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Mobility LimitationPhase 3OPTIMenNCT01275365

Optimizing Protein Intake in Older Americans With Mobility Limitations

A Phase 3 study testing Testosterone enanthate in people with Mobility Limitation, run by Brigham and Women's Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This will be a randomized, placebo-controlled, parallel group, double blind, clinical trial in community dwelling, older men, 65 years of age or older, who have mobility limitation and low protein intake. Read more about this study

Who is it for?
Ages 65 years and older, men only
Conditions the study is for
Mobility Limitation
What is being tested?
Testosterone enanthate
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
92 participants
Where
1 siteUnited States
Study dates
May 2011to 19 Jan 2017
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • Men only
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Community-dwelling men 65 years of age or older
  • A score of 3-10 on the short physical performance battery (SPPB)
  • Daily protein intake less than the recommended daily allowance of 0.83 g/kg/day (from 3 24-hour food recalls)
  • Able to give informed consent

Who cannot join

  • History of prostate or breast cancer
  • American Urological Association [AUA] symptom index score of >19
  • Prostate specific antigen (PSA) >4 ng/ml in White men or >3 ng/ml in Black men
  • Prostate specific antigen (PSA) > 4 ng/ml in non-Black men or >3 ng/ml in Black men. These subjects may be enrolled if they have a negative transrectal biopsy within the past year.
  • Myocardial infarction or stroke within the last 6 months
  • Uncontrolled congestive heart failure, based on the study physician's evaluation
Show all 30Show fewer
  • Serum creatinine > 2.0 mg/dL; men on any kind of dialysis will be excluded.
  • History of celiac disease, Crohn's disease, or ulcerative colitis
  • History of any malignancy requiring treatment within the previous 2 years, except non-melanic skin cancers. Men with cancers who have not required active treatment within the past two years and who have not had disease recurrence within the past two years may be enrolled at the discretion of the study physician.
  • Neuromuscular diseases: motor neuron diseases, multiple sclerosis, adult muscular dystrophies, and myasthenia gravis
  • History of stroke with residual limb weakness that affected the individual's ability to walk; subjects with history of stroke who do not have residual limb weakness may be enrolled.
  • Schizophrenia, bipolar disorder, or untreated diagnosed depression. Subjects with unipolar depression who are on an antidepressant medication are eligible.
  • TSH levels <0.4 or >5 mlU/L
  • Systolic blood pressure (BP) >160 or diastolic BP >100 mm Hg (average of 2 measurements taken at Visit 1)
  • Hemoglobin A1c >8.0% or taking insulin. Men with diabetes mellitus whose A1C is less than 8.0% or who are not taking insulin will be eligible.
  • Mini-Mental Status Exam [MMSE] <24
  • Body mass index (BMI) less than 20 or greater than 40 kg/m2
  • Not willing to eat all of the following: red meat, eggs, poultry, fish and shellfish
  • Allergy to sesame, peanuts, soy, gluten or shellfish
  • Current alcohol use >21 drinks/week based on self-report
  • Confinement to a wheelchair
  • Use of anabolic therapies (Testosterone, DHEA, androstenedione, rhGH) within the past year
  • Current use of levodopa or anticoagulants
  • Current enrollment in a structured weight management program or participation in any weight intervention studies in the last 90 days
  • Serum ALT and AST greater than 3 x upper limit of normal
  • Hematocrit < 30% or >48%
  • Subject is not able to eat 3 frozen study meals per day for 6 months
  • Subject is unwilling to stop current nutritional supplements
  • Progressive intensive resistance training within 12 weeks of screening
  • Non-compliant with run-in diet and/or supplement

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

Other trials in United States

About this study

This will be a randomized, placebo-controlled, parallel group, double blind, clinical trial in community dwelling, older men, 65 years of age or older, who have mobility limitation and low protein intake. The study will have a 2 X 2 factorial design, which will allow us to investigate the effects of dietary protein intake and testosterone separately and together.

Read the detailed description

The recommended dietary allowance (RDA) for protein, set at 0.8 grams/kg/day for adult men and women, has engendered debate and many experts advocate protein intakes substantially above the RDA to help maintain muscle anabolism in older individuals. It is not known whether increasing protein intake in older Americans, whose current intake is below the RDA, increases skeletal muscle mass, muscle performance and physical function.

