Trial Outcomes & Findings for Effect of DPP4 Inhibition on Growth Hormone Secretion (NCT NCT01701973)

NCT ID: NCT01701973

Last Updated: 2018-05-29

Results Overview

Subjects underwent two study days separated by a washout period. On one study day they will receive sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine (30 grams i.v. over 30 minutes) on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

44 participants

Primary outcome timeframe

Growth Hormone Level at 30 minutes (i.e. at completion of arginine infusion), 45 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes

Results posted on

2018-05-29

Participant Flow

Healthy Lean Adults are randomized to two cross-over studies (Aim 1 and Aim 2).

In Aim 1, Healthy adults were randomized in a double-blinded cross-over fashion to sitagliptin vs placebo. A minimum 8 week wash-out separated Aims 1 \& 2. 23 of the same adults who completed Aim 1 participated in Aim 2. In Aim 2, these adults were divided into three subgroups and randomized to sitagliptin+placebo vs. sitagliptin+antagonist.

Participant milestones

Participant milestones
Measure
Aim 1: Sitagliptin, Then Placebo
In Aim 1: Healthy Lean adults are randomized in a double-blinded cross over fashion to sitagliptin versus placebo.
Aim 1: Placebo, Then Sitagliptin
In Aim 1: Healthy Lean adults are randomized in a double-blinded cross over fashion to sitagliptin versus placebo.
Aim 2: Sitagliptin + Placebo,Then Sitagliptin + LNMMA
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either L-NMMA (L-N-Monomethyl-arginine) versus placebo.
Aim 2:Sitagliptin + LNMMA, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either L-NMMA (L-N-Monomethyl-arginine) versus placebo.
Aim 2: Sitagliptin + Placebo, Then Sitagliptin + Pegvisomant
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either pegvisomant versus placebo.
Aim 2: Sitagliptin + Pegvisomant, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either pegvisomant versus placebo.
Aim 2: Sitagliptin + Placebo, Then Sitagliptin + Exendin 9-39
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either Exendin 9-39 versus placebo.
Aim 2: Sitagliptin + Exendin 9-39, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either Exendin 9-39 versus placebo.
Aim 1: First Intervention (1 Day)
STARTED
23
21
0
0
0
0
0
0
Aim 1: First Intervention (1 Day)
COMPLETED
23
20
0
0
0
0
0
0
Aim 1: First Intervention (1 Day)
NOT COMPLETED
0
1
0
0
0
0
0
0
Aim 1: Second Intervention (1 Day)
STARTED
22
17
0
0
0
0
0
0
Aim 1: Second Intervention (1 Day)
COMPLETED
22
17
0
0
0
0
0
0
Aim 1: Second Intervention (1 Day)
NOT COMPLETED
0
0
0
0
0
0
0
0
Aim 2: First Intervention (1 Day)
STARTED
0
0
5
4
2
3
5
4
Aim 2: First Intervention (1 Day)
COMPLETED
0
0
5
4
2
3
5
4
Aim 2: First Intervention (1 Day)
NOT COMPLETED
0
0
0
0
0
0
0
0
Aim 2: Second Intervention (1 Day)
STARTED
0
0
5
4
2
3
5
3
Aim 2: Second Intervention (1 Day)
COMPLETED
0
0
5
4
2
3
5
3
Aim 2: Second Intervention (1 Day)
NOT COMPLETED
0
0
0
0
0
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Aim 1: Sitagliptin, Then Placebo
In Aim 1: Healthy Lean adults are randomized in a double-blinded cross over fashion to sitagliptin versus placebo.
Aim 1: Placebo, Then Sitagliptin
In Aim 1: Healthy Lean adults are randomized in a double-blinded cross over fashion to sitagliptin versus placebo.
Aim 2: Sitagliptin + Placebo,Then Sitagliptin + LNMMA
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either L-NMMA (L-N-Monomethyl-arginine) versus placebo.
Aim 2:Sitagliptin + LNMMA, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either L-NMMA (L-N-Monomethyl-arginine) versus placebo.
Aim 2: Sitagliptin + Placebo, Then Sitagliptin + Pegvisomant
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either pegvisomant versus placebo.
Aim 2: Sitagliptin + Pegvisomant, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either pegvisomant versus placebo.
Aim 2: Sitagliptin + Placebo, Then Sitagliptin + Exendin 9-39
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either Exendin 9-39 versus placebo.
Aim 2: Sitagliptin + Exendin 9-39, Then Sitagliptin + Placebo
In Aim 2: Healthy Lean adults receive sitagliptin and are randomized in a double-blinded cross over fashion to pre-treatment with either Exendin 9-39 versus placebo.
Aim 1: First Intervention (1 Day)
Adverse Event
0
1
0
0
0
0
0
0

