ObesityNCT03967691
IL-6 Regulation of Substrate Metabolism and Influence of Obesity
A study testing Tocilizumab infusion and Saline 0.9% in people with Obesity and Healthy, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.
Trial summary
The aim of the study is to investigate the effects of blocking IL-6 signaling with tocilizumab on lipid, glucose and protein metabolism during rest and exercise in healthy and obese humans. Interleukin-6 is a molecule produced by a variety of cells and impacts on energy metabolism during fasting and fed conditions. Read more about this study
- Who is it for?
- Ages 18 to 60 years, men onlyHealthy volunteers can take part
- What is being tested?
- Tocilizumab infusion and Saline 0.9%
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 22 participants
- Where
- 1 siteDenmark
- Study dates
- 12 Jun 2019to 3 Apr 2020
- Phase
- Interventional
- 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 18 to 60 years
- Men only
- Healthy volunteers accepted
- Adult
Who may be able to join
- BMI < 18 and > 25 kg/m2 or ≥ 30 and ≤ 40 kg/m2
- Healthy (based on screening)
Who cannot join
- Smoking
- Severe thyroid or heart disease
- inflammatory diseases
- current infection
- liver disease
- kidney disease
Show all 17Show fewer
- immunosuppressive disease
- corticosteroid use
- regular NSAID usage
- aspirin use >100 mg/d
- history of carcinoma
- history of tuberculosis
- anemia
- neutropenia
- low platelets
- bleeding disorders
- obstructive pulmonary disease
Trial locations and contacts
1 site in 1 country.
Denmark1 site
Rigshospitalet, Centre of Inflammation and Metabolism (CIM) Centre for Physical Activity Research (CFAS)
Copenhagen, 2100
About this study
The aim of the study is to investigate the effects of blocking IL-6 signaling with tocilizumab on lipid, glucose and protein metabolism during rest and exercise in healthy and obese humans.
Interleukin-6 is a molecule produced by a variety of cells and impacts on energy metabolism during fasting and fed conditions. Systemic IL-6 levels are low but increase acutely in response to fasting, exercise and infection, and also chronically in response to obesity and other conditions of lowgrade inflammation.Our recent human intervention study showed that IL-6 receptor blockade prevents exercise training from reducing visceral fat mass.
Whether IL-6 receptor blockade directly regulates lipolysis and/or lipid oxidation in humans is however unclear. Therefore, this study will be performed to investigate the physiological role of IL-6 on lipid, glucose and protein metabolism in humans.
Read the detailed description
The aim of the study is to assess changes in substrate kinetics, that is, lipolytic rate, rate of appearance and disappearance of free fatty acids, fatty acid oxidation, glucose rate of appearance and disappearance and protein synthesis and degradation during rest and exercise with and without IL-6 receptor blockade. We will assess the acute effects of blocking IL-6 as well as the long-term consequences of IL-6 receptor blockade on all the above parameters.
Overall, we hypothesize that blocking IL-6 changes substrate kinetics. More specifically we hypothesize that blocking IL-6 reduces the appearance of free fatty acids, reduces the lipolytic rate and lipid oxidation. We hypothesize that the consequences of blocking IL-6 will be observed during resting and exercising conditions and both immediately and longterm after IL-6 receptor blockade. We hypothesize that IL-6 receptor blockade results in an increased respiratory exchange ratio (RER) and thus increased reliance on glucose as substrate.
In this study 10 healthy males and 10 obese males will be included. Subjects will be infused with saline on 2 of the study days and tocilizumab on 1 of the study days.
Isotope dilution techniques with [6,6-2H2]Glucose, [1,1,2,3,3-D5]glycerol, K-[U-13C16]palmitate, L-[ring-D5]phenylalanine, L-[D2]tyrosine will be applied to assess lipid, glucose and protein kinetics. Respiratory exchange ratio will be measured by indirect calorimetry. The BORG scale will be used to assess the perceived exertion during exercise.
- Being tested
- Tocilizumab infusion, Saline 0.9%
- Keywords
- Interleukin-6, Tocilizumab, Exercise, Substrate Metabolism, Lipolysis
- Medical subject headings
- Obesity, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Tocilizumab infusionDrug
Also called RoActemra
Tocilizumab (8mg/kg body weight diluted to 100 ml NaCl 0.9%) will be infused over 1 hour
Saline 0.9%Drug
Also called Saline
100 ml NaCl 0.9% will be infused over 1 hour
| Study group | Role | What they receive |
|---|---|---|
| Saline infusion | Placebo comparator | Subjects will be infused with saline (placebo) on study day 1 Receives: Drug: Saline 0.9% |
| Tocilizumab infusion | Active comparator | Subjects will be infused with tocilizumab on study day 2 Receives: Drug: Tocilizumab infusion |
| Saline infusion under tocilizumab influence | Other | Subjects will be infused withsaline (but still under the influence of tocilizumab) on study day 3 Receives: Drug: Saline 0.9% |
What is being measured
The primary outcome is the main question the study is designed to answer.
