11β-Hydroxysteroid dehydrogenase type 1 inhibition in idiopathic intracranial hypertension: a double-blind randomized controlled trial

Abstract Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hyp...

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Published inBrain communications Vol. 2; no. 1; p. fcz050
Main Authors Markey, Keira, Mitchell, James, Botfield, Hannah, Ottridge, Ryan S, Matthews, Tim, Krishnan, Anita, Woolley, Rebecca, Westgate, Connar, Yiangou, Andreas, Alimajstorovic, Zerin, Shah, Pushkar, Rick, Caroline, Ives, Natalie, Taylor, Angela E, Gilligan, Lorna C, Jenkinson, Carl, Arlt, Wiebke, Scotton, William, Fairclough, Rebecca J, Singhal, Rishi, Stewart, Paul M, Tomlinson, Jeremy W, Lavery, Gareth G, Mollan, Susan P, Sinclair, Alexandra J
Format Journal Article
LanguageEnglish
Published England Oxford University Press 2020
Subjects
Online AccessGet full text
ISSN2632-1297
2632-1297
DOI10.1093/braincomms/fcz050

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Abstract Abstract Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18–55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: −2.8, 95% confidence interval: −7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: −4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: −0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest. Preclinical research highlighted the role of 11β-hydroxysteroid dehydrogenase type 1 inhibition in modulating intracranial pressure. We report the first phase II randomized clinical trial in idiopathic intracranial hypertension evaluating safety, tolerability, in vivo efficacy and initial clinical efficacy of a novel inhibitor of 11β-hydroxysteroid dehydrogenase type 1 to lower intracranial pressure in active idiopathic intracranial hypertension. Graphical Abstract Graphical Abstract
AbstractList Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18–55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: −2.8, 95% confidence interval: −7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: −4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: −0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest. Preclinical research highlighted the role of 11β-hydroxysteroid dehydrogenase type 1 inhibition in modulating intracranial pressure. We report the first phase II randomized clinical trial in idiopathic intracranial hypertension evaluating safety, tolerability, in vivo efficacy and initial clinical efficacy of a novel inhibitor of 11β-hydroxysteroid dehydrogenase type 1 to lower intracranial pressure in active idiopathic intracranial hypertension. Graphical Abstract
Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18-55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: -2.8, 95% confidence interval: -7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: -4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: -0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest.Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18-55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: -2.8, 95% confidence interval: -7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: -4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: -0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest.
Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18-55 years with active idiopathic intracranial hypertension (>25 cmH O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m ] were randomized to AZD4017 (  = 17) or placebo (  = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH O) compared with placebo (31.3 cmH O), but the difference between groups was not statistically significant (mean difference: -2.8, 95% confidence interval: -7.1 to 1.5; = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: -4.3 cmH O (SD = 5.7); = 0.009] but not in the placebo group [mean change: -0.3 cmH O (SD = 5.9); = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (  = 0.005,  = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity . Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest.
Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18–55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: −2.8, 95% confidence interval: −7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: −4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: −0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest.
