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Muscle WeaknessPhase 2/3PROGRESSNCT02873559

Effect of PROGRESSive Training and Teststerone in Older Frail Men

A Phase 2/3 study testing testosterone and Progressive muscle training in people with Muscle Weakness, run by University Hospital, Gentofte, Copenhagen at 2 sites in Denmark.

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

In this scientific clinical investigation we will test whether testosterone and progressive resistance training can improve muscle strength and reduce the risk of falls in older men. Read more about this study

Who is it for?
Ages 70 years and older, men onlyHealthy volunteers can take part
Conditions the study is for
Muscle Weakness
What is being tested?
testosterone and Progressive muscle training
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
192 participants
Where
2 sitesDenmark
Study dates
1 Nov 2016to Mar 2023
Phase
Phase 2/3
Are there results?
None posted in the registry

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 70 years and older
  • Men only
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • Living in their own home or in sheltered accommodation. Independent gait possible. with tool. Capable of stand-up and sit in a chair at least 8 times in 30 sec. There must be at least 3 symptoms or objective findings of low testosterone . Serum testosterone <10nmol /L as the average of two independent measurements
  • -

Who cannot join

  • Known or previous prostate cancer. Abnormally elevated serum PSA (PSA = prostate specific antigen) corresponding to PSA> 5 ng / ml or PSA> 0.15 ng / ml / cc (relative to the prostatic volume in cubic centimeters (cc)). Hæmatomacrose. Heart disease in the form of: peri-, myo-, or endocarditis, angina, severe heart failure (NYHA class III and IV), severe hypertension (systolic blood pressure> 180 or diastolic BT> 105 mmHg after antihypertensive therapy). Dyspnoea at rest. Liver (AST> 2 x ULN) or renal impairment (serum creatinine> 200 micromoles / L). Severe and insufficiently treated epilepsy or migraine. Insulin treatment. Previous or current bifosfonat-, fluoride, HRT, SERM-, strontium, teraparatid- or more than 3 weeks of prednisolone. Joint disease with acute inflammation. Active cancer disease in chemo- or radiotherapy. Bone metabolic disease apart from age-related osteoporosis. Autoimmune diseases, chronic systemic diseases (cirrhosis, AIDS, chronic renal failure). Primary testosterone deficiency in the form of testicular dysgenesis, Klinefelter syndrome (47, XXY), 46, XX males, LH-resistance, the Y chromosome deletions, other sex chromosome abnormalities ,. Significant abuse, mental illness, dementia, physical disability with inability to implement intervention or tests or to give informed consent. Contraindications to testosterone undecanoate is included in the exclusion criteria, such as. presence of liver tumors, breast and prostate cancer, as subjects will be examined before the trial starts.

Trial locations and contacts

2 sites in 1 country.

Denmark2 sites
  • Karsten Overgaard

    Hellerup, Danmark, DK-2900

  • Medical Dept. O, Geriatric Section

    Herlev, 2730

Other trials in Denmark

About this study

Official title: Effect of PROGRESSive Resistance Training, Protein Supplements and Testosterone in Older Frail Men With Testosterone Deficiency (PROGRESS Trial)

In this scientific clinical investigation we will test whether testosterone and progressive resistance training can improve muscle strength and reduce the risk of falls in older men. In addition, we will examine whether this treatment improves quality of life, functional capacity, including sexual function and counteracts depression. Such a project have not been performed earlier.

Read the detailed description

Project background: In Denmark more than 1,000 people each year die of a fall, which is more than five times as many dying in traffic accidents. Fall accidents are also the leading cause of traumatic brain injury and is a relatively unnoticed problem, although this type of accidents causes more hospital bed days than all other accidents combined.

Annually, almost half of the 375,000 elderly Danes over 75 years of age and relatively three times as many of the approximately 40,000 elderly people in nursing homes fall every year, causing over 40,000 hospital contacts annually. Ten percent of all elderly people hospitalized each year because of a fall, mostly with fractures, for which the risk increases fivefold after a fall. In Denmark there are now now around 1 million people over 65 years of age. Over the next 25 years we will experience a 50% growth to 1.5 million people over 65 years of age.

Injury, disability and death caused by falls is therefore a widespread and growing human and societal problem. Many will never recover completely and will therefore need help to cope with everyday life. After the first fall risk increase for repeated falls. Especially for older people living in their own homes permanent or temporary disabilities results in a severe deterioration of the quality of life. Treatment of falls is also a significant financial burden on health and social care.

The main reason for the decline is muscle weakness. Muscle weakness leads to greatly increased risk of falling, decreased quality of life and functional capacity. Musclemass and -power decrease about 40 percent from age 20 to 80 years old.

Recent studies have shown that even 90-year-old persons can double their muscle strength by intensive training just three times per week. The level of the male sex hormone testosterone decreases with age and leads to impaired muscle mass. Twenty percent of men over 60 and 50 percent over 80 years, a low level of testosterone in total equivalent to more than 100,000 Danes. From the human and socio-economic perspective, it is important to find treatments that can enhance function in the elderly.

Conditions
Muscle Weakness
Being tested
testosterone, Progressive muscle training
Keywords
older, frail, men, progressive muscle training, muscle training, exercise, testosterone
Medical subject headings
Muscle Weakness, Multiple Endocrine Neoplasia Type 1, Motor Activity

What participants receive

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

  • testosteroneDrug

    Testosterone supplemented in 5 months

  • Progressive muscle trainingOther

    Also called Training

    Progressive muscle training during 4 months

Study groups in NCT02873559
Study groupRoleWhat they receive
ControlsNo interventionA control group, which is 20 weeks with placebo injections without training.
TestosteroneExperimentalA testosterone group given 20 weeks on testosterone injections without training
Receives: Drug: testosterone
TrainingExperimentalA Training Group, which is 20 weeks with placebo injections and 16 weeks of progressive resistance training supplemented with vitamin D and protein supplements
Receives: Other: Progressive muscle training
Testosterone and trainingExperimentalA combination group that is 20 weeks with testosterone injections and 16 weeks of progressive resistance training supplemented with vitamin D and protein supplements
Receives: Drug: testosterone; Other: Progressive muscle training

What is being measured

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

  1. Stand-up-and Sit-test

    It is a measure of overall strength in the lower extremities. Result of the test is defined as the number of times the participant can stand up and sit from a chair in 30 seconds. There is a good correlation (r = 0.78) with a leg press and an acceptable test-retest reliability (ICC = 0.86).

    Measured: up to 5 months (at study completion)

Secondary outcomes (35)
  1. Frequency and severity of falls via questionaire

    included in the monitoring of adverse events.

    Measured: At baseline, 1 month, 5 months (at study completion)

  2. Balance ability,

    Tandem Test containing three starting positions: 1) Standing with feet together, standing in the semi-tandem position and standing in the tandem stand. coupled with decrease risk of fall.

    Measured: At baseline, 1 month, 5 months (at study completion)

  3. Avlund mobility scale

    Questions about experiencing fatigue and support needs of ordinary everyday activities. Avlund mobility scale is correlated with the isometric muscle strength, simple function tests , increased risk of hospitalization and mortality

    Measured: At baseline, 1 month, 5 months (at study completion)

  4. Leg extensor Power Rig test

    An instrument for measuring muscle strength in the lower extremities.

    Measured: At baseline, 1 month, 5 months (at study completion)

  5. Isometric muscle strength

    Measurement of isometric muscle strength m. quadriceps in a seated leg press.

    Measured: At baseline, 1 month, 5 months (at study completion)

  6. Armflexion Test:

    Measures of overall strength in the upper extremities. The number of times the participant can inflect the elbow with dumbbell is measured in 30 sec.

    Measured: At baseline, 1 month, 5 months (at study completion)

  7. 2-minute knee lift test:

    Measures aerobic capacity in the elderly. Number of high knee lifts in 2 minutes.

    Measured: At baseline, 1 month, 5 months (at study completion)

  8. 2,45minute up-and-go test:

    Target for basic mobility in the elderly. Time it takes to rise from a chair, walk around a cone 2,45m away, go back and sit down again. Moderate to good correlation between the corresponding 3m test and Berg Balance Scale (r = 0.81), walking speed (r = 0.61) and Barthel index (r = 0.78) and a good test-retest- reliability (ICC = 0.98).

    Measured: At baseline, 1 month, 5 months (at study completion)

  9. DXA scan

    Lean body mass. Measurement of fat and fat-free mass and total bone mass (BMC). Executed only at baseline and at study end.

    Measured: At baseline, 1 month, 5 months (at study completion)

  10. Bone Mineral Density

    Of the spine, distal forearm bilaterally, total hip bilaterally and in the skeleton as a whole (total body). In case of osteoporosis treatment will be initiated following the department's usual guidelines, which can blur the results for bone density.

    Measured: At baseline, 1 month, 5 months (at study completion

  11. Major Depression Inventory (MDI):

    Questionnaire on depression and mental well-being.

    Measured: At baseline, 1 month, 5 months (at study completion)

  12. Montreal Cognitive Assessment (MoCA):

    A cognitive screening test that provides an estimate of the intellectual functioning; This test is also sensitive to mild cognitive problems and dementia.

    Measured: At baseline, 1 month, 5 months (at study completion)

  13. Quality of Life EQ-5D:

    Questionnaire on the experienced quality of life.

    Measured: At baseline, 1 month, 5 months (at study completion)

  14. Modified PISQ-12:

    An assessment of sexual performance (potency) and sexual desire. There are previously found improved sexual function, mood, muscle strength and body composiAn evaluation questionnaire of sexual function

    Measured: At baseline, 1 month, 5 months (at study completion)

  15. Aastrands Test:

    Sub-maximal fitness test performed on a treadmill. Includes monitoring heart rate

    Measured: At baseline, 1 month, 5 months (at study completion)

  16. Measurements of the Heart Rate Variability (HRV)

    Studies have indicated that hypogonodal men can improve the Heart Rate Variability by testosterone treatment

    Measured: At baseline, 1 month, 5 months (at study completion)

  17. Dual-energy X-ray absorptiometry

    Measurement of the body composition bioimpedance.