Our first aim is to determine whether administration of 1.3 g/kg/day of protein, compared to the RDA (0.8 g/kg/day), will result in greater improvements in lean body mass, maximal voluntary muscle strength and power, and self-reported and performance-based measures of physical function in older men. Our second aim is to determine whether the gains in lean body mass, maximal voluntary strength and self-reported and performance-based measures of physical function during testosterone administration are greater with 1.3 g protein than with the RDA in older men on a eucaloric diet.

We will conduct a randomized, placebo-controlled, double-blind trial using a 2 X 2 factorial design. Community dwelling men, 65 years or older, who have self-reported mobility limitation, a daily protein intake of <0.8 g/kg/day and no contraindications for testosterone therapy, will be randomly assigned to one of four groups: placebo injections plus protein 0.8 g/kg/day; placebo injections plus protein 1.3 g/kg/day; testosterone enanthate 100 mg weekly plus protein 0.8 g/kg/day; testosterone enanthate 100 mg weekly plus protein 1.3 g/kg/day. Treatment duration will be 6 months. The primary outcome is change in lean body mass from baseline to 6 months, measured by dual energy X-ray absorptiometry. Secondary outcomes include change in maximal voluntary strength in leg and chest press exercises, leg power, self-reported (physical function domain of SF-36) and performance-based measures of physical function (6-min walking distance and speed, stair climbing power, and load carrying), fatigue, well-being and affectivity balance. Safety measures include urinary calcium excretion, hematocrit, prostate specific antigen (PSA) and prostate examination.

Being tested
Testosterone enanthate
Keywords
Mobility Limitation, Low Protein Intake, Older Men, Testosterone
Medical subject headings
Mobility Limitation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Testosterone enanthateDrug

    Testosterone enanthate 100 mg intramuscularly weekly

  • Testosterone enanthateDrug

    Testosterone enanthate 100 mg intramuscularly weekly

Study groups in NCT01275365
Study groupRoleWhat they receive
Placebo/Low ProteinNo interventionPlacebo injections weekly; 0.8 g/kg/day protein
Placebo/High ProteinNo interventionPlacebo injections weekly; 1.3 g/kg/day protein
Testosterone/Low ProteinOtherTestosterone enanthate 100 mg intramuscularly weekly; 0.8 g/kg/day protein
Receives: Drug: Testosterone enanthate
Testosterone/High ProteinOtherTestosterone enanthate 100 mg intramuscularly weekly; 1.3 g/kg/day protein
Receives: Drug: Testosterone enanthate

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Lean Body Mass as Measured by Dual Energy X-ray Absorptiometry (DXA)

    Primary outcome is change in lean body mass, measured by dual energy X-ray absorptiometry (DXA)

    Measured: 6 months from baseline

Secondary outcomes (9)
  1. Change of Maximal Voluntary Strength

    Tests of Muscle Performance: (1) Maximal voluntary strength measured by 1-repetition maximum method in leg press; (2) Maximal voluntary strength in chest press; this exercise was chosen because it involves the large muscle groups of the upper extremities.

    Measured: 6 months from baseline

  2. Change of Leg Press Power

    Muscle Performance measured using Power of hip and knee extension by Bassey's leg rig.

    Measured: 6 months from baseline

  3. Change of 6-minute Walking Distance

    Tests of Physical Function and Task-Specific Performance measured by 6-min walking distance

    Measured: 6 months from baseline

  4. Change of Stair Climbing Tests

    Tests of Physical Function and Task-Specific Performance measured by Stair-climbing power +/- 20% load carry. Physical Function was evaluated using two tests of stair climb power using an indoor 12-step staircase. One test consisted of ascending the 12-steps as rapidly as possible without running (unloaded stair climb) while the second test required participants to carry a load equivalent to 20% of their baseline body weight evenly distributed in two canvas tote bags (loaded stair climb). Time to ascend the stairs was measured electronically with a digital clock and switch mats placed at the base of the steps and on the 12th step. Power in watts is calculated by the following: [body weight (kilograms) * distance (meters)/ (time/60)] /6.12.

    Measured: 6 months from baseline

  5. Change of 50-meter Loaded Walking Test

    Tests of Physical Function and Task-Specific Performance measured by 50-meter timed walk + 20% load carry. Physical Function was evaluated using test of 50-meter loaded walking speed. The test required participants to carry a load equivalent to 20% of their baseline body weight evenly distributed in two canvas tote bags. Time was measured electronically with a digital clock. Speed in meters per second is calculated by the following: 50/time.