Baseline Characteristics

Effect of DPP4 Inhibition on Growth Hormone Secretion

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Participants From All Groups
n=39 Participants
Data was collected as one group
Age, Continuous
25 years
STANDARD_DEVIATION 5 • n=99 Participants
Sex: Female, Male
Female
29 Participants
n=99 Participants
Sex: Female, Male
Male
10 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
35 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
2 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=99 Participants
Race (NIH/OMB)
White
35 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Region of Enrollment
United States
39 participants
n=99 Participants

PRIMARY outcome

Timeframe: Growth Hormone Level at 30 minutes (i.e. at completion of arginine infusion), 45 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes

Population: Data from all subjects who completed both study days in Aim 1 were analyzed. Subjects represented young, healthy adults without any chronic medical conditions and who did not take any medications. Oral birth control use was not permitted.

Subjects underwent two study days separated by a washout period. On one study day they will receive sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine (30 grams i.v. over 30 minutes) on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 1: Stimulated Peak Growth Hormone Level
30 minutes
5.2 ng/ml
Standard Deviation 4.2
3.1 ng/ml
Standard Deviation 3.3
1.9 ng/ml
Standard Deviation 1.9
2.0 ng/ml
Standard Deviation 2.3
Aim 1: Stimulated Peak Growth Hormone Level
45 minutes
9.5 ng/ml
Standard Deviation 6.1
6.6 ng/ml
Standard Deviation 5.0
3.4 ng/ml
Standard Deviation 3.5
3.9 ng/ml
Standard Deviation 3.3
Aim 1: Stimulated Peak Growth Hormone Level
60 minutes
9.4 ng/ml
Standard Deviation 6.4
7.0 ng/ml
Standard Deviation 6.0
3.0 ng/ml
Standard Deviation 3.6
3.3 ng/ml
Standard Deviation 2.3
Aim 1: Stimulated Peak Growth Hormone Level
90 minutes
5.0 ng/ml
Standard Deviation 3.4
6.4 ng/ml
Standard Deviation 4.8
1.1 ng/ml
Standard Deviation 1.00
2.1 ng/ml
Standard Deviation 2.0
Aim 1: Stimulated Peak Growth Hormone Level
120 minutes
2.7 ng/ml
Standard Deviation 2.1
4.2 ng/ml
Standard Deviation 3.4
1.5 ng/ml
Standard Deviation 3.1
0.9 ng/ml
Standard Deviation 0.8
Aim 1: Stimulated Peak Growth Hormone Level
150 minutes
1.8 ng/ml
Standard Deviation 2.5
2.4 ng/ml
Standard Deviation 2.1
2.2 ng/ml
Standard Deviation 4.3
1.8 ng/ml
Standard Deviation 3.3
Aim 1: Stimulated Peak Growth Hormone Level
180 minutes
0.9 ng/ml
Standard Deviation 0.9
1.3 ng/ml
Standard Deviation 1.9
1.0 ng/ml
Standard Deviation 1.9
1.0 ng/ml
Standard Deviation 1.8

PRIMARY outcome

Timeframe: Percent change from baseline in forearm vascular resistance at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes

Forearm blood flow was determined by strain gauge plethysmography. Forearm vascular resistance was then calculated by dividing this into mean arterial pressure. The percent change from baseline was determined at each timepoint.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
30 minutes
-5.0677 percentage change from baseline
Standard Deviation 18.56794
-5.3498 percentage change from baseline
Standard Deviation 19.60881
1.4929 percentage change from baseline
Standard Deviation 21.57596
-11.2235 percentage change from baseline
Standard Deviation 13.60628
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
60 minutes
-5.1365 percentage change from baseline
Standard Deviation 16.61555
-1.0195 percentage change from baseline
Standard Deviation 22.62776
6.7355 percentage change from baseline
Standard Deviation 23.96889
4.6875 percentage change from baseline
Standard Deviation 31.77169
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
90 minutes
-10.1867 percentage change from baseline
Standard Deviation 22.00489
-1.6694 percentage change from baseline
Standard Deviation 31.84989
1.0144 percentage change from baseline
Standard Deviation 28.50393
-3.8029 percentage change from baseline
Standard Deviation 35.33295
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
120 minutes
-12.5192 percentage change from baseline
Standard Deviation 31.29272
-5.0763 percentage change from baseline
Standard Deviation 26.06546
-10.3674 percentage change from baseline
Standard Deviation 32.22945
-2.7449 percentage change from baseline
Standard Deviation 31.52281
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
150 minutes
-24.1962 percentage change from baseline
Standard Deviation 23.92090
-11.8335 percentage change from baseline
Standard Deviation 27.88447
-9.7129 percentage change from baseline
Standard Deviation 30.40280
-7.1590 percentage change from baseline
Standard Deviation 30.41909
Aim 1: Percent Change From Baseline in Forearm Vascular Resistance
180 minutes
-22.4043 percentage change from baseline
Standard Deviation 27.60020
-16.5358 percentage change from baseline
Standard Deviation 32.22119
-11.9609 percentage change from baseline
Standard Deviation 20.50786
-15.0591 percentage change from baseline
Standard Deviation 25.33331

PRIMARY outcome

Timeframe: Percent change from baseline in forearm blood flow at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes.

Population: Data from all subjects who completed both study days in Aim 1 were analyzed. Subjects represented young, healthy adults without any chronic medical conditions and who did not take any medications. Oral birth control use was not permitted.

Forearm blood flow was determined by strain gauge plethysmography. The percent change from baseline was determined at each timepoint.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=29 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=10 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 1: Percent Change From Baseline in Forearm Blood Flow
30 minutes
0.4835 percent change from baseline
Standard Deviation 19.44436
1.6458 percent change from baseline
Standard Deviation 19.42502
-.0238 percent change from baseline
Standard Deviation 23.86278
9.2597 percent change from baseline
Standard Deviation 14.60368
Aim 1: Percent Change From Baseline in Forearm Blood Flow
60 minutes
5.3416 percent change from baseline
Standard Deviation 21.33943
4.9101 percent change from baseline
Standard Deviation 37.42841
-2.8869 percent change from baseline
Standard Deviation 25.79685
0.6789 percent change from baseline
Standard Deviation 24.91588
Aim 1: Percent Change From Baseline in Forearm Blood Flow
90 minutes
15.9192 percent change from baseline
Standard Deviation 36.11077
11.7285 percent change from baseline
Standard Deviation 47.44341
1.5212 percent change from baseline
Standard Deviation 30.57639
13.5358 percent change from baseline
Standard Deviation 37.76659
Aim 1: Percent Change From Baseline in Forearm Blood Flow
120 minutes
23.2248 percent change from baseline
Standard Deviation 40.83970
10.3081 percent change from baseline
Standard Deviation 28.31870
20.1185 percent change from baseline
Standard Deviation 38.89402
9.9379 percent change from baseline
Standard Deviation 28.93967
Aim 1: Percent Change From Baseline in Forearm Blood Flow
150 minutes
39.9269 percent change from baseline
Standard Deviation 45.00577
19.7355 percent change from baseline
Standard Deviation 30.90766
21.6011 percent change from baseline
Standard Deviation 42.67343
15.0944 percent change from baseline
Standard Deviation 34.56449
Aim 1: Percent Change From Baseline in Forearm Blood Flow
180 minutes
40.6354 percent change from baseline
Standard Deviation 50.48606
30.0924 percent change from baseline
Standard Deviation 36.51124
16.8489 percent change from baseline
Standard Deviation 24.95539
26.1772 percent change from baseline
Standard Deviation 34.75120

PRIMARY outcome

Timeframe: Percent change from baseline in forearm blood flow at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes.

Population: 19 of the original 29 females in Aim 1 returned to complete two more study days (Aim 2) in which they received sitagliptin + double-blinded study drug vs. sitagliptin plus placebo in a cross-over study. Three men from Aim 1 also returned to complete two more study days (Aim 2).

Subjects undergo two study days separated by a washout period. On one study day they received sitagliptin plus another study drug and on another sitagliptin plus placebo, in a randomized double-blind fashion. Forearm blood flow was assessed at each visit.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=2 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=2 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
n=5 Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
n=5 Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
n=7 Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
n=7 Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
n=1 Participants
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
n=1 Participants
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
120 minutes
4.22 percent change from baseline
Standard Error 12.54
9.80 percent change from baseline
Standard Error 18.23
32.92 percent change from baseline
Standard Error 0.97
56.26 percent change from baseline
Standard Error 55.06
54.10 percent change from baseline
Standard Error 21.87
41.97 percent change from baseline
Standard Error 31.29
31.10 percent change from baseline
Standard Error 9.04
22.24 percent change from baseline
Standard Error 11.14
16.52 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-22.00 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
150 minutes
16.09 percent change from baseline
Standard Error 13.00
11.26 percent change from baseline
Standard Error 28.45
26.27 percent change from baseline
Standard Error 13.73
71.51 percent change from baseline
Standard Error 76.00
59.08 percent change from baseline
Standard Error 32.36
26.87 percent change from baseline
Standard Error 17.56
29.48 percent change from baseline
Standard Error 8.22
15.59 percent change from baseline
Standard Error 8.26
45.98 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
1.33 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
180 minutes
14.80 percent change from baseline
Standard Error 15.85
17.12 percent change from baseline
Standard Error 20.53
29.24 percent change from baseline
Standard Error 35.21
65.31 percent change from baseline
Standard Error 80.28
51.21 percent change from baseline
Standard Error 26.07
43.51 percent change from baseline
Standard Error 26.31
30.76 percent change from baseline
Standard Error 8.88
27.11 percent change from baseline
Standard Error 12.21
54.91 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-1.67 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
30 minutes
-0.71 percent change from baseline
Standard Error 6.75
-9.34 percent change from baseline
Standard Error 8.60
5.17 percent change from baseline
Standard Error 4.27
14.78 percent change from baseline
Standard Error 14.78
15.64 percent change from baseline
Standard Error 5.06
0.39 percent change from baseline
Standard Error 8.93
-7.33 percent change from baseline
Standard Error 8.66
-0.98 percent change from baseline
Standard Error 12.08
-7.59 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-22.67 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
60 minutes
-3.64 percent change from baseline
Standard Error 12.68
-17.06 percent change from baseline
Standard Error 12.93
7.05 percent change from baseline
Standard Error 4.06
4.56 percent change from baseline
Standard Error 0.97
6.58 percent change from baseline
Standard Error 10.16
16.10 percent change from baseline
Standard Error 12.79
-10.54 percent change from baseline
Standard Error 8.53
6.95 percent change from baseline
Standard Error 9.53
9.37 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-13.00 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Blood Flow
90 minutes
3.24 percent change from baseline
Standard Error 10.02
-6.35 percent change from baseline
Standard Error 16.60
25.69 percent change from baseline
Standard Error 6.25
20.32 percent change from baseline
Standard Error 12.83
36.96 percent change from baseline
Standard Error 14.71
16.67 percent change from baseline
Standard Error 33.39
2.23 percent change from baseline
Standard Error 8.69
2.08 percent change from baseline
Standard Error 11.60
5.36 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-18.33 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.

PRIMARY outcome

Timeframe: Percent change from baseline in forearm vascular resistance at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes

Population: 19 of the original 29 females who participated in Aim 1 returned to complete an additional two study days (Aim 2) in which they received sitagliptin + double-blinded study drug vs. sitagliptin plus placebo in a cross-over study. Three men from Aim 1 also returned to complete two more study days (Aim 2).

Subjects undergo two study days separated by a washout period. On one study day they will receive sitagliptin plus another study drug and on another sitagliptin plus placebo, in a randomized double-blind fashion. Forearm blood flow was assessed at each visit every 30 minutes for 3 hours. This was divided into mean arterial pressure to determine forearm vascular resistance.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=2 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=2 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
n=5 Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
n=5 Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
n=7 Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
n=7 Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
n=1 Participants
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
n=1 Participants
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
150 minutes
-13.25 percent change from baseline
Standard Error 8.49
42.27 percent change from baseline
Standard Error 44.03
-20.62 percent change from baseline
Standard Error 6.34
-32.11 percent change from baseline
Standard Error 24.34
-30.12 percent change from baseline
Standard Error 11.10
-14.25 percent change from baseline
Standard Error 13.15
-20.92 percent change from baseline
Standard Error 5.30
-8.49 percent change from baseline
Standard Error 9.03
-32.30 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
-1.32 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
180 minutes
-10.25 percent change from baseline
Standard Error 10.76
5.28 percent change from baseline
Standard Error 19.22
-22.56 percent change from baseline
Standard Error 13.90
-19.52 percent change from baseline
Standard Error 37.12
-25.00 percent change from baseline
Standard Error 11.92
-17.97 percent change from baseline
Standard Error 15.66
-22.58 percent change from baseline
Standard Error 5.82
-16.76 percent change from baseline
Standard Error 8.94
-34.69 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
1.69 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
30 minutes
-8.67 percent change from baseline
Standard Error 9.66
8.98 percent change from baseline
Standard Error 12.07
-9.87 percent change from baseline
Standard Error 0.82
-14.60 percent change from baseline
Standard Error 12.22
-20.00 percent change from baseline
Standard Error 3.67
-3.75 percent change from baseline
Standard Error 12.43
5.30 percent change from baseline
Standard Error 8.19
4.53 percent change from baseline
Standard Error 12.62
0.57 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
27.77 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
60 minutes
8.77 percent change from baseline
Standard Error 17.03
51.82 percent change from baseline
Standard Error 36.73
-9.75 percent change from baseline
Standard Error 2.28
-2.42 percent change from baseline
Standard Error 3.34
-4.05 percent change from baseline
Standard Error 10.67
-10.97 percent change from baseline
Standard Error 11.64
14.46 percent change from baseline
Standard Error 11.08
-4.26 percent change from baseline
Standard Error 7.26
-11.80 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
6.73 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
90 minutes
-4.89 percent change from baseline
Standard Error 8.93
39.24 percent change from baseline
Standard Error 35.45
-23.34 percent change from baseline
Standard Error 8.00
-16.75 percent change from baseline
Standard Error 4.25
-25.28 percent change from baseline
Standard Error 7.02
3.79 percent change from baseline
Standard Error 19.09
1.76 percent change from baseline
Standard Error 8.96
4.82 percent change from baseline
Standard Error 16.53
-14.02 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
22.45 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
Aim 2: Percent Change From Baseline in Forearm Vascular Resistance
120 minutes
0.99 percent change from baseline
Standard Error 11.00
21.98 percent change from baseline
Standard Error 35.57
-24.81 percent change from baseline
Standard Error 1.18
-28.34 percent change from baseline
Standard Error 21.27
-32.39 percent change from baseline
Standard Error 8.90
-14.57 percent change from baseline
Standard Error 18.78
-22.37 percent change from baseline
Standard Error 6.11
-13.16 percent change from baseline
Standard Error 10.34
-16.20 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.
26.68 percent change from baseline
Standard Error NA
Cannot be determined with 1 participant.

SECONDARY outcome

Timeframe: baseline and every 30 minutes for 180 minutes

Population: Data from the first 14 subjects (7 men and 7 women) who completed both study days in Aim 1 were analyzed. We do not report tPA results from the remaining participants as the manufacturer changed the tPA assay standard and results were not comparable.

