A PiLot ClinicaL TrIal of ParicAlcitol for ChroNiC PancrEatitis

Study Overview
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Brief Summary
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The purpose of this pilot study to examine the feasibility and acceptability of paricalcitol in adults with Chronic Pancreatitis (CP).

Detailed Description
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Examine the feasibility of a trial to test the effect of paricalcitol through health-related quality of life, imaging, and biomarker analysis in patients with chronic pancreatitis (CP). The study hopes the proposed intervention will improve symptoms based on preclinical evidence that vitamin D analogues have significant and beneficial effects on pancreatitis cancer by blocking certain signaling proteins to reduce pain. Medical history, concomitant medications, and laboratory test results will be reviewed at all visits by one of the study physicians. In addition, at the beginning and end of the study period, patients will have an MRI to assess condition and DEXA scan to measure bone mineral density, to compare and determine if those receiving paricalcitol have a clinically significant decrease in bone mineral density compared to those receiving placebo for safety. In addition to scans, routine labs will be obtained to assess for any adverse events or safety concerns. Mechanistic specimens for research purposes will be collected at each of the following in person visits: Screening/Randomization, Month 6, Month 12.

Official Title
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A PiLot ClinicaL TrIal of ParicAlcitol for ChroNiC PancrEatitis

Conditions
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Chronic Pancreatitis

Intervention / Treatment
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* Drug: Paricalcitol
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Provision of signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Male or female, aged 18-75 at time of enrollment Diagnosis of Chronic Pancreatitis episode is not attributable to gallstones (i.e. suspected or definite biliary etiology), medications, trauma or autoimmune pancreatitis. Ability to take oral medication and be willing to adhere to the dosing regimen Normal Calcium levels- 8.5 to 10.2 mg/dL Normal Phosphate levels- 2.8 to 4.5 mg/dL Normal Parathyroid hormone levels- 10 to 65 pg/mL For females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation and for an additional 1 week after the end of Investigational Product administration For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner No prior pancreatic surgery Pancreatic necrosis, if present, is <50% (to be verified by a CPDPC site radiologist) No involvement in any interventional trials currently or within 6 months of enrollment Exclusion Criteria: Pregnancy or lactation History of autoimmune or traumatic pancreatitis, or sentinel attack of acute necrotizing pancreatitis which results in suspected disconnected duct syndrome Primary pancreatic tumors - pancreatic ductal adenocarcinoma, suspected cystic neoplasm (>1 cms in size or main duct involvement), neuroendocrine tumors, and other uncommon tumors. Pancreatic metastasis from other malignancies History of solid organ transplant, HIV/AIDS. Abnormal lab values: calcium, phosphate, or parathyroid hormone Known isolated pancreatic exocrine insufficiency (e.g. in the absence of any eligible inclusion criteria) Participants must not have medical or psychiatric illnesses or ongoing substance abuse that in the investigator's opinion would compromise their ability to tolerate study interventions or participate in longitudinal follow up Patients with known abnormal creatinine (GFR < 30) or renal failure (applies to patients with chronic upper abdominal pain of suspected pancreatic origin and suspected CP. Known Pregnancy. All participants of childbearing potential, except if post-menopausal [i.e. no menses for ≥2 years] or had a hysterectomy, bilateral tubal ligation/clip (surgical sterilization) or surgical removal of both the ovaries), must have a negative urine or serum B-HCG pregnancy test documented within 2 days prior to any endoscopic or radiologic procedures done for research purposes. Any standard of care tests will follow institutional policies regarding pregnancy test Currently incarcerated Inability to tolerate MRI

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Paricalcitol<br>Participants receive Paricalcitol 2mcg capsule once daily for 12 months. | Drug: Paricalcitol<br>* 2 MCG Oral Capsule<br>|
| Placebo Comparator: Placebo<br>Participants receive Paricalcitol Placebo capsule matching Paricalcitol once daily for 12 months. | Drug: Placebo<br>* Matching capsule to 2 MCG Paricalcitol Oral Capsule<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Examine the feasibility of testing the effect of paricalcitol on health-related quality of life in patients with chronic pancreatitis | The proposed trial will examine the feasibility of testing the effect of the vitamin D analogue called paricalcitol (also known as Zemplar), on health-related quality of life, imaging, and biomarkers in patients with chronic pancreatitis (CP). Health-related quality of life measurements will be collected via questionnaires to assess overall health, quality of life, and pain. An Acceptability Form will be provided during the last visit to gauge the general acceptability of the intervention. Feasibility will be met if ≥75% of enrolled patients complete the 12-month study. There will be a 21-month recruitment period and a one-year treatment period. | End of study (12 Months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare the mean change in health related quality of life from baseline across the times points 6 and 12 months between the treatment group and placebo | The study will monitor health-related quality of life measures, imaging, and biomarkers to identify potential measures of response to treatment with the intent do develop larger efficacy focused trials. | End of study (12 Months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Paricalcitol