- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01656629
Stem Cell Recruitment in Osteoporosis Therapy
August 10, 2020 updated by: Johns Hopkins University
Osteoporosis is an important health problem in the rapidly-aging demographic.
Fragility fractures are devastating consequences of osteoporosis.
The most common treatment approach in osteoporosis is inhibition of bone resorption with drugs like alendronate (ALN).
Parathyroid hormone (PTH) stimulates bone formation and is the only anabolic drug available.
Dual therapy with ALN and PTH is not as effective as single-drug therapy in preventing fracture.
Bone progenitor cells (MSCs) are recruited to sites of bone remodeling when a growth factor called Transforming Growth Factor Beta (TGF-β1) is released from bone.
Different osteoporosis medicines may have differing effects on this process.
The effects of ALN versus PTH on bone progenitor recruitment in humans are unknown.
This is a randomized, clinical trial of ALN, PTH, and calcium and vitamin D in post-menopausal women with low bone mass.
Women will be treated for 3 months with ALN or PTH or calcium and vitamin D. Data collected will include bone biopsies for histomorphometry and micro computed tomography (µCT), bone marrow aspirates for molecular studies, peripheral blood to detect circulating bone progenitor cells and dual X-ray absorptiometry.
The investigators hypothesize that in humans, PTH will 1) increase bone progenitor number, 2) enhance recruitment of bone progenitor cells to bone resorption sites, and 3) increase bone progenitor number in peripheral circulation.
Furthermore, the investigators hypothesize that ALN treatment will have the opposite effect.
Understanding the differences in bone progenitor cell activity and recruitment during osteoporosis therapy will provide a mechanistic rationale for effective use of PTH and anti-resorptive drugs in osteoporosis treatment.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
55
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Maryland
-
Baltimore, Maryland, United States, 21224
- Johns Hopkins Bayview Medical Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Post-menopausal women aged 50-80 years
- T score < -2.5 at lumbar spine, total hip or femoral neck on dual x-ray absorptiometry (DXA) OR T score < -1.5 with a personal or family history of fracture
Exclusion Criteria:
- Previous use of bisphosphonates or Teriparatide; current estrogen therapy; any other osteoporosis therapy in the past 6 months
- Metabolic bone disease other than osteoporosis
- Body mass index (BMI) < 18
- Weight > 325 lbs
- Current smoking or current alcohol use that exceeds 3 units of alcohol daily
- Use of medications known to affect bone metabolism
- Renal disease, history of kidney stones or hypercalciuria
- Hypo- or hyperparathyroidism; hypo- or hypercalcemia
- Serum vitamin D level < 20 ng/dL
- Refusal to adjust their dietary calcium to <750mg (i.e. two servings per day of calcium rich food)
- History of bone marrow or organ transplant
- History of malignancy or radiation to the bone
- History of esophageal stricture, dysmotility or severe reflux disease
- Gastrointestinal malabsorption
- Use of digoxin
- Need for chronic anticoagulation therapy such as Coumadin, heparin or low molecular weight heparin or inability to discontinue anti-platelet medication
- Bleeding diathesis; hemoglobin ≤ 12.5 g/dL (American Red Cross cut-off to donate blood)
- International normalized ratio (INR) pro time > 1.1 or activated partial thromboplastin time (APT) T ratio > 1.2
- Platelets < 150K/cu mm
- Cellulitis at site of iliac crest
- History of allergy to medications used in bone biopsy (demeclocycline, lidocaine)
- Inability to understand and provide informed consent.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: teriparatide
teriparatide 20 mcg sq for 3 months
|
20 mcg subq daily for 3 months
|
Active Comparator: Alendronate
70 mg po weekly for 3 months
|
70 mg weekly for 3 months
|
Active Comparator: calcium and vitamin D
calcium 630 mg vitamin D 500 units daily for 3 months
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The Percent Change in Circulating Osteoprogenitor Cells as Assessed by Flow Cytometry in the Blood Before and After Treatment With Parathyroid Hormone (PTH) or Alendronate (ALN).
Time Frame: up to 3 months
|
up to 3 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Difference in Bone Formation as Assessed by Bone Histomorphometry on Bone Biopsy Between Treatment Groups
Time Frame: 3 months
|
3 months
|
Difference in Osteogenic Potential of Bone Marrow as Measure by Colony Forming Unit Osteoblast (CFU-Ob) Assays Between Treatment Groups
Time Frame: 3 months
|
3 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Suzanne Jan De Beur, MD, Johns Hopkins University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 1, 2012
Primary Completion (Actual)
June 1, 2014
Study Completion (Actual)
August 7, 2020
Study Registration Dates
First Submitted
August 1, 2012
First Submitted That Met QC Criteria
August 1, 2012
First Posted (Estimate)
August 3, 2012
Study Record Updates
Last Update Posted (Actual)
August 21, 2020
Last Update Submitted That Met QC Criteria
August 10, 2020
Last Verified
August 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NA_00050448
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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