- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03164928
Safety and Efficiency of Denosumab in Pediatric Subjects With Glucocorticoid-induced Osteoporosis
A Phase 3 Randomized, Double-blind, Placebo-controlled, Parallel-group Study to Evaluate the Safety and Efficacy of Denosumab in Pediatric Subjects With Glucocorticoid-induced Osteoporosis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Title: A Phase 3 Randomized, Double-blind, Placebo-controlled, Parallel-group Study to Evaluate the Safety and Efficacy of Denosumab in Pediatric Subjects With Glucocorticoid-induced Osteoporosis
Study Phase: 3 Indication: Glucocorticoid-induced Osteoporosis
Primary Objective: To evaluate the effect of denosumab on lumbar spine bone mineral density (BMD) Z-score as assessed by dual-energy X-ray absorptiometry (DXA) at 12 months in children 5 to 17 years of age with Glucocorticoid (GC)-induced osteoporosis (GiOP).
Secondary Objective(s): To evaluate the effect of denosumab in children 5 to 17 years of age with GiOP with respect to:
- Change in lumbar spine BMD Z-score as assessed by DXA from baseline to 6, 18, 24, and 36 months
- Change in proximal femur BMD Z-score as assessed by DXA from baseline to 6, 12, 18, 24, and 36 months
- Number of participants with X-ray confirmed long-bone fractures and new and worsening vertebral fractures from pre-treatment to posttreatment at 12, 24, and 36 months
- Number of participants with improving vertebral fractures from pre-treatment to posttreatment at 12, 24, and 36 months (overall, among subjects with clinical fracture reduction, and among subjects with clinical fracture increase)
- Number of participants with pre-treatment, post-treatment, and post-withdrawal vertebral and nonvertebral fractures at 12, 24, and 36 months
- Change in Childhood Health Questionnaire - Parent Form-50 (CHQ-PF-50) Physical Summary Score at 12, 24, and 36 months
- Change in CHQ-PF-50 Psychological Summary Score at 12, 24, and 36 months
- Change in Childhood Health Assessment Questionnaire (CHAQ) Disability Index Score at 12, 24, and 36 months
- Change in Wong-Baker Faces Pain Rating Scale (WBFPRS) at 12, 24, and 36 months
- Change in growth velocity, determined by calculating age-adjusted Z-scores for height, weight, and body mass index (BMI), at 24 and 36 months
- Serum concentration of denosumab at 1 and 10 days, and 6, 12, and 18 months (additional serum denosumab pharmacokinetics [PK] samples to be collected at day 30 and month 3 in a PK/bone turnover marker [BTM] substudy of up to 15 subjects) Hypotheses: The hypothesis of this study is that the change from baseline in lumbar spine BMD Z-score following 12 months of denosumab treatment in children 5 to 17 years of age with GiOP will be greater than placebo.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Western Australia
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Nedlands, Western Australia, Australia, 6909
- Perth Childrens Hospital
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Bruxelles, Belgium, 1200
- Cliniques Universtaire Saint Luc Universite Catholique de Louvain
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Sofia, Bulgaria, 1784
- Medical Centre Synexus Sofia EOOD
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Ontario
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Ottawa, Ontario, Canada, K1H 8L1
- Childrens Hospital of Eastern Ontario
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Quebec
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Montreal, Quebec, Canada, H3T 1C5
- Centre Hospitalier Universitaire Sainte Justine
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Antioquia
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Medellin, Antioquia, Colombia, 050021
- Center for Clinical and Basic Research Colombia
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Cundinamarca
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Bogota, Cundinamarca, Colombia, 110221
- Solano y Terront Servicios Medicos Ltda - Unidad Integral de Endocrinologia Uniendo
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Santander
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Floridablanca, Santander, Colombia, 681004
- Foscal Internacional-Fundacion Oftalmologica de Santander
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Andhra Pradesh
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Hyderabad, Andhra Pradesh, India, 500 025
- Gandhi Medical College
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Delhi
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New Delhi, Delhi, India, 110 022
- Sir Ganga Ram Hospital
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Karnataka
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Belagavi, Karnataka, India, 590010
- KLES Dr Prabhakar Kore Hospital and Medical Research Centre
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Tamil Nadu
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Vellore, Tamil Nadu, India, 632 004
- Christian medical college
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Firenze, Italy, 50139
- Azienda Ospedaliera Universitaria Meyer
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Milan, Italy, 20145
- Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico
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Roma, Italy, 00161
- Azienda Ospedaliera Policlinico Umberto I
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Ciudad de Mexico, Mexico, 03100
- RM Pharma Specialists SA de CV
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Arequipa, Peru, 040001
- Centro Especializado de Enfermedades Neoplasicas
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Callao, Peru, Callao 2
- Hospital Nacional Alberto Sabogal Sologuren
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Lima, Peru, Lima 27
- Clinica Angloamericana
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Lima, Peru, Lima27
- Centro de Investigacion Ricardo Palma
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Lima
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Brena, Lima, Peru, Lima 5
- Instituto Nacional de Salud del Nino
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Moscow, Russian Federation, 119991
- FSAI Scientific Center of Childrens Health of MoH of the RF
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Moscow, Russian Federation, 119991
- SBEI of HPE First Moscow state medical university na I M Sechenov of MoH of Russian Federation
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Novosibirsk, Russian Federation, 630007
- SBHI of Novosibirsk region City Pediatric Clinical Hospital of Emