Teriparatide (Forsteo) Treatment in Postmenopausal Women: Mechanism of Action (Forsteo)
Teriparatide (Forsteo) Treatment in Postmenopausal Women: Mechanism of Action. A Two-year Open-label Single-arm Study of Teriparatide in Secondary Care
Previously the approach to treatment of osteoporosis has been to use medications which prevent excessive resorption of bone. More recently medications that build up new bone, i.e. anabolic treatments, have been, and are being, developed. The investigators would like to develop a strategy for evaluating the effectiveness of anabolic therapies by studying a currently available therapy (teriparatide). This strategy could then be used to assess new anabolic treatments as they are developed for use in humans.
The aims of this study are 1) to fully describe the changes in bone turnover in response to teriparatide by biochemical marker type and by time; 2) to fully describe the changes in bone mineral density (BMD) in response to teriparatide by site, bone compartment and time.
If this study is able to identify an early response to treatment, then this will help speed up drug development in this area, by allowing the identification of promising new anabolic drugs and enabling us to understand their mechanism of action. This will benefit the investigators patients as the investigators will have a better understanding of how these drugs work.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
South Yorkshire
-
Sheffield, South Yorkshire, United Kingdom, S5 7AU
- Sheffield Teaching Hospitals NHS Foundation Trust
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
Subjects must:
- Have a bone mineral density T-score (at the lumbar spine or total hip) of less than or equal to -2.5
- Be female
- Be at least 5 years post menopausal (more than 5 years since their last menstrual period) but <85 years old.
- Be ambulatory
- Be able and willing to participate in the study and provide written informed consent
- Have a serum 25(OH)2 vitamin D3 >50 nmol/L (after vitamin D3 loading)
Exclusion Criteria
Patients will not be admitted to the study if they exhibit any of the following:
- Evidence of a clinically significant organic disease which could prevent the patient from completing the study
- A body mass index less than 18 or greater than 35
- Abuse of alcohol or use illicit drugs (information obtained from medical history) or who consumed more than 4 servings of any alcoholic beverage one day prior to the visit (i.e., subjects who might be binge drinkers)
- Any history of cancer within the past 5 years excluding skin cancer non melanomas
- Any history of ongoing conditions or diseases known to cause abnormalities of calcium metabolism or skeletal health including Paget's disease of bone
- Chronic renal disease (as defined by an estimated glomerular filtration rate of ≤ 30mL/min)
- Acute or chronic hepatic disease
- Malabsorption syndromes
- Hyperthyroidism as manifested by TSH outside the lower limit of the normal range
- Hyperparathyroidism
- Hypocalcemia or hypercalcemia
- Osteomalacia
- Cushing's syndrome
- Current use of glucocorticoid therapy
- A corrected serum calcium less than 2.2 mmol/L and a PTH above 100 ng/L (that persists after testing and treatment for vitamin D deficiency)
- A history of any known condition that would interfere with the assessment of DXA at either lumbar spine or femoral neck
- Markedly abnormal clinical laboratory parameters that are assessed as clinically significant by the investigator
- Any previous use of bisphosphonate
- Use any of the following medications within 12 months of starting study drug
- Any fluoride with the exception of use for oral hygiene
- Strontium Ranelate
- Other bone agents (e.g. SERM, isoflavones, HRT)
- Participation in another clinical trial involving active therapy 3 months prior to enrolment
- Less than 5 years since menopause
- Bilateral fractures in the measurement regions (hip, tibia and forearm)
- Recent fracture within the last 12 months
- Prior radiation therapy which may involve the skeleton
- Hypersensitivity to teriparatide or any of its excipients
- Unexplained elevations of alkaline phosphatase
- Any known contraindication to the use of teriparatide
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Volumetric bone mineral density (BMD) of the lumbar spine (mg hydroxyapatite/cm3)
Time Frame: 0 to 104 weeks
|
Change in volumetric BMD of the lumbar spine (vertebrae L1-3) (mg hydroxyapatite/cm3) measured by quantitative computed tomography (QCT) from 0 to 104 weeks treatment.
|
0 to 104 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Lumbar spine, total hip and whole body bone mineral density (g/cm2)
Time Frame: 0 to 104 weeks
|
Changes in lumbar spine, total hip and whole body bone mineral density (g/cm2) measured by dual x-ray absorptiometry (DXA) from 0 to 104 weeks.
|
0 to 104 weeks
|
|
Biochemical markers of bone turnover
Time Frame: 0 to 104 weeks
|
Changes in biochemcial markers of bone turnover (OC, PINP, bone ALP, urinary NTX, serum CTX, sclerostin, DKK-1) from 0 to 104 weeks.
|
0 to 104 weeks
|
|
Distal tibia and radius volumetric body bone mineral density (BMD) (mg hydroxyapatite/cm3)
Time Frame: 0 to 104 weeks
|
Changes in distal tibia and radius volumetric bone mineral density (mg hydroxyapatite/cm3) measured by High Resolution peripheral Quantitative Computed Tomography (HR-pQCT) from 0 to 104 weeks.
|
0 to 104 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Richard Eastell, MD, FRCP, FRCPath, FMedSci, University of Sheffield
- Principal Investigator: Jennifer Walsh, PhD MRCP, Sheffield Teaching Hospitals NHS Foundation Trust
- Principal Investigator: Eugene McCloskey, MD, FRCPI, University of Sheffield
- Principal Investigator: Nicola Peel, DM FRCP, Sheffield Teaching Hospitals NHS Foundation Trust
- Principal Investigator: Angela Rogers, BSc (Hons), PhD, MCSP, University of Sheffield
- Principal Investigator: Margaret Paggiosi, Bsc (Hons), PhD, MICR, Sheffield Teaching Hospitals NHS Foundation Trust
- Principal Investigator: Lang Yang, PhD CSci, University of Sheffield
- Principal Investigator: David Hughes, BMedSci MBChB PhD FRCPath, Sheffield Teaching Hospitals NHS Foundation Trust
- Principal Investigator: Mark Wilkinson, PhD, FRCS (Tr&Orth), University of Sheffield
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- STH15466
- 2010-021009-19 (EudraCT Number)
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