In Aim 1 subjects underwent two study days separated by a washout period. On one study day they received study drug and on another placebo, in a randomized double-blind fashion. Venous blood samples were obtained at each visit.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
n=7 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
Baseline prior to Arginine
0.30 IU/ml
Standard Error 0.05
0.28 IU/ml
Standard Error 0.05
0.44 IU/ml
Standard Error 0.14
0.22 IU/ml
Standard Error 0.07
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
30 minutes
0.40 IU/ml
Standard Error 0.04
0.32 IU/ml
Standard Error 0.04
0.28 IU/ml
Standard Error 0.08
0.25 IU/ml
Standard Error 0.07
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
60 minutes
0.40 IU/ml
Standard Error 0.06
0.32 IU/ml
Standard Error 0.05
0.37 IU/ml
Standard Error 0.09
0.34 IU/ml
Standard Error 0.08
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
150 minutes
0.44 IU/ml
Standard Error 0.04
0.41 IU/ml
Standard Error 0.04
0.42 IU/ml
Standard Error 0.12
0.37 IU/ml
Standard Error 0.08
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
45 minutes
0.43 IU/ml
Standard Error 0.04
0.35 IU/ml
Standard Error 0.04
0.40 IU/ml
Standard Error 0.10
0.32 IU/ml
Standard Error 0.08
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
90 minutes
0.39 IU/ml
Standard Error 0.07
0.35 IU/ml
Standard Error 0.06
0.34 IU/ml
Standard Error 0.09
0.27 IU/ml
Standard Error 0.07
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
120 minutes
0.40 IU/ml
Standard Error 0.07
0.35 IU/ml
Standard Error 0.04
0.38 IU/ml
Standard Error 0.12
0.28 IU/ml
Standard Error 0.07
Aim 1: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
180 minutes
0.55 IU/ml
Standard Error 0.06
0.50 IU/ml
Standard Error 0.05
0.51 IU/ml
Standard Error 0.12
0.45 IU/ml
Standard Error 0.09

SECONDARY outcome

Timeframe: baseline and every 30 minutes until 180 minutes

Population: Five of the original 29 women returned for two more study days separated by a wash-out. As pre-specified in the protocol, men did not complete this portion of the study. We do not report tPA results from participants who received LNMMA and Exendin 9-39 in this table as the manufacturer changed the tPA assay standard and results were not comparable.

Subjects undergo two study days separated by a washout period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized double-blind fashion. Tissue plasminogen activator activity (tPA) was assessed at each visit.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=5 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=5 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
180 minutes
0.35 IU/ml
Standard Error 0.06
0.23 IU/ml
Standard Error 0.05
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
Baseline prior to Arginine
0.24 IU/ml
Standard Error 0.05
0.10 IU/ml
Standard Error 0.03
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
30 minutes
0.26 IU/ml
Standard Error 0.04
0.15 IU/ml
Standard Error 0.05
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
45 minutes
0.33 IU/ml
Standard Error 0.06
0.17 IU/ml
Standard Error 0.06
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
60 minutes
0.27 IU/ml
Standard Error 0.08
0.14 IU/ml
Standard Error 0.04
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
90 minutes
0.26 IU/ml
Standard Error 0.07
0.16 IU/ml
Standard Error 0.05
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
120 minutes
0.28 IU/ml
Standard Error 0.08
0.16 IU/ml
Standard Error 0.05
Aim 2: Venous Blood Sampling for Tissue Plasminogen Activator (TPA) Activity Levels
150 minutes
0.31 IU/ml
Standard Error 0.07
0.20 IU/ml
Standard Error 0.05

SECONDARY outcome

Timeframe: baseline and every 30 minutes until 180 minutes

Population: Five of the original 29 women returned for an additional two study days separated by a wash-out period. As pre-specified in the protocol, men did not complete this portion of the study. We did not measure GH levels in participants who received LNMMA or Exendin 9-39 as these drugs are not known to influence GH secretion.

Subjects undergo two study days separated by a washout period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized double-blind fashion. Growth hormone secretion following arginine stimulation was assessed at each visit. Growth hormone levels were determined using an assay that is not subject to interference by pegvisomant.