Abstract Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations in intracranial pressure in idiopathic intracranial hypertension. We assessed therapeutic efficacy, safety and tolerability and investigated indicators of in vivo efficacy of the 11β-hydroxysteroid dehydrogenase type 1 inhibitor AZD4017 compared with placebo in idiopathic intracranial hypertension. A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017 or placebo was conducted. Women aged 18–55 years with active idiopathic intracranial hypertension (>25 cmH2O lumbar puncture opening pressure and active papilledema) were included. Participants received 400 mg of oral AZD4017 twice daily compared with matching placebo over 12 weeks. The outcome measures were initial efficacy, safety and tolerability. The primary clinical outcome was lumbar puncture opening pressure at 12 weeks analysed by intention-to-treat. Secondary clinical outcomes were symptoms, visual function, papilledema, headache and anthropometric measures. In vivo efficacy was evaluated in the central nervous system and systemically. A total of 31 subjects [mean age 31.2 (SD = 6.9) years and body mass index 39.2 (SD = 12.6) kg/m2] were randomized to AZD4017 (n = 17) or placebo (n = 14). At 12 weeks, lumbar puncture pressure was lower in the AZD4017 group (29.7 cmH2O) compared with placebo (31.3 cmH2O), but the difference between groups was not statistically significant (mean difference: −2.8, 95% confidence interval: −7.1 to 1.5; P = 0.2). An exploratory analysis assessing mean change in lumbar puncture pressure within each group found a significant decrease in the AZD4017 group [mean change: −4.3 cmH2O (SD = 5.7); P = 0.009] but not in the placebo group [mean change: −0.3 cmH2O (SD = 5.9); P = 0.8]. AZD4017 was safe, with no withdrawals related to adverse effects. Nine transient drug-related adverse events were reported. One serious adverse event occurred in the placebo group (deterioration requiring shunt surgery). In vivo biomarkers of 11β-hydroxysteroid dehydrogenase type 1 activity (urinary glucocorticoid metabolites, hepatic prednisolone generation, serum and cerebrospinal fluid cortisol:cortisone ratios) demonstrated significant enzyme inhibition with the reduction in serum cortisol:cortisone ratio correlating significantly with reduction in lumbar puncture pressure (P = 0.005, R = 0.70). This is the first phase II randomized controlled trial in idiopathic intracranial hypertension evaluating a novel therapeutic target. AZD4017 was safe and well tolerated and inhibited 11β-hydroxysteroid dehydrogenase type 1 activity in vivo. Reduction in serum cortisol:cortisone correlated with decreased intracranial pressure. Possible clinical benefits were noted in this small cohort. A longer, larger study would now be of interest. Preclinical research highlighted the role of 11β-hydroxysteroid dehydrogenase type 1 inhibition in modulating intracranial pressure. We report the first phase II randomized clinical trial in idiopathic intracranial hypertension evaluating safety, tolerability, in vivo efficacy and initial clinical efficacy of a novel inhibitor of 11β-hydroxysteroid dehydrogenase type 1 to lower intracranial pressure in active idiopathic intracranial hypertension. Graphical Abstract Graphical Abstract
Author Gilligan, Lorna C
Botfield, Hannah
Mollan, Susan P
Markey, Keira
Stewart, Paul M
Scotton, William
Sinclair, Alexandra J
Matthews, Tim
Fairclough, Rebecca J
Yiangou, Andreas
Westgate, Connar
Singhal, Rishi
Krishnan, Anita
Rick, Caroline
Ives, Natalie
Tomlinson, Jeremy W
Alimajstorovic, Zerin
Arlt, Wiebke
Ottridge, Ryan S
Woolley, Rebecca
Shah, Pushkar
Taylor, Angela E
Jenkinson, Carl
Lavery, Gareth G
Mitchell, James
AuthorAffiliation 5 Birmingham Clinical Trials Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham , Birmingham B15 2TT, UK
3 Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital , Birmingham B15 2WB, UK
1 Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham , Birmingham B15 2TT, UK
12 Medical School, University of Leeds , Leeds LS2 9JT, UK
9 Nottingham Clinical Trials Unit, Queens Medical Centre , Nottingham NG7 2UH, UK
10 Emerging Innovations Unit, Discovery Sciences , BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0SL, UK
7 Department of Neurology, The Walton Centre NHS Foundation Trust , Liverpool L9 7LJ, UK
13 Oxford Centre for Diabetes, Endocrinology & Metabolism (OCDEM), NIHR Oxford Biomedical Research Centre, University of Oxford , Churchill Hospital, Headington, Oxford OX3 7LJ, UK
11 Upper GI Unit and Minimally Invasive Unit, Heartland
AuthorAffiliation_xml – name: 8 Institute of Neurological Sciences, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde , Glasgow G51 4TF, UK
– name: 3 Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital , Birmingham B15 2WB, UK