    Measured: At baseline, 1 month, 5 months (at study completion)

  18. Safety parameters - blood pressure

    Blood pressure. Blood samples: Serum testosterone, hemoglobin, hematocrit, lipid profile, Potassium, Natrium, creatinine, CRP, AST, bilirubin, alkaline phosphatase, TSH, p-ionized calcium, PTH, Ca ++, and 25-OH vitamin D.

    Measured: Measured every four weeks through the study (for 5 months)

  19. Side effects

    Measuring a lot of posssible side effects to training and testosterone

    Measured: Measured every four weeks through the study (for 5 months)

  20. Safety parameters - blood sample - testosterone level

    Measuring levels of testosterone and safely parameter

    Measured: Measured every four weeks through the study (for 5 months)

  21. Safety parameters - blood sample - hemoglobin level

    Measuring levels hemoglobin

    Measured: Measured every four weeks through the study (for 5 months)

  22. Safety parameters - blood sample - hematocrit level

    Measuring levels of hematocrit

    Measured: Measured every four weeks through the study (for 5 months)

  23. Safety parameters - blood sample - lipid profile

    Measuring levels cholesterol

    Measured: Measured every four weeks through the study (for 5 months)

  24. Safety parameters - blood sample - Potassium

    Measuring levels of potassium

    Measured: Measured every four weeks through the study (for 5 months)

  25. Safety parameters - blood sample - Natrium

    Measuring levels of natrium

    Measured: Measured every four weeks through the study (for 5 months)

  26. Safety parameters - blood sample - creatinine

    Measuring levels of creatinine

    Measured: Measured every four weeks through the study (for 5 months)

  27. Safety parameters - blood sample - CRP

    Measuring levels of CRP

    Measured: Measured every four weeks through the study (for 5 months)

  28. Safety parameters - blood sample - Aspartate aminotransferase (AST)

    Measuring levels of aspartate aminotransferase (AST)

    Measured: Measured every four weeks through the study (for 5 months)

  29. Safety parameters - blood sample - bilirubin

    Measuring levels of bilirubin

    Measured: Measured every four weeks through the study (for 5 months)

  30. Safety parameters - blood sample - alkaline phosphatase

    Measuring levels of alkaline phosphatase

    Measured: Measured every four weeks through the study (for 5 months)

  31. Safety parameters - blood sample - Thyreoid Stimulating Hormone (TSH)

    Measuring levels of TSH

    Measured: Measured every four weeks through the study (for 5 months)

  32. Safety parameters - blood sample - p-ionized calcium

    Measuring levels of p-ionized calcium

    Measured: Measured every four weeks through the study (for 5 months)

  33. Safety parameters - blood sample - PTH

    Measuring levels of PTH

    Measured: Measured every four weeks through the study (for 5 months)

  34. Safety parameters - blood sample - Ca ++

    Measuring levels of Ca2+

    Measured: Measured every four weeks through the study (for 5 months)

  35. Safety parameters - blood sample - 25-OH vitamin D.

    Measuring levels of vitamin D

    Measured: Measured every four weeks through the study (for 5 months)

Timeline

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

  1. First posted19 Aug 2016 (estimated)
  2. Study start1 Nov 2016
  3. Primary completion31 Mar 2022
  4. Study completionMar 2023

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
192 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02873559
Sponsor's protocol ID
Ethical protocol H-16020521
Acronym
PROGRESS
Status last verified
May 2024
First submitted
12 Aug 2016
Last updated
29 May 2024
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Rasmussen RS, Midttun M, Zerahn B, Pedersen M, Rashid A, Ostergren PB, Paulin TK, Podenphanth TW, Karlsson LK, Rosendahl E, Ragle AM, Vinther A, Overgaard K. Testosterone and resistance training improved physical performance and reduced fatigue in frail older men: 1 year follow-up of a randomized clinical trial. Aging Male. 2024 Dec;27(1):2403519. doi: 10.1080/13685538.2024.2403519. Epub 2024 Sep 17.

    PubMed 39289825
  • Rasmussen R, Midttun M, Kolenda T, Ragle AM, Sorensen TW, Vinther A, Zerahn B, Pedersen M, Overgaard K. Therapist-Assisted Progressive Resistance Training, Protein Supplements, and Testosterone Injections in Frail Older Men with Testosterone Deficiency: Protocol for a Randomized Placebo-Controlled Trial. JMIR Res Protoc. 2018 Mar 2;7(3):e71. doi: 10.2196/resprot.8854.

    PubMed 29500160

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing testosterone and Progressive muscle training in people with Muscle Weakness, run by University Hospital, Gentofte, Copenhagen at 2 sites in Denmark.

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 2 inclusion and 1 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 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Denmark. 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 combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Stand-up-and Sit-test (time frame: up to 5 months (at study completion)). 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 NCT02873559, which also lists 2 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 May 2024.

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