Outcome measures

Outcome measures
Measure
Aim 1: Sitagliptin,Female Participants
n=5 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Female Participants
n=5 Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Sitagliptin, Male Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 1: Placebo, Male Participants
Subjects underwent two study days separated by a washout period. On one study day they received sitagliptin and on another placebo, in a randomized double-blind fashion. Growth hormone secretion was stimulated using arginine on each study day. Growth hormone levels were assessed during a 3 hour period following arginine stimulation.
Aim 2: Sitagliptin and Pegvisomant, Female Participants
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin & Placebo, Females in Pegvisomant Group
Five of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus pegvisomant and on another sitagliptin plus placebo, in a randomized cross-over fashion. The protocol specified a priori not to study men further if the first seven men randomized to sitagliptin vs. placebo in Aim 1 showed no effect of sitagliptin in men.
Aim 2: Sitagliptin and Exendin 9-39, Female Participants
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Females in Exendin 9-39 Group
Seven of the original 29 women returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Exendin 9-39, Male Participant
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Sitagliptin and Placebo, Male in Exendin 9-39 Group
One of the men from Aim 1 returned for an additional two study days separated by a wash-out period. On one study day they received sitagliptin plus Exendin 9-39 and on another sitagliptin plus placebo, in a randomized cross-over fashion.
Aim 2: Measurement of Growth Hormone (GH) Levels
30 minutes
2.99 ng/mL
Standard Error 1.60
4.27 ng/mL
Standard Error 2.19
Aim 2: Measurement of Growth Hormone (GH) Levels
60 minutes
5.92 ng/mL
Standard Error 2.37
7.00 ng/mL
Standard Error 2.20
Aim 2: Measurement of Growth Hormone (GH) Levels
90 minutes
6.05 ng/mL
Standard Error 2.39
11.53 ng/mL
Standard Error 4.67
Aim 2: Measurement of Growth Hormone (GH) Levels
120 minutes
4.06 ng/mL
Standard Error 2.18
6.17 ng/mL
Standard Error 1.21
Aim 2: Measurement of Growth Hormone (GH) Levels
150 minutes
1.83 ng/mL
Standard Error 0.83
4.09 ng/mL
Standard Error 1.33
Aim 2: Measurement of Growth Hormone (GH) Levels
180 minutes
1.57 ng/mL
Standard Error 0.82
1.77 ng/mL
Standard Error 0.32

Adverse Events

Sitagliptin

Serious events: 0 serious events
Other events: 7 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Sitagliptin Plus Pegvisomant

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Sitagliptin Plus LNMMA

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sitagliptin Plus Exendin 9-39

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Sitagliptin
n=40 participants at risk
Healthy lean adults completed a double blinded cross over study in which they took sitagliptin vs. placebo separated by a wash-out.
Placebo
n=43 participants at risk
Healthy lean adults completed a double blinded cross over study in which they took sitagliptin vs. placebo separated by a wash-out.
Sitagliptin Plus Pegvisomant
n=5 participants at risk
Five women from Aim 1 returned for an additional two study days in which they were randomized to sitagliptin plus placebo vs. sitagliptin plus pre-treatment with pegvisomant.
Sitagliptin Plus LNMMA
n=9 participants at risk
9 participants from Aim 1 returned for an additional two study days in which they were randomized to sitagliptin plus placebo vs. sitagliptin plus L-N-mono-methylarginine (LNMMA).
Sitagliptin Plus Exendin 9-39
n=8 participants at risk
8 participants from Aim 1 returned for an additional two study days in which they were randomized to sitagliptin plus placebo vs. sitagliptin plus Exendin 9-39.
Skin and subcutaneous tissue disorders
Bruising related to placement of intravenous catheter
7.5%
3/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Cardiac disorders
Palpitations
2.5%
1/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Gastrointestinal disorders
Nausea
7.5%
3/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
2.3%
1/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Ear and labyrinth disorders
Nasal congestion
2.5%
1/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Gastrointestinal disorders
Reflux
2.5%
1/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Nervous system disorders
Dizziness and paresthesias during arginine infusion
0.00%
0/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
20.0%
1/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
Gastrointestinal disorders
Abdominal cramping and diarrhea
0.00%
0/40 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/43 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
20.0%
1/5 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/9 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.
0.00%
0/8 • The first subject started drug 2/11/13 and the last completed 2/10/2017. In Aim 1, each subject took oral study drug (placebo vs. sitagliptin). Adverse event data was collected over a one month period for each subject. In Aim 2, each subject took oral sitagliptin and also received a single dose of LNMMA, Exendin 9-39 or Pegvisomant based upon their subgroup assigment. Adverse event data was collected over a 6 week period for each subject.

Additional Information

Dr. Jessica Devin

Vanderbilt University Medical Center

Phone: 6159361665

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place