Prevention of Bone Loss After Acute SCI by Zoledronic Acid
Prevention of Bone Loss After Acute SCI by Zoledronic Acid: Durability, Effect on Bone Strength, and Use of Biomarkers to Guide Therapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Illinois
-
Chicago, Illinois, United States, 60611
- Northwestern University Feinberg School of Medicine
-
Chicago, Illinois, United States, 60611
- Rehabilitation Institute of Chicago
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- In-patient at Rehabilitation Institute of Chicago (RIC) or an outpatient who was recently discharged from RIC
- Males and females
- Age >/=18 years
- Medically stable in the opinion of subject's physiatrist
- SCI at within 120 days inclusive at time of screening
- SCI with inability to ambulate independently
- ASIA Impairment Scale (AIS) A, B, or C, at time of study entry
- Capable of positioning to have DXA performed
- Able to tolerate acetaminophen
- No known endocrinopathies (diabetes type 1 or 2 can be included)
- Normal TSH levels
- Normal 25-OH vitamin D levels (>/= 20 ng/ml) at baseline (subjects may be repleted)
- Normal calcium levels
- Normal renal function (creatinine <2.0 mg/dl)
- Well hydrated with adequate intake of liquids
- Able to return for all follow-up visits
- Capable of reading and understanding informed consent document
- Males and females of childbearing potential must be willing and able to use double barrier method of contraception for 2 months after having received study drug
Exclusion Criteria:
- Have Paget's disease of the bone
- Malignancy as a cause of acute SCI
- Have unexplained high levels of alkaline phosphatase in blood
- Any active gastrointestinal condition that results in malabsorption
- Poor dental hygiene or requirement for invasive dental procedure within two months prior to enrollment
- History of bone metastasis and skeletal malignancies
- History of alcoholism or drug abuse within the 2 years prior to study screening
- Other medical conditions that in the opinion of the investigator would preclude the subject from completing the study
- Elevated liver function tests >2x normal
- Currently being prescribed anti-convulsants at a dose or frequency that is determined to interfere with bone metabolism as determined by the investigator
- Currently being prescribed glucocorticoids, other than inhaled glucocorticoids
- Current or recent use any bone-active agents, including any bisphosphonate, raloxifene, hormone therapy (estrogen and estrogen/progestin), calcitonin or strontium-containing compounds within 60 days of screening.
- Pregnant, planning to become pregnant, or lactating
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Zol
Intravenous infusion of zoledronic acid (zol) 5 mg at baseline.
|
Intravenous infusion of zoledronic acid 5 mg.
Other Names:
|
|
Experimental: Placebo
Intravenous infusion of placebo at baseline.
|
Placebo (saline) infusion to match zoledronic acid
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent Change in Bone Mass Density (BMD) in the Hip
Time Frame: 0-12 months
|
Percent change of bone mass density (BMD) in the total hip (as measured by DXA)
|
0-12 months
|
|
Percent Change of Bone Mass Density (BMD) in the Femoral Neck
Time Frame: 0-12 months
|
Percent change of bone mass density (BMD) in the femoral neck (as measured by DXA)
|
0-12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent Change in the Epiphyseal Integral Bone Mass Content (iBMC) of the Femur
Time Frame: 0-12 months
|
Percent change in the epiphyseal integral bone mass content (iBMC) of the femur, as collected by CT.
|
0-12 months
|
|
Percent Change in the Metaphyseal Integral Bone Mass Content (iBMC) of the Femur
Time Frame: 0-12 months
|
Percent change in the metaphyseal integral bone mass content (iBMC) of the femur, as collected by CT
|
0-12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Thomas J Schnitzer, MD, PhD, Northwestern University Feinberg School of Medicine
Publications and helpful links
General Publications
- Edwards WB, Haider IT, Simonian N, Barroso J, Schnitzer TJ. Durability and delayed treatment effects of zoledronic acid on bone loss after spinal cord injury: a randomized, controlled trial. J Bone Miner Res. 2021 Nov;36(11):2127-2138. doi: 10.1002/jbmr.4416. Epub 2021 Jul 29.
- Haider IT, Lobos SM, Simonian N, Schnitzer TJ, Edwards WB. Bone fragility after spinal cord injury: reductions in stiffness and bone mineral at the distal femur and proximal tibia as a function of time. Osteoporos Int. 2018 Dec;29(12):2703-2715. doi: 10.1007/s00198-018-4733-0. Epub 2018 Oct 17.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Estimated)
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
- Nervous System Diseases
- Central Nervous System Diseases
- Musculoskeletal Diseases
- Spinal Cord Injury
- Osteoporosis
- Physiological Effects of Drugs
- Bone Diseases
- Pharmacologic Actions
- Metabolic Bone Diseases
- Spinal Cord Diseases
- Nervous System
- Wounds and Injuries
- Bone Density Conservation Agents
- Department of Defense
Additional Relevant MeSH Terms
- Metabolic Diseases
- Trauma, Nervous System
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Neurologic Manifestations
- Wounds and Injuries
- Osteoporosis
- Spinal Cord Injuries
- Musculoskeletal Diseases
- Nervous System Diseases
- Central Nervous System Diseases
- Bone Diseases
- Bone Diseases, Metabolic
- Spinal Cord Diseases
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Azoles
- Imidazoles
- Inorganic Chemicals
- Chlorine Compounds
- Organophosphorus Compounds
- Organophosphonates
- Sodium Compounds
- Chlorides
- Hydrochloric Acid
- Zoledronic Acid
- Diphosphonates
- Sodium Chloride
Other Study ID Numbers
Other Study ID Numbers
- STU00098239
- CDMRP-130125 (Other Grant/Funding Number: Department of Defense)
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