Evidence map›Paper›PMID 36694227›Full record

ArticleTrials2023

Effects of half-dose spiomet treatment in girls with early puberty and accelerated bone maturation: a multicenter, randomized, placebo-controlled study protocol.

Judit Bassols, Francis de Zegher, Marta Diaz, Gemma Carreras-Badosa, Cristina Garcia-Beltran, Elsa Puerto-Carranza, Cora Oliver-Vila, Paula Casano, Céline Alicia Franco, Rita Malpique and 2 more

Erratum issuedOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 2 countries.

Judit Bassols *Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
Francis de Zegher *Leuven Research & Development, University of Leuven, Leuven, Belgium.
Marta DiazEndocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Gemma Carreras-BadosaPediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
Cristina Garcia-BeltranEndocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Elsa Puerto-CarranzaPediatrics, Dr. Josep Trueta Hospital, Girona, Spain.
Cora Oliver-VilaPediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
Paula CasanoEndocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Céline Alicia FrancoEndocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Rita MalpiqueEndocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Abel López-Bermejo *Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain. alopezbermejo@idibgi.org.
Lourdes Ibáñez *Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain. lourdes.ibanez@sjd.es.ORCID http://orcid.org/0000-0003-4595-7191
Hospital Sant Joan de Déu Barcelona · ESInstitut d'Investigació Biomèdica de Girona · ESHospital Universitari de Girona Doctor Josep Trueta · ESInstituto de Salud Carlos III · ESKU Leuven · BEUniversitat de Girona · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA "mismatch" sequence of less prenatal weight gain and more postnatal weight gain may lead to ectopic lipid accumulation, and trigger the development of early adrenarche/pubarche and the activation of the gonadotropic axis resulting in early puberty and ending up in full-blown adolescent polycystic ovary syndrome (PCOS). In the present study, we assess whether a low-dose combination of generics that collectively reduce ectopic fat through different pathways can slow down the accelerated maturation in "mismatch" girls with early puberty.

methodsRandomized, placebo-controlled, multicenter, phase 2a, study in 64 girls [age, 8.0-9.3 years; birthweight (BW) for gestational age in lower tertile (-1.96< Z-score <-0.44), body mass index (BMI) in upper tertile (+0.44< Z-score < +1.96) and early progressive puberty (Tanner B2 at 7.7-9.0 years)]. Pharmacological intervention will be with a half-dose version of SPIOMET (mini-spiomet), a combination that reverts the PCOS phenotype in "mismatch" adolescents; mini-spiomet will contain spironolactone (25 mg/day, to raise brown adipose tissue activity), pioglitazone (3.75 mg/day, to raise adiponectin and insulin sensitivity), and metformin (425 mg/day, to raise AMPK activity and GDF15). Recruitment: 1 year; double-blind treatment: 1 year; open follow-up: 1 year; analyses and reporting: 1 year.

interventionsrandomization (1:1) for placebo vs mini-spiomet. PRIMARY OUTCOME: annualized bone age advancement (0-1 year) by BoneXpert; secondary outcomes: insulin, IGF-I, high-molecular-weight adiponectin (HMW-adip), sex hormone binding globulin (SHBG), ultra-sensitive C-reactive protein (usCRP), androgens, luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol, growth-and-differentiation factor 15 (GDF15), C-X-C motif chemokine ligand-14 (CXCL14), safety parameters, and quantification of hepato-visceral fat. DISCUSSION: The present study, if successful, may provide a first proof of the concept that the rapid maturation of girls with an upward mismatch between pre- and post-natal weight gain can be slowed down with a fixed low-dose combination of old and safe generics jointly targeting a reduction of ectopic fat without necessarily lowering body weight.

trial registrationEudraCT 2021-006766-21. Registered on May 30, 2022.

Indexed as

MetforminPolycystic Ovary SyndromeAdiponectinFemaleHumansHypoglycemic AgentsMulticenter Studies as TopicPubertyRandomized Controlled Trials as TopicWeight GainAdiponectinHypoglycemic AgentsMetforminBone maturationEarly menarcheEarly pubertyEctopic fatMetforminPCOSPioglitazonePostnatal weight gainPrenatal weight gainSpironolactone

Identifiers

PMID36694227
PMCPMC9873221
OpenAlexW4317899404

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.