– name: 6 Birmingham Neuro-Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital , Birmingham B15 2WB, UK
– name: 12 Medical School, University of Leeds , Leeds LS2 9JT, UK
– name: 5 Birmingham Clinical Trials Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham , Birmingham B15 2TT, UK
– name: 2 Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TH, UK
– name: 4 Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham , Birmingham B15 2TT, UK
– name: 7 Department of Neurology, The Walton Centre NHS Foundation Trust , Liverpool L9 7LJ, UK
– name: 11 Upper GI Unit and Minimally Invasive Unit, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B9 5SS, UK
– name: 10 Emerging Innovations Unit, Discovery Sciences , BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0SL, UK
– name: 13 Oxford Centre for Diabetes, Endocrinology & Metabolism (OCDEM), NIHR Oxford Biomedical Research Centre, University of Oxford , Churchill Hospital, Headington, Oxford OX3 7LJ, UK
– name: 1 Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham , Birmingham B15 2TT, UK
– name: 9 Nottingham Clinical Trials Unit, Queens Medical Centre , Nottingham NG7 2UH, UK
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  organization: Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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  organization: Institute of Neurological Sciences, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow G51 4TF, UK
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  organization: Nottingham Clinical Trials Unit, Queens Medical Centre, Nottingham NG7 2UH, UK
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  organization: Birmingham Clinical Trials Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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– sequence: 18
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  fullname: Scotton, William
  organization: Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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  givenname: Rebecca J
  surname: Fairclough
  fullname: Fairclough, Rebecca J
  organization: Emerging Innovations Unit, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0SL, UK
– sequence: 20
  givenname: Rishi
  surname: Singhal
  fullname: Singhal, Rishi
  organization: Upper GI Unit and Minimally Invasive Unit, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B9 5SS, UK
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  organization: Medical School, University of Leeds, Leeds LS2 9JT, UK
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  surname: Tomlinson
  fullname: Tomlinson, Jeremy W
  organization: Oxford Centre for Diabetes, Endocrinology & Metabolism (OCDEM), NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Headington, Oxford OX3 7LJ, UK
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  givenname: Susan P
  surname: Mollan
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  organization: Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
– sequence: 25
  givenname: Alexandra J
  orcidid: 0000-0001-9396-7330
  surname: Sinclair
  fullname: Sinclair, Alexandra J
  email: a.b.sinclair@bham.ac.uk
  organization: Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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Cites_doi 10.1097/WNO.0000000000000114
10.1038/s41433-018-0238-5
10.1186/s10194-015-0521-9
10.1016/S1474-4422(15)00298-7
10.1111/cen.13889
10.1136/practneurol-2018-002009
10.1210/jc.2015-1516
10.1210/er.2012-1050
10.1016/S2213-8587(13)70170-0
10.1053/beem.2000.0119
10.1016/j.mce.2003.11.015
10.1210/jc.2007-1912
10.1016/j.brainres.2014.11.031
10.1212/WNL.0b013e3182a55f17
10.1136/jnnp.45.1.13
10.1136/bmjophth-2016-000063
10.1136/bmj.c2701
10.1210/jc.2010-0729
10.1158/0008-5472.CAN-11-3980
10.1111/j.1365-2826.2007.01569.x
10.1136/jnnp-2017-317440
10.1007/s00415-010-5861-4
10.1016/j.vaccine.2016.04.032
10.1016/j.ajo.2006.12.040
10.1136/practneurol-2014-000821
10.1111/cen.12834
10.2196/resprot.7806
10.1177/0333102418776455
10.1371/journal.pone.0124582
10.1007/s11695-016-2467-7
10.1001/jama.2014.3312
10.1186/s10194-018-0919-2
10.1126/scitranslmed.aan0972
10.2337/diabetes.54.3.872
ContentType Journal Article
Copyright The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain. 2020
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Issue 1
Keywords phase II
11β-hydroxysteroid dehydrogenase type 1
idiopathic intracranial hypertension
papilloedema
randomized controlled trial
Language English
License This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
http://creativecommons.org/licenses/by/4.0
The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain.
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Keira Markey, James Mitchell and Hannah Botfield contributed equally to this work.
