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Completed

NCT Number: NCT03578497

Effects of Interleukin-1 Receptor Antagonism on Hyperandrogenemia in Women With Polycystic Ovary Syndrome

A prospective, interventional, open-label, single-arm, proof-of-concept study: 18 women with Polycystic Ovary Syndrome (PCOS) will be treated with 100 mg of Anakinra/Kineret® for 4 weeks. 1 week after last injection patients will have a follow-up and a dexamethasone visit after a dexamethasone suppression test. Goal of this study is to investigate the effect of the Interleukin 1( IL-1) receptor antagonist Anakinra/Kineret® on laboratory and clinical features in women with PCOS.

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Key information

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Phase 2

Primary location

University Hospital Basel Endocrinology, Diabetes and Metabolism

Basel, 4031, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Informed Consent as documented by signature
  • Premenopausal women aged 18 years or older
  • Onset of menarche ≥5 years ago
  • Diagnosis of PCOS defined by the Rotterdam criteria
  • High sensitivity C-reactive protein level ≥1 mg/l
  • Follicular phase of menstrual cycle as evident by
  • Serum estradiol level <200 pmol/l AND
  • Serum progesterone level <8 ng/ml
  • Willingness to use non-hormonal contraceptive measures adequate to prevent becoming pregnant during the study

Exclusion criteria

  • Intake of any testosterone level modifying drugs in the 8 weeks prior to study inclusion,
  • Contraindications to the class of drugs under study, e.g. known hypersensitivity or allergy to Anakinra/Kineret,
  • Women who are pregnant or breast feeding,
  • Female participants who are ovariectomized or hysterectomised or post-menopausal
  • Known or suspected non-compliance, drug or alcohol abuse,
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant,
  • Participation in another study with investigational drug within the 30 days preceding and during the present study,
  • Previous enrolment into the current study,
  • Enrolment of the investigator, his/her family members, employees and other dependent persons,
  • Clinical signs of infection in the week before inclusion or history of a severe infection during the last 2 months,
  • Potentially severe immunosuppression or intake of other immunosuppressive drugs
  • Severe hematologic disease
  • Other clinically significant concomitant disease states (e.g., renal failure, hepatic dysfunction, active carcinoma),
  • History of or suspected tuberculosis and/or hepatitis B/C

Treatment and study plan

IL-1 receptor antagonist Anakinra

Drug

IL-1 receptor antagonist Anakinra is a recombinant, non-glycosylated form of the human IL-1Ra in a 100 mg/ 0.67 ml solution for subcutaneous injection. Standard dosage licensed by the FDA and European Medicines Agency (EMA) is 100 mg Anakinra daily. It is supplied in single use prefilled glass syringes with 27 gauge needles as a sterile, clear, colourless-to-white, preservative free solution for daily s.c. administration.

Other names: Kineret

Primary outcomes

  1. Absolute change in fasting serum androstenedione level (nmol/l) from start (baseline, day 1) to one week after treatment start with Anakinra.

    Time frame: 7 days

    Absolute change in fasting serum androstenedione level (nmol/l) from start (baseline, day 1) to one week after treatment start with Anakinra.

Secondary outcomes

  1. Ferriman-Gallwey-score

    Time frame: Day 1 and 28

    Effect of Anakinra/Kineret® on hirsutism by Ferriman-Gallwey-score (representation of hair growth in a male pattern on a woman shown in four different degrees of severity ( 0= no hair growth; 1= light hair growth; 2= moderate hair growth; 4= severe hair growth) in 11 different body parts; namely the upper lip, chin, chest, upper back, lower back, upper abdomen, lower abdomen, arm, forearm, thigh, and lower leg) will be assessed

  2. Sebum production measures

    Time frame: At day 1 and 28

    Effect of Anakinra/Kineret® on sebum production will be assessed with Sebumeter® SM 815, Courage + Khazaka electronic Gesellschaft mit beschränkter Haftung (GmbH)

  3. Self-reported frequency of hair removal (times/week)

    Time frame: At day 1 and 28

    Effect of Anakinra/Kineret® on hirsutism will be assessed

  4. Plewig-Kligman-score

    Time frame: At day 1 and 28

    Effect of Anakinra/Kineret® on acne severity, assessed with Plewig-Kligman score (presentation of comedonal and inflammatory acne severity, separately graded based on the number of lesions and type; lesion counting done at right side of the face, excluding other side, chest and back.

