RecruitingPhase 4NCT03153527

Taper Or Abrupt Steroid Stop: TOASSTtrial

Glucocorticoid Withdrawal and Glucocorticoid-induced Adrenal Insufficiency: a Randomized Controlled Multicenter Trial


Sponsor

University Hospital, Basel, Switzerland

Enrollment

530 participants

Start Date

May 31, 2017

Study Type

INTERVENTIONAL

Conditions

Summary

This study is an Investigator-initiated, placebo-controlled, multicenter noninferiority trial, comparing rapid termination of systemic glucocorticoid treatment with a tapering regime over 4 weeks.


Eligibility

Min Age: 18 Years

Inclusion Criteria5

  • Informed Consent as documented by signature (Appendix Informed Consent Form)
  • Age ≥ 18 years
  • Daily glucocorticoid dose ≥ 7.5 mg prednisone-equivalent at the time of inclusion
  • Therapy over ≥ 28 days, ≥ 7.5 mg average daily dose, with a cumulative glucocorticoid dose ≥ 420 mg prednisone-equivalent prior to inclusion
  • Tapering not or no longer mandatory to treat underlying disease

Exclusion Criteria12

  • Primary adrenal failure
  • Treatment with systemic depot glucocorticoids (e.g. intramuscular, epidural)
  • Incapability to administer glucocorticoid cover treatment in situations of stress
  • Inability or unwillingness to provide informed consent
  • Women who are pregnant or breast feeding,
  • Intention to become pregnant during the course of the study,
  • Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases.
  • Known or suspected non-compliance
  • 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

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Interventions

DRUGPrednisone

The control intervention (standard treatment) consists of prednisone treatment in decreasing doses, starting with 7.5 mg q.d. and reducing the dose every 7 days, such that prednisone treatment is stopped after a total of 4 weeks.

OTHERPlacebo Arm

The experimental intervention consists of stopping glucocorticoid treatment abruptly and administering matching placebo over 4 weeks.


Locations(16)

University Hospital Frankfurt

Frankfurt, Germany

University Hospital Würzburg

Würzburg, Germany

Departement of Internal Medicine, Kantonsspital Aarau

Aarau, Switzerland

Kantonsspital Baden

Baden, Switzerland

Endocrinology/Diabetology/Metabolism; University Hospital Basel

Basel, Switzerland

St. Claraspital Basel

Basel, Switzerland

Department of Rheumatology, Immunology, and Allergology, Inselspital

Bern, Switzerland

Division of Gastroenterology, Spital Bülach AG

Bülach, Switzerland

Kantonsspital Frauenfeld

Frauenfeld, Switzerland

Geneva University Hospitals

Geneva, Switzerland

Center for Primary Health Care,University of Basel, Kantonsspital Baselland

Liestal, Switzerland

Internal Medicine, Kantonsspital Baselland/Liestal

Liestal, Switzerland

Department of Internal Medicine, Kantonsspital Münsterlingen

Münsterlingen, Switzerland

Stoffwechselzentrum, Kantonsspital Olten

Olten, Switzerland

Department of Internal Medicine, Kantonsspital St. Gallen

Sankt Gallen, Switzerland

Dept. of Endocrinology, Diabetology and Clinical Nutrition, University Hospital

Zurich, Switzerland

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NCT03153527


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