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References Markey (2020081109064817400_fcz050-B26) 2017; 6
Piper (2020081109064817400_fcz050-B35) 2015
Sinclair (2020081109064817400_fcz050-B43) 2010; 95
Colquitt (2020081109064817400_fcz050-B10) 2014; 8
Schwab (2020081109064817400_fcz050-B39) 2017; 1
Frisen (2020081109064817400_fcz050-B17) 1982; 45
Mulla (2020081109064817400_fcz050-B32) 2015; 16
(2020081109064817400_fcz050-B3) 2000
Friedman (2020081109064817400_fcz050-B15) 2013; 81
(2020081109064817400_fcz050-B5) 2000
Friedman (2020081109064817400_fcz050-B16) 2014; 34
Mollan (2020081109064817400_fcz050-B30) 2014; 14
Markey (2020081109064817400_fcz050-B25) 2016; 15
Wake (2020081109064817400_fcz050-B46) 2004; 215
Sagmeister (2020081109064817400_fcz050-B37) 2018; 90
(2020081109064817400_fcz050-B1) 2000
Hassan-Smith (2020081109064817400_fcz050-B19) 2015; 100
Manfield (2020081109064817400_fcz050-B24) 2017; 27
Mollan (2020081109064817400_fcz050-B27) 2018; 33
Sinclair (2020081109064817400_fcz050-B42) 2007; 19
Bayliss (2020081109064817400_fcz050-B7) 2003
Mooij (2020081109064817400_fcz050-B31) 2015; 83
Long (2020081109064817400_fcz050-B23) 2016; 34
Tomlinson (2020081109064817400_fcz050-B45) 2001; 15
Hoffmann (2020081109064817400_fcz050-B20) 2018; 19
Sandeep (2020081109064817400_fcz050-B38) 2005; 54
(2020081109064817400_fcz050-B4) 2000
Eftekhari (2020081109064817400_fcz050-B14) 2015; 1600
Sinclair (2020081109064817400_fcz050-B41) 2010; 341
Wall (2020081109064817400_fcz050-B33) 2014; 311
Juhlen (2020081109064817400_fcz050-B22) 2015; 10
Ball (2020081109064817400_fcz050-B6) 2011; 258
Courtney (2020081109064817400_fcz050-B11) 2008; 93
O'Reilly (2020081109064817400_fcz050-B34) 5348
Mollan (2020081109064817400_fcz050-B28) 2018; 89
Botfield (2020081109064817400_fcz050-B8) 2017; 9
Daniels (2020081109064817400_fcz050-B12) 2007; 143
Mollan (2020081109064817400_fcz050-B29) 2018; 18
Richards (2020081109064817400_fcz050-B36) 2012; 72
Scotton (2020081109064817400_fcz050-B40) 2019; 39
Hornby (2020081109064817400_fcz050-B21) 2018
Gathercole (2020081109064817400_fcz050-B18) 2013; 34
Davson (2020081109064817400_fcz050-B13) 1966
Stefan (2020081109064817400_fcz050-B44) 2014; 2
(2020081109064817400_fcz050-B2) 2000
Boyle (2020081109064817400_fcz050-B9) 2008; 11
32955507 - Brain Commun. 2020 Aug 25;2(2):fcaa108. doi: 10.1093/braincomms/fcaa108.