  5. Ovulation and menstruation rates [%]

    Time frame: Between day 1 and day 35

    Effect of Anakinra/Kineret® on ovulation and menstruation rates will be assessed

  6. Estradiol (pmol/l), free testosterone (nmol/l), total testosterone (nmol/l), sex hormone-binding globulin (SHBG) [nmol/l], Anti-Muellerian Hormone [pmol/l], dehydroepiandrosterone (DHEA) [nmol/l]), basal cortisol (nmol/l)

    Time frame: Day 1, 7, 14, 21, 28 and 35

    Effect of Anakinra/Kineret® on peripheral (sexual) hormones will be assessed

  7. Fasting glucose (mmol/l), homeostatic model of assessment of insulin resistance (HOMA-IR)

    Time frame: At day 1, 7, 14, 21, 28 and 35

    Effect of Anakinra/Kineret® on glucose metabolism will be assessed

  8. Pituitary hormones (luteinizing hormone (LH), follicle stimulating hormone (FSH), adrenocorticotropic hormone (ACTH) [IU/L])

    Time frame: Day 1, 7, 14, 21, 28 and 35

    Effect of Anakinra/Kineret® on the pituitary-gonadal axis will be assessed

  9. Treatment response according to a Dexamethasone suppression test

    Time frame: At days 35 and 36

    Dexamethasone suppression test will be evaluated as a predictor for treatment response

  10. inflammatory marker white blood cell count [x109/l],

    Time frame: Day 1, 7, 14, 21, 28 and 35

    Time course of inflammatory marker white blood cell count [x109/l] will be assessed

  11. inflammatory marker C reactive protein (CRP) [mg/l]

    Time frame: Day 1, 7, 14, 21, 28 and 35

    Time course of inflammatory marker CRP [mg/l] will be assessed

  12. inflammatory marker IL-6 [pg/ml]

    Time frame: Day 1 and 28

    Time course of inflammatory marker IL-6 [pg/ml] will be assessed

  13. inflammatory marker IL-1Ra [pg/ml]

    Time frame: Day 1, 7, 14, 21, 28 and 35

    Time course of inflammatory marker IL-1Ra [pg/ml] will be assessed

  14. Change in androstenedione level (nmol/l) from start (baseline, day 1) to days 14, 21, 28, and 35 after treatment start with Anakinra.

    Time frame: Days 14, 21, 28, and 35 after treatment start with Anakinra

    Change in androstenedione level (nmol/l) from start (baseline, day 1) to days 14, 21, 28, and 35 after treatment start with Anakinra.

  15. Change in 11-oxygenated androgens (e.g. 11-ketotestosterone, 11-ketoandrostenedione, 11β-hydroxytestosterone, 11β-hydroxyandrostenedione [nmol/l]) on days 7, 14, 28, and 35 after treatment start with Anakinra

    Time frame: Days 7, 14, 28, and 35 after treatment start with Anakinra

    Change in 11-oxygenated androgens (e.g. 11-ketotestosterone, 11-ketoandrostenedione, 11β-hydroxytestosterone, 11β-hydroxyandrostenedione [nmol/l]) on days 7, 14, 28, and 35 after treatment start with Anakinra

Sponsors and collaborators

Lead sponsor

University Hospital, Basel, Switzerland

Other

Registry information

Official study title

Effects of Interleukin-1 Receptor Antagonism on Hyperandrogenemia in Women With Polycystic Ovary Syndrome - a Prospective, Interventional, Single-arm, Open-label, Proof-of-concept Study

Acronym: FertIL

Important dates

Study start
2018
Primary completion
2020
Study completion
2020
First posted
Jul 6, 2018
Registry last updated
Jan 27, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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