Efficacy and safety of systemic, high-dose glucocorticoid therapy for idiopathic sudden sensorineural hearing loss : Study protocol for a three-armed, randomized, triple-blind, multicenter trial (HODOKORT)
© 2022. The Author(s)..
BACKGROUND: Systemic glucocorticosteroids ("steroids") are widely used worldwide as a standard of care for primary therapy of idiopathic sudden sensorineural hearing loss (ISSHL). The German ISSHL guideline recommends high-dose steroids without evidence from randomized controlled trials (RCTs) and refers solely to retrospective cohort studies. This RCT aims to assess the efficacy (improvement in hearing) and safety (especially systemic side effects) of high-dose steroids versus standard of care (standard dose systemic steroids) for the treatment of unilateral ISSHL, when given as a primary therapy.
METHODS: The study is designed as a multicenter (approximately 40 centers), randomized, triple-blind, three-armed, parallel group, clinical trial with 312 adult patients. The interventions consist of 5 days of 250 mg/day intravenous prednisolone (intervention 1) + oral placebo, or 5 days of 40 mg/day oral dexamethasone (intervention 2) + intravenous placebo. The control intervention consists of 60 mg oral prednisolone for 5 days followed by five tapering doses + intravenous placebo. The primary efficacy endpoint is the change in hearing threshold in the three most affected contiguous frequencies between 0.25 and 8 kHz 1 month after ISSHL. Secondary endpoints include further measures of hearing improvement including speech audiometry, tinnitus, quality of life, blood pressure, and altered glucose tolerance.
DISCUSSION: There is an unmet medical need for an effective medical therapy of ISSHL. Although sensorineural hearing impairment can be partially compensated by hearing aids or cochlear implants (CI), generic hearing is better than using hearing aids or CIs. Since adverse effects of a short course of high-dose systemic corticosteroids have not been documented with good evidence, the trial will improve knowledge on possible side effects in the different treatment arms with a focus on hyperglycemia and hypertension.
TRIAL REGISTRATION: EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) Nr. 2015-002602-36; Sponsor code: KKSH-127.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:70 |
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| Enthalten in: |
HNO - 70(2022), Suppl 2 vom: 20. Juli, Seite 30-44 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Wirksamkeit und Sicherheit der systemischen Hochdosis-Glukokortikoidtherapie beim akuten idiopathischen sensorineuralen Hörverlust (Hörsturz) : Studienprotokoll für eine dreiarmige, randomisierte, dreifach verblindete Multizenterstudie (HODOKORT) |
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| Beteiligte Personen: |
Plontke, Stefan K [VerfasserIn] |
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| Links: |
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| Themen: |
7S5I7G3JQL |
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| Anmerkungen: |
Date Completed 07.07.2022 Date Revised 22.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00106-022-01184-8 |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Plontke, Stefan K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Efficacy and safety of systemic, high-dose glucocorticoid therapy for idiopathic sudden sensorineural hearing loss |b Study protocol for a three-armed, randomized, triple-blind, multicenter trial (HODOKORT) |
| 246 | 3 | 3 | |a Wirksamkeit und Sicherheit der systemischen Hochdosis-Glukokortikoidtherapie beim akuten idiopathischen sensorineuralen Hörverlust (Hörsturz) : Studienprotokoll für eine dreiarmige, randomisierte, dreifach verblindete Multizenterstudie (HODOKORT) |
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| 500 | |a Date Completed 07.07.2022 | ||
| 500 | |a Date Revised 22.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a BACKGROUND: Systemic glucocorticosteroids ("steroids") are widely used worldwide as a standard of care for primary therapy of idiopathic sudden sensorineural hearing loss (ISSHL). The German ISSHL guideline recommends high-dose steroids without evidence from randomized controlled trials (RCTs) and refers solely to retrospective cohort studies. This RCT aims to assess the efficacy (improvement in hearing) and safety (especially systemic side effects) of high-dose steroids versus standard of care (standard dose systemic steroids) for the treatment of unilateral ISSHL, when given as a primary therapy | ||
| 520 | |a METHODS: The study is designed as a multicenter (approximately 40 centers), randomized, triple-blind, three-armed, parallel group, clinical trial with 312 adult patients. The interventions consist of 5 days of 250 mg/day intravenous prednisolone (intervention 1) + oral placebo, or 5 days of 40 mg/day oral dexamethasone (intervention 2) + intravenous placebo. The control intervention consists of 60 mg oral prednisolone for 5 days followed by five tapering doses + intravenous placebo. The primary efficacy endpoint is the change in hearing threshold in the three most affected contiguous frequencies between 0.25 and 8 kHz 1 month after ISSHL. Secondary endpoints include further measures of hearing improvement including speech audiometry, tinnitus, quality of life, blood pressure, and altered glucose tolerance | ||
| 520 | |a DISCUSSION: There is an unmet medical need for an effective medical therapy of ISSHL. Although sensorineural hearing impairment can be partially compensated by hearing aids or cochlear implants (CI), generic hearing is better than using hearing aids or CIs. Since adverse effects of a short course of high-dose systemic corticosteroids have not been documented with good evidence, the trial will improve knowledge on possible side effects in the different treatment arms with a focus on hyperglycemia and hypertension | ||
| 520 | |a TRIAL REGISTRATION: EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) Nr. 2015-002602-36; Sponsor code: KKSH-127 | ||
| 650 | 4 | |a Clinical Trial Protocol | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Corticosteroids | |
| 650 | 4 | |a Dexamethasone | |
| 650 | 4 | |a Glucocorticoids | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Idiopathic | |
| 650 | 4 | |a Prednisolone | |
| 650 | 4 | |a Randomized controlled trial | |
| 650 | 4 | |a Steroids | |
| 650 | 4 | |a Sudden hearing loss | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 650 | 7 | |a Dexamethasone |2 NLM | |
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| 700 | 1 | |a Girndt, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a Meisner, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Böselt, Iris |e verfasserin |4 aut | |
| 700 | 1 | |a Ludwig-Kraus, Beatrice |e verfasserin |4 aut | |
| 700 | 1 | |a Richter, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Rahne, Torsten |e verfasserin |4 aut | |
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