References_xml – start-page: CD003434
  year: 2015
  ident: 2020081109064817400_fcz050-B35
  article-title: Interventions for idiopathic intracranial hypertension
  publication-title: Cochrane Database Syst Rev
– volume: 34
  start-page: 107
  year: 2014
  ident: 2020081109064817400_fcz050-B16
  article-title: The idiopathic intracranial hypertension treatment trial: design considerations and methods
  publication-title: J Neuroophthalmol
  doi: 10.1097/WNO.0000000000000114
– volume: 33
  start-page: 478
  year: 2018
  ident: 2020081109064817400_fcz050-B27
  article-title: The expanding burden of idiopathic intracranial hypertension
  publication-title: Eye (London)
  doi: 10.1038/s41433-018-0238-5
– volume: 16
  start-page: 521
  year: 2015
  ident: 2020081109064817400_fcz050-B32
  article-title: Headache determines quality of life in idiopathic intracranial hypertension
  publication-title: J Headache Pain
  doi: 10.1186/s10194-015-0521-9
– volume: 8
  start-page: CD003641
  year: 2014
  ident: 2020081109064817400_fcz050-B10
  article-title: Surgery for weight loss in adults
  publication-title: Cochrane Database Syst Rev
– volume: 15
  start-page: 78
  year: 2016
  ident: 2020081109064817400_fcz050-B25
  article-title: Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions
  publication-title: Lancet Neurol
  doi: 10.1016/S1474-4422(15)00298-7
– volume: 90
  start-page: 241
  year: 2018
  ident: 2020081109064817400_fcz050-B37
  article-title: Glucocorticoid activation by 11beta-hydroxysteroid dehydrogenase enzymes in relation to inflammation and glycaemic control in chronic kidney disease: a cross-sectional study
  publication-title: Clin Endocrinol
  doi: 10.1111/cen.13889
– year: 2000
  ident: 2020081109064817400_fcz050-B1
– start-page: 238
  year: 1966
  ident: 2020081109064817400_fcz050-B13
  article-title: Formation and drainage of the cerebrospinal fluid
  publication-title: Sci Basis Med Annu Rev
– year: 2000
  ident: 2020081109064817400_fcz050-B3
– volume: 18
  start-page: 485
  year: 2018
  ident: 2020081109064817400_fcz050-B29
  article-title: Evaluation and management of adult idiopathic intracranial hypertension
  publication-title: Pract Neurol
  doi: 10.1136/practneurol-2018-002009
– volume: 100
  start-page: 2673
  year: 2015
  ident: 2020081109064817400_fcz050-B19
  article-title: Gender-specific differences in skeletal muscle 11beta-HSD1 expression across healthy aging
  publication-title: J Clin Endocrinol Metab
  doi: 10.1210/jc.2015-1516
– volume: 34
  start-page: 525
  year: 2013
  ident: 2020081109064817400_fcz050-B18
  article-title: 11β-Hydroxysteroid dehydrogenase 1: translational and therapeutic aspects
  publication-title: Endocr Rev
  doi: 10.1210/er.2012-1050
– volume: 2
  start-page: 406
  year: 2014
  ident: 2020081109064817400_fcz050-B44
  article-title: Inhibition of 11beta-HSD1 with RO5093151 for non-alcoholic fatty liver disease: a multicentre, randomised, double-blind, placebo-controlled trial
  publication-title: Lancet Diabetes Endocrinol
  doi: 10.1016/S2213-8587(13)70170-0
– volume: 15
  start-page: 61
  year: 2001
  ident: 2020081109064817400_fcz050-B45
  article-title: Cortisol metabolism and the role of 11beta-hydroxysteroid dehydrogenase
  publication-title: Best Pract Res Clin Endocrinol Metab
  doi: 10.1053/beem.2000.0119
– volume: 215
  start-page: 45
  year: 2004
  ident: 2020081109064817400_fcz050-B46
  article-title: 11 beta-hydroxysteroid dehydrogenase type 1 in obesity and the metabolic syndrome
  publication-title: Mol Cell Endocrinol
  doi: 10.1016/j.mce.2003.11.015
– volume: 93
  start-page: 550
  year: 2008
  ident: 2020081109064817400_fcz050-B11
  article-title: Modulation of 11β-hydroxysteroid dehydrogenase (11βHSD) activity biomarkers and pharmacokinetics of PF-00915275, a selective 11βHSD1 inhibitor
