Testosterone Plus Finasteride Treatment After Spinal Cord Injury

• Status: Recruiting
• Trial end date: 2022-05-01
• Target enrollment: 0
• Participant gender: Male

Summary

The purpose of this study is to determine whether testosterone plus finasteride treatment will improve musculoskeletal health, neuromuscular function, body composition, and metabolic health in hypogonadal men who have experienced ambulatory dysfunction subsequent to incomplete spinal cord injury. The investigators hypothesize that this treatment will improve bone mineral density, enhance muscle size and muscle function, and improve body composition, without causing prostate enlargement.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: VA Office of Research and Development
• Collaborator: University of Florida
• Treatments: Antineoplastic Agents; Antineoplastic Agents, Hormonal; Bone Density Conservation Agents; Finasteride; Methyltestosterone; Testosterone; Testosterone 17 beta-cypionate; Testosterone enanthate; Testosterone undecanoate

Criteria

Inclusion Criteria:

• Male > 18 years of age

• Traumatic, vascular, or orthopedic spinal cord injury between C2-L3 >12 months prior to enrollment

• Motor incomplete spinal cord (AIS C/D)

• Ambulatory dysfunction

• Medically stable condition that is asymptomatic for bladder infection, decubiti, cardiopulmonary disease, or other significant medical conditions

• Serum total testosterone (<325 ng/dL) or bioavailable testosterone (<70 ng/dL)

Exclusion Criteria:

• Currently participating in another research protocol that may influence study outcomes

• Life expectancy <1 year

• History of or current congenital spinal cord injury or other degenerative spinal disorder

• Diagnosis of multiple sclerosis, amyotrophic lateral sclerosis, or other neurologic impairment/injury

• History of venous thromboembolism within the last 6 months, specifically deep venous thromboembolism and pulmonary embolism, history of recurrent venous thromboembolism or know hereditary thrombophilia

• Poorly compensated or uncontrolled cardiovascular disease

• Any major cardiovascular event within the last 12 months (defined as a history of acute myocardial infarction, any cardiac revascularization procedure including angioplasty, stenting, or coronary artery bypass grafting, hospitalization due to unstable angina, transient ischemic attack, or stroke)

• Any angina that is not controlled on a current medical regimen (Canadian class II, III, or IV)

• New York Heart Association (NYHA) class III or IV congestive heart failure

• Systolic blood pressure >160 mmHg or diastolic blood pressure >100 mm Hg

• Poorly controlled arrhythmia

• Severe valvular disease

• LDL cholesterol >160 mg/dl with known history of any major cardiovascular event, as defined above, within the last 12 months

• Baseline EKG findings (e.g. left bundle branch block) or marked EKG abnormalities that would preclude serial screening for occult ischemic events

• Current prostate, breast, or other organ cancer

• History of prostate, breast, or other organ cancer, with the exceptions of completely resolved basal or squamous cell carcinoma for a duration of >24 months or completely resolved melanoma for a duration of >24 months

• Serum prostate-specific antigen (PSA) >3.0 ng/ml

• History of benign prostate enlargement (BPE) >40cc, evaluated via TRUS

• Hematocrit >47%

• Liver enzymes (AST / ALT) above normal upper limit

• Creatinine >1.4 mg/dL

• Serum calcium >10.5 mg/dL

• Gynecomastia

• Mental state that precludes understanding of the protocol

• Diagnosed, but untreated moderate or severe sleep apnea

• Spinal nutrition screening tool score >15

• Severe claustrophobia that precludes MRI testing

• Current anticoagulant therapy

• Use of any of the following pharmacologic agents in the previous 3 months (testosterone, leuprolide, androgenic hormones, growth hormone, oral androgen precursors, 5-alpha reductase or aromatase inhibitors)

• Use of anti-resorptive or bone anabolic drug therapy in the previous 6 months

• Known allergy to sesame oil