Preventing Osteoporosis Using Denosumab
Last updated on July 2021Recruitment
- Recruitment Status
- Active, not recruiting
- Estimated Enrollment
- 212
Summary
- Conditions
- Osteoporosis
- Osteoporosis, Postmenopausal
- Osteoporotic Fractures
- Type
- Interventional
- Phase
- Phase 4
- Design
- Allocation: RandomizedIntervention Model: Parallel AssignmentMasking: Triple (Participant, Care Provider, Investigator)Primary Purpose: Treatment
Participation Requirements
- Age
- Between 65 years and 125 years
- Gender
- Both males and females
Description
Objective: The long term goal is to improve health, well-being and quality of life in the frail long-term care (LTC) elderly population by reducing fractures. The short term goal is to demonstrate efficacy of the non-bisphosphonate denosumab to improve bone mineral density (BMD), a necessary (but no...
Objective: The long term goal is to improve health, well-being and quality of life in the frail long-term care (LTC) elderly population by reducing fractures. The short term goal is to demonstrate efficacy of the non-bisphosphonate denosumab to improve bone mineral density (BMD), a necessary (but not sufficient) pre-condition of a large fracture reduction trial. The investigators propose to conduct a 2-year, randomized, double-blind, calcium-vitamin D controlled trial to test the efficacy and predictability of the antiresorptive RANK ligand inhibitor, denosumab (60 mg), among a cohort of 212 institutionalized, under-served, frail men and women ?65 years old in LTC. Specific Aims: Aim 1: To evaluate efficacy of denosumab in improving/maintaining bone mineral density. The investigators will measure conventional hip and spine bone mineral density (BMD). Primary Hypothesis: After 2 years, women and men on denosumab will have greater hip and spine BMD increases. Zoledronic Acid Infusion Safety Treatment and Follow-up Extension: After the trial was started, case reports suggested a potential increase in fracture risk with disuse. A post hoc analysis that combined the pivotal denosumab trial and extension trial data suggested there was an increase in multiple vertebral fractures when patients discontinued therapy. Following discontinuation of denosumab/placebo, all patients will be offered treatment with 1 dose of intravenous zoledronic acid 5 mg. For those consenting to receive end of study treatment, the zoledronic acid will be given at month 27 for an individual patient. Zoledronic Acid Safety Infusion Extension Specific Aims: Aim 1: To evaluate maintenance of bone mineral density (BMD). Zoledronic acid will be administered intravenously at 9 months post-denosumab (month 27) and assess BMD by DXA at months 33 and 39 (6 months and 12 months after zoledronic acid infusion). Primary Hypothesis: Zoledronic acid will prevent BMD loss at the spine and hip following denosumab discontinuation.
Tracking Information
- NCT #
- NCT02753283
- Collaborators
- National Institutes of Health (NIH)
- National Institute on Aging (NIA)
- Investigators
- Principal Investigator: Susan L Greenspan, MD University of Pittsburgh