  publication-title: J Clin Endocrinol Metab
  doi: 10.1210/jc.2007-1912
– volume: 1600
  start-page: 93
  year: 2015
  ident: 2020081109064817400_fcz050-B14
  article-title: Localization of CGRP, CGRP receptor, PACAP and glutamate in trigeminal ganglion. Relation to the blood–brain barrier
  publication-title: Brain Res
  doi: 10.1016/j.brainres.2014.11.031
– volume: 81
  start-page: 1159
  year: 2013
  ident: 2020081109064817400_fcz050-B15
  article-title: Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children
  publication-title: Neurology
  doi: 10.1212/WNL.0b013e3182a55f17
– year: 5348
  ident: 2020081109064817400_fcz050-B34
  article-title: A unique androgen excess signature in idiopathic intracranial hypertension is linked to cerebrospinal fluid dynamics
  publication-title: JCI Insight
– volume: 45
  start-page: 13
  year: 1982
  ident: 2020081109064817400_fcz050-B17
  article-title: Swelling of the optic nerve head: a staging scheme
  publication-title: J Neurol Neurosurg Psychiatry
  doi: 10.1136/jnnp.45.1.13
– volume: 1
  start-page: e000063
  year: 2017
  ident: 2020081109064817400_fcz050-B39
  article-title: Oral administration of the 11β-hydroxysteroid-dehydrogenase type 1 inhibitor RO5093151 to patients with glaucoma: an adaptive, randomised, placebo-controlled clinical study
  publication-title: BMJ Open Ophthalmol
  doi: 10.1136/bmjophth-2016-000063
– start-page: 1
  year: 2018
  ident: 2020081109064817400_fcz050-B21
  article-title: Metabolic concepts in idiopathic intracranial hypertension and their potential for therapeutic intervention
  publication-title: J Neuroophthalmol
– volume: 341
  start-page: c2701
  year: 2010
  ident: 2020081109064817400_fcz050-B41
  article-title: Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study
  publication-title: BMJ
  doi: 10.1136/bmj.c2701
– volume: 95
  start-page: 5348
  year: 2010
  ident: 2020081109064817400_fcz050-B43
  article-title: Cerebrospinal fluid corticosteroid levels and cortisol metabolism in patients with idiopathic intracranial hypertension: a link between 11beta-HSD1 and intracranial pressure regulation?
  publication-title: J Clin Endocrinol Metab
  doi: 10.1210/jc.2010-0729
– year: 2000
  ident: 2020081109064817400_fcz050-B2
– volume: 72
  start-page: 2176
  year: 2012
  ident: 2020081109064817400_fcz050-B36
  article-title: Interactions of abiraterone, eplerenone, and prednisolone with wild-type and mutant androgen receptor: a rationale for increasing abiraterone exposure or combining with MDV3100
  publication-title: Cancer Res
  doi: 10.1158/0008-5472.CAN-11-3980
– volume: 19
  start-page: 614
  year: 2007
  ident: 2020081109064817400_fcz050-B42
  article-title: Corticosteroids, 11beta-hydroxysteroid dehydrogenase isozymes and the rabbit choroid plexus
  publication-title: J Neuroendocrinol
  doi: 10.1111/j.1365-2826.2007.01569.x
– volume: 89
  start-page: 1088
  year: 2018
  ident: 2020081109064817400_fcz050-B28
  article-title: Idiopathic intracranial hypertension: consensus guidelines on management
  publication-title: J Neurol Neurosurg Psychiatry
  doi: 10.1136/jnnp-2017-317440
– volume: 258
  start-page: 874
  year: 2011
  ident: 2020081109064817400_fcz050-B6
  article-title: A randomised controlled trial of treatment for idiopathic intracranial hypertension
  publication-title: J Neurol
  doi: 10.1007/s00415-010-5861-4
– volume: 34
  start-page: 2679
  year: 2016
  ident: 2020081109064817400_fcz050-B23
  article-title: Morning vaccination enhances antibody response over afternoon vaccination: a cluster-randomised trial
  publication-title: Vaccine
  doi: 10.1016/j.vaccine.2016.04.032
– volume: 143
  start-page: 635
  year: 2007
  ident: 2020081109064817400_fcz050-B12
  article-title: Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension (pseudotumor cerebri)
  publication-title: Am J Ophthalmol