Lipolytic rate
Rate of appearance and disappearance of glycerol and palmitate, fatty acid oxidation during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Secondary outcomes (14)
Glucose kinetics
Rate of appearance and disappearance of glucose during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Protein metabolism
Rate of appearance and disappearance of phenylalanine and tyrosine during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Respiratory exchange ratio (RER)
RER during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Perceived exhaustion during exercise
Borg scale (rate of perceived exertion during exercise; score range from minimum 6 to maximum 20; 6 = "no feeling of exertion", 20 = "very, very hard") in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Glucose
Change in glucose during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Insulin
Changes in insulin during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
C-peptide
Change in c-peptide during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Glucagon
Change in glucagon during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Cortisol
Change in cortisol during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Adrenaline
Change in adrenaline during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Noradrenaline
Changes in noradrenaline during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Interleukin 6
Change in IL-6 during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Free fatty acids
Change in free fatty acids during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Triglycerides
Changes in triglycerides during rest and exercise in the presence of tocilizumab as compared to placebo
Measured: 0-28 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 May 2019
- Study start12 Jun 2019
- Primary completion3 Apr 2020
- Study completion3 Apr 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for ObesityStudies of the same condition, open and under way.
- More trials run by Copenhagen University Hospital, RigshospitaletThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Basic science
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Model description
- The study is designed in a placebo-controlled crossover manner, consisting of a screening visit and three study visits/study days. the Subjects will be infused with saline (placebo) on two of the study days and tocilizumab on one of the study days.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 22 participants (actual)
Sponsor and investigators
- Lead sponsor
- Copenhagen University Hospital, Rigshospitalet
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Helga Ellingsgaard, Copenhagen University Hospital, Rigshospitalet
- Investigators
- Helga Ellingsgaard, Ph.D., Principal investigator, CFAS, Rigshospitalet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03967691
- Sponsor's protocol ID
- TOSS
- Status last verified
- Oct 2020
- First submitted
- 22 May 2019
- Last updated
- 8 Oct 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Trinh B, Peletier M, Simonsen C, Plomgaard P, Karstoft K, Pedersen BK, van Hall G, Ellingsgaard H. Amino Acid Metabolism and Protein Turnover in Lean and Obese Humans During Exercise-Effect of IL-6 Receptor Blockade. J Clin Endocrinol Metab. 2022 Jun 16;107(7):1854-1864. doi: 10.1210/clinem/dgac239.
PubMed 35442403Trinh B, Peletier M, Simonsen C, Plomgaard P, Karstoft K, Klarlund Pedersen B, van Hall G, Ellingsgaard H. Blocking endogenous IL-6 impairs mobilization of free fatty acids during rest and exercise in lean and obese men. Cell Rep Med. 2021 Sep 9;2(9):100396. doi: 10.1016/j.xcrm.2021.100396. eCollection 2021 Sep 21.
PubMed 34622233
Study at a glance
From the registry record, last updated by the sponsor on 8 Oct 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- IL-6 Regulation of Substrate Metabolism and Influence of Obesity
- ClinicalTrials.gov ID
- NCT03967691
- Acronym / sponsor ID
- TOSS
- Keywords
- Interleukin-6, Tocilizumab, Exercise, Substrate Metabolism, Lipolysis
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 22 participants (actual)
- Lead sponsor
- Copenhagen University Hospital, RigshospitaletUniversity, hospital or other
- Study start
- 12 Jun 2019 (actual)
- Primary completion
- 3 Apr 2020 (actual)
- Study completion
- 3 Apr 2020 (actual)
- First posted
- 30 May 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of the study is to investigate the effects of blocking IL-6 signaling with tocilizumab on lipid, glucose and protein metabolism during rest and exercise in healthy and obese humans.
Interleukin-6 is a molecule produced by a variety of cells and impacts on energy metabolism during fasting and fed conditions. Systemic IL-6 levels are low but increase acutely in response to fasting, exercise and infection, and also chronically in response to obesity and other conditions of lowgrade inflammation.Our recent human intervention study showed that IL-6 receptor blockade prevents exercise training from reducing visceral fat mass.
Whether IL-6 receptor blockade directly regulates lipolysis and/or lipid oxidation in humans is however unclear. Therefore, this study will be performed to investigate the physiological role of IL-6 on lipid, glucose and protein metabolism in humans.
Detailed description
The aim of the study is to assess changes in substrate kinetics, that is, lipolytic rate, rate of appearance and disappearance of free fatty acids, fatty acid oxidation, glucose rate of appearance and disappearance and protein synthesis and degradation during rest and exercise with and without IL-6 receptor blockade. We will assess the acute effects of blocking IL-6 as well as the long-term consequences of IL-6 receptor blockade on all the above parameters.
