Stimulation Test With Intranasal Glucagon for Corticotroph, Somatotroph and Antidiuretic Axes
Status:
Completed
Trial end date:
2021-12-31
Target enrollment:
Participant gender:
Summary
The diagnosis of secondary hypoadrenalism and GH deficiency (GHD) often requires the
performance of a dynamic test. The glucagon stimulation test (GST) is one of the options for
evaluating hypothalamic-pituitary function, representing a stimulus for both the
corticotropic and somatotropic axis, substantially safe and easily available. The standard
procedure involves the intramuscular injection of 1-1.5 mg of glucagon based on the patient's
weight.
In addition to its antero-pituitary function, glucagon has also shown its ability to
stimulate neurohypophyseal secretion. Using the copeptin dosage, it has been shown that after
the administration of glucagon in healthy subjects there is a significant release of ADH.
However, the available data are scarse and there is no standardized protocol for the use of
the glucagon test in diabetes insipidus.
At the moment, GST is not the most frequently chosen diagnostic option. In fact, despite
having the advantage of being able to investigate different areas of anterohypophyseal and
probably posterohypophyseal function at the same time, the test has some disadvantages: the
prolonged duration makes the procedure challenging, the intramuscular injection can be
unwelcome, and many variables can come into play in the definition of a normal response (age,
BMI, glycemic status).
The recent introduction of a single-dose nasal powder formulation (Baqsimi®) could overcome
some of the limitations of classic GST and make the procedure less demanding.
To date, no assessments are yet available regarding a purely diagnostic role in the context
of hypopituitarism of this new formulation.
Through the knowledge of the physiological response of the adrenocortical, somatotropic and
ADH axis to the administration of intranasal glucagon in healthy subjects, it will be
possible to evaluate its possible application in the diagnosis of GH deficiency, central
adrenal insufficiency and possibly diabetes insipidus.
Phase:
Phase 4
Details
Lead Sponsor:
Azienda Ospedaliera Città della Salute e della Scienza di Torino