The Effect of Liraglutide on Bone Turnover, Bone Mass and Bone Cell Function (LIRABONE)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background: Type 2 diabetes may cause complications such as ischemic heart disease, nephropathy, neuropathy, and retinopathy. Several epidemiologic and animal studies also suggest that fracture risk is increased in diabetes.
Bone is remodelled throughout life through bone resorption by the bone resorbing cells, the osteoclasts, and by bone formation by the bone forming cells, the osteoblasts. Bone remodelling can be monitored by biochemical markers of bone turnover and the effect of bone remodelling can be measured by changes in bone mineral density (BMD) by Dual X-ray absorptiometry (DXA) or bone structure by quantitative CT (QCT) or high resolution peripheral QCT (HRpQCT). The remodelling activity and the balance between resorption and formation are influenced by many factors including food consumption. The gut hormone glucagon-like polypeptide 1 (GLP-1) is released in relation to food intake and reduces serum levels of glucagon, increases serum levels of insulin, and reduces blood glucose in diabetes. Liraglutide is a GLP-1 analogue and has been approved for the treatment of type 2 diabetes.
Aim: To investigate the effect of the GLP-1 analogue Liraglutide on bone turnover, bone mass, and bone structure in patients with type 2 diabetes.
Methods: The clinical study will be conducted as a randomised, double-blinded, placebo-controlled, prospective, clinical trial with comparative treatment regimes with either subcutaneous Liraglutide or subcutaneous placebo injections.
Perspectives: The project will bring new knowledge about the possible effects of GLP-1 analogues on bone turnover and structure. This is important given that type 2 diabetes deteriorates bone health and increases risk of fractures. If Liraglutide can be demonstrated to have a positive effect on bone, this may be one among other factors to consider before the decision about specific treatment of type 2 diabetes is made for the individual patient.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Aarhus C
-
Aarhus, Aarhus C, Denmark, 8000
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Informed consent
- Diagnosis of type 2 diabetes (HbA1c > 48 mmol/mol)
- Age older than 30 years
Exclusion Criteria:
- Type 1 diabetes
- Treatment with insulin
- Body weight > 140 kg
- HbA1c > 75 mmol/mol
- Treatment with GLP-1 analogues, Dipeptidyl peptidase-4 inhibitors, or glitazones
- Chronic kidney disease
- Hepatic disease
- Pancreatitis
- Inflammatory bowel disease
- Osteoporosis
- Family or personal history of medullary thyroid carcinoma
- Treatment with glucocorticoids
- Hormone replacement therapy
- Diabetic gastroparesis
- Pregnancy or lactation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Liraglutide
Liraglutide ("Victoza"), subcutaneous 1,8 mg once daily for 180 days
|
Once daily
Other Names:
|
|
Placebo Comparator: Placebo
Saline, subcutaneous once daily for 180 days
|
Once daily
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in collagen I cross-linked C-terminal telopeptide measured in serum
Time Frame: Days 0, 7, 28, 90, 180
|
Collagen I cross-linked C-terminal telopeptide has been chosen as primary endpoint as the expected mechanism of action is reduction in bone resorption, and as it is the most responsive bone resorption marker.
|
Days 0, 7, 28, 90, 180
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in bone alkaline phosphatase measured in serum
Time Frame: Days 0, 7, 28, 90, 180
|
Days 0, 7, 28, 90, 180
|
|
Change in BMD evaluated by DXA
Time Frame: Days 0, 90, 180
|
Days 0, 90, 180
|
|
Change in bone structure evaluated by QCT and HRpQCT
Time Frame: Days 0, 90, 180
|
Days 0, 90, 180
|
|
Change in HbA1c
Time Frame: Days 0, 180
|
Days 0, 180
|
|
Change in osteocalcin measured in serum
Time Frame: Days 0, 7, 28, 90, 180
|
Days 0, 7, 28, 90, 180
|
|
Change in procollagen type I N-terminal propeptide measured in serum
Time Frame: Days 0, 7, 28, 90, 180
|
Days 0, 7, 28, 90, 180
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Bente L Langdahl, MD PhD DMSc, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
Publications and helpful links
General Publications
- Fehmann HC, Hering BJ, Wolf MJ, Brandhorst H, Brandhorst D, Bretzel RG, Federlin K, Goke B. The effects of glucagon-like peptide-I (GLP-I) on hormone secretion from isolated human pancreatic islets. Pancreas. 1995 Aug;11(2):196-200. doi: 10.1097/00006676-199508000-00014.
- Leslie WD, Rubin MR, Schwartz AV, Kanis JA. Type 2 diabetes and bone. J Bone Miner Res. 2012 Nov;27(11):2231-7. doi: 10.1002/jbmr.1759. Epub 2012 Sep 28. Erratum In: J Bone Miner Res. 2017 Nov;32(11):2319.
- Schwartz AV, Sellmeyer DE. Diabetes, fracture, and bone fragility. Curr Osteoporos Rep. 2007 Sep;5(3):105-11. doi: 10.1007/s11914-007-0025-x.
- Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int. 2007 Apr;18(4):427-44. doi: 10.1007/s00198-006-0253-4. Epub 2006 Oct 27.
- Yamada C, Yamada Y, Tsukiyama K, Yamada K, Udagawa N, Takahashi N, Tanaka K, Drucker DJ, Seino Y, Inagaki N. The murine glucagon-like peptide-1 receptor is essential for control of bone resorption. Endocrinology. 2008 Feb;149(2):574-9. doi: 10.1210/en.2007-1292. Epub 2007 Nov 26.
- Nuche-Berenguer B, Lozano D, Gutierrez-Rojas I, Moreno P, Marinoso ML, Esbrit P, Villanueva-Penacarrillo ML. GLP-1 and exendin-4 can reverse hyperlipidic-related osteopenia. J Endocrinol. 2011 May;209(2):203-10. doi: 10.1530/JOE-11-0015. Epub 2011 Mar 3.
- Su B, Sheng H, Zhang M, Bu L, Yang P, Li L, Li F, Sheng C, Han Y, Qu S, Wang J. Risk of bone fractures associated with glucagon-like peptide-1 receptor agonists' treatment: a meta-analysis of randomized controlled trials. Endocrine. 2015 Feb;48(1):107-15. doi: 10.1007/s12020-014-0361-4. Epub 2014 Jul 30.
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 (Estimate)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 07052015
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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