

Lead Investigator: Department of Veterans Affairs U.S. Fed

Overall Clinical Trial Officials and Contacts

William Bauman, MD Principal Investigator VA Medical Center, Bronx  

Information obtained from ClinicalTrials.gov on February 09, 2012

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00266864

Study ID Number: B2648C

ClinicalTrials.gov Identifier: NCT00266864

Health Authority: United States: Federal Government

Click here for more information about this study: Testosterone Replacement Therapy in Chronic Spinal Cord Injury