  doi: 10.1016/j.ajo.2006.12.040
– volume: 14
  start-page: 380
  year: 2014
  ident: 2020081109064817400_fcz050-B30
  article-title: A practical approach to, diagnosis, assessment and management of idiopathic intracranial hypertension
  publication-title: Pract Neurol
  doi: 10.1136/practneurol-2014-000821
– volume: 83
  start-page: 629
  year: 2015
  ident: 2020081109064817400_fcz050-B31
  article-title: Characterization of the molecular genetic pathology in patients with 11beta-hydroxylase deficiency
  publication-title: Clin Endocrinol
  doi: 10.1111/cen.12834
– year: 2000
  ident: 2020081109064817400_fcz050-B5
– start-page: 386
  volume-title: Frontiers in headache research reducing the burden of headache
  year: 2003
  ident: 2020081109064817400_fcz050-B7
– volume: 6
  start-page: e181
  year: 2017
  ident: 2020081109064817400_fcz050-B26
  article-title: Assessing the efficacy and safety of an 11beta-hydroxysteroid dehydrogenase type 1 inhibitor (AZD4017) in the idiopathic intracranial hypertension drug trial, IIH:DT: clinical methods and design for a phase II randomized controlled trial
  publication-title: JMIR Res Protoc
  doi: 10.2196/resprot.7806
– volume: 39
  start-page: 209
  year: 2019
  ident: 2020081109064817400_fcz050-B40
  article-title: Topiramate is more effective than acetazolamide at lowering intracranial pressure
  publication-title: Cephalalgia
  doi: 10.1177/0333102418776455
– volume: 11
  start-page: 495
  year: 2008
  ident: 2020081109064817400_fcz050-B9
  article-title: Recent advances in the discovery of 11beta-HSD1 inhibitors
  publication-title: Curr Opin Drug Discov Dev
– volume: 10
  start-page: e0124582
  year: 2015
  ident: 2020081109064817400_fcz050-B22
  article-title: Role of ALADIN in human adrenocortical cells for oxidative stress response and steroidogenesis
  publication-title: PLoS One
  doi: 10.1371/journal.pone.0124582
– volume: 27
  start-page: 513
  year: 2017
  ident: 2020081109064817400_fcz050-B24
  article-title: Bariatric surgery or non-surgical weight loss for idiopathic intracranial hypertension? A systematic review and comparison of meta-analyses
  publication-title: Obes Surg
  doi: 10.1007/s11695-016-2467-7
– volume: 311
  start-page: 1641
  year: 2014
  ident: 2020081109064817400_fcz050-B33
  article-title: Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial
  publication-title: JAMA
  doi: 10.1001/jama.2014.3312
– volume: 19
  start-page: 93
  year: 2018
  ident: 2020081109064817400_fcz050-B20
  article-title: European headache federation guideline on idiopathic intracranial hypertension
  publication-title: J Headache Pain
  doi: 10.1186/s10194-018-0919-2
– year: 2000
  ident: 2020081109064817400_fcz050-B4
– volume: 9
  start-page: 404
  year: 2017
  ident: 2020081109064817400_fcz050-B8
  article-title: A glucagon-like peptide-1 receptor agonist reduces intracranial pressure in a rat model of hydrocephalus
  publication-title: Sci Transl Med
  doi: 10.1126/scitranslmed.aan0972
– volume: 54
  start-page: 872
  year: 2005
  ident: 2020081109064817400_fcz050-B38
  article-title: Increased in vivo regeneration of cortisol in adipose tissue in human obesity and effects of the 11beta-hydroxysteroid dehydrogenase type 1 inhibitor carbenoxolone
  publication-title: Diabetes
  doi: 10.2337/diabetes.54.3.872
– reference: 32955507 - Brain Commun. 2020 Aug 25;2(2):fcaa108. doi: 10.1093/braincomms/fcaa108.
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Snippet Abstract Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in...
Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating...
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Title 11β-Hydroxysteroid dehydrogenase type 1 inhibition in idiopathic intracranial hypertension: a double-blind randomized controlled trial
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