Overall, we hypothesize that blocking IL-6 changes substrate kinetics. More specifically we hypothesize that blocking IL-6 reduces the appearance of free fatty acids, reduces the lipolytic rate and lipid oxidation. We hypothesize that the consequences of blocking IL-6 will be observed during resting and exercising conditions and both immediately and longterm after IL-6 receptor blockade. We hypothesize that IL-6 receptor blockade results in an increased respiratory exchange ratio (RER) and thus increased reliance on glucose as substrate.
In this study 10 healthy males and 10 obese males will be included. Subjects will be infused with saline on 2 of the study days and tocilizumab on 1 of the study days.
Isotope dilution techniques with [6,6-2H2]Glucose, [1,1,2,3,3-D5]glycerol, K-[U-13C16]palmitate, L-[ring-D5]phenylalanine, L-[D2]tyrosine will be applied to assess lipid, glucose and protein kinetics. Respiratory exchange ratio will be measured by indirect calorimetry. The BORG scale will be used to assess the perceived exertion during exercise.
Study design
- Primary purpose
- Basic science
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 3
- Model description
- The study is designed in a placebo-controlled crossover manner, consisting of a screening visit and three study visits/study days. the Subjects will be infused with saline (placebo) on two of the study days and tocilizumab on one of the study days.
| Arm | Type | Receives |
|---|---|---|
| Saline infusion | Placebo comparator | Drug: Saline 0.9%Subjects will be infused with saline (placebo) on study day 1 |
| Tocilizumab infusion | Active comparator | Drug: Tocilizumab infusionSubjects will be infused with tocilizumab on study day 2 |
| Saline infusion under tocilizumab influence | Other | Drug: Saline 0.9%Subjects will be infused withsaline (but still under the influence of tocilizumab) on study day 3 |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- BMI < 18 and > 25 kg/m2 or ≥ 30 and ≤ 40 kg/m2
- Healthy (based on screening)
Key exclusion criteria (17 listed)
- Smoking
- Severe thyroid or heart disease
- inflammatory diseases
- current infection
- liver disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Tocilizumab infusionAlso: RoActemraTocilizumab (8mg/kg body weight diluted to 100 ml NaCl 0.9%) will be infused over 1 hour | Drug | Tocilizumab infusion |
| Saline 0.9%Also: Saline100 ml NaCl 0.9% will be infused over 1 hour | Drug | Saline infusion, Saline infusion under tocilizumab influence |
Primary outcome
Lipolytic rate
Time frame: 0-28 days
Rate of appearance and disappearance of glycerol and palmitate, fatty acid oxidation during rest and exercise in the presence of tocilizumab as compared to placebo
14 secondary outcomes
Glucose kinetics
Time frame: 0-28 days
Protein metabolism
Time frame: 0-28 days
Respiratory exchange ratio (RER)
Time frame: 0-28 days
Perceived exhaustion during exercise
Time frame: 0-28 days
Glucose
Time frame: 0-28 days
Insulin
Time frame: 0-28 days
C-peptide
Time frame: 0-28 days
Glucagon
Time frame: 0-28 days
Cortisol
Time frame: 0-28 days
Adrenaline
Time frame: 0-28 days
Noradrenaline
Time frame: 0-28 days
Interleukin 6
Time frame: 0-28 days
Free fatty acids
Time frame: 0-28 days
Triglycerides
Time frame: 0-28 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Oct 2020.
- Derived from this study: PubMed 35442403Trinh B, Peletier M, Simonsen C, Plomgaard P, Karstoft K, Pedersen BK, van Hall G, Ellingsgaard H. Amino Acid Metabolism and Protein Turnover in Lean and Obese Humans During Exercise-Effect of IL-6 Receptor Blockade. J Clin Endocrinol Metab. 2022 Jun 16;107(7):1854-1864. doi: 10.1210/clinem/dgac239.
- Derived from this study: PubMed 34622233Trinh B, Peletier M, Simonsen C, Plomgaard P, Karstoft K, Klarlund Pedersen B, van Hall G, Ellingsgaard H. Blocking endogenous IL-6 impairs mobilization of free fatty acids during rest and exercise in lean and obese men. Cell Rep Med. 2021 Sep 9;2(9):100396. doi: 10.1016/j.xcrm.2021.100396. eCollection 2021 Sep 21.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Helga Ellingsgaard, Ph.D. principal investigator
CFAS, Rigshospitalet
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Tocilizumab infusion and Saline 0.9% in people with Obesity and Healthy, run by Copenhagen University Hospital, Rigshospitalet at 1 site 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 17 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 8 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
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?
Lipolytic rate (time frame: 0-28 days). 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 NCT03967691, 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 8 Oct 2020.