    Measured: 6 months from baseline

  6. Change of Self-reported Physical Function Domain of Short Form Health Survey (SF-36)

    36-Item Short Form Health Survey (SF-36) is a set of generic, coherent, and easily administered quality-of-life measures. Physical function domain of the Medical Outcomes Study Short Form-36 (SF-36) contains 10 items with the score range of 0-100. Higher score yields better performance.

    Measured: 6 months from baseline

  7. Change of Psychological Well Being Index (PGWBI)

    The PGWBI is a 22-item health-related Quality of Life (HRQoL) questionnaire developed in US which produces a self-perceived evaluation of psychological well-being expressed by a summary score. The 22 items are grouped in 6 dimensions. A global score is computed as the sum of all items with range of 0-110. A higher score yields better performance.

    Measured: 6 months from baseline

  8. Change of Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale

    The FACIT Fatigue Scale is a 13-item questionnaire that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four point scale (4 = not at all fatigued to 0 = very much fatigued). Score ranges 0-52. The higher the score, the better the quality of life.

    Measured: 6 months from baseline

  9. Change of Derogatis Affective Balance Scale (DABS)

    The Derogatis Affects Balance Scale (DABS) is a multidimensional self-report mood and affects inventory comprised of 40 adjective-items using a 5-point Likert style scale. The DABS global scores consist of the Positive Total score (PTOT), Negative Total score (NTOT), where The Positive Affects Total (PTOT) is defined as the sum of all scores on the four positive affects dimensions of joy, contentment, vigor and affection, ranging 0-80. Similarly, the Negative Affects Total (NTOT) is represented as the sum of scores on the four negative dimensions of anxiety, depression, guilt and hostility, ranging 0-80. The Affects Expressiveness Index (AEI) is defined as the sum total of PTOT and NTOT, ranging 0-160. Higher score yields stronger affective intensity.

    Measured: 6 months from baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jan 2011 (estimated)
  2. Study startMay 2011
  3. Primary completion19 Jan 2017
  4. Study completion19 Jan 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
92 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01275365
Sponsor's protocol ID
2012P001321
Other IDs
7R01AG037547
Acronym
OPTIMen
Status last verified
Jul 2021
First submitted
11 Jan 2011
Last updated
29 Jul 2021
Data monitoring committee
Yes

Publications

  • Huang G, Pencina K, Li Z, Apovian CM, Travison TG, Storer TW, Gagliano-Juca T, Basaria S, Bhasin S. Effect of Protein Intake on Visceral Abdominal Fat and Metabolic Biomarkers in Older Men With Functional Limitations: Results From a Randomized Clinical Trial. J Gerontol A Biol Sci Med Sci. 2021 May 22;76(6):1084-1089. doi: 10.1093/gerona/glab007.

    PubMed 33417663
  • Krok-Schoen JL, Archdeacon Price A, Luo M, Kelly OJ, Taylor CA. Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES analysis. J Nutr Health Aging. 2019;23(4):338-347. doi: 10.1007/s12603-019-1174-1.

    PubMed 30932132
  • Bhasin S, Apovian CM, Travison TG, Pencina K, Moore LL, Huang G, Campbell WW, Li Z, Howland AS, Chen R, Knapp PE, Singer MR, Shah M, Secinaro K, Eder RV, Hally K, Schram H, Bearup R, Beleva YM, McCarthy AC, Woodbury E, McKinnon J, Fleck G, Storer TW, Basaria S. Effect of Protein Intake on Lean Body Mass in Functionally Limited Older Men: A Randomized Clinical Trial. JAMA Intern Med. 2018 Apr 1;178(4):530-541. doi: 10.1001/jamainternmed.2018.0008.

    PubMed 29532075
  • Apovian CM, Singer MR, Campbell WW, Bhasin S, McCarthy AC, Shah M, Basaria S, Moore LL. Development of a Novel Six-Month Nutrition Intervention for a Randomized Trial in Older Men with Mobility Limitations. J Nutr Health Aging. 2017;21(10):1081-1088. doi: 10.1007/s12603-017-0990-4.

    PubMed 29188864

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Testosterone enanthate in people with Mobility Limitation, run by Brigham and Women's Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Feb 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Lean Body Mass as Measured by Dual Energy X-ray Absorptiometry (DXA) (time frame: 6 months from baseline). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01275365, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2021.

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OPTIMen Clinical Trial NCT01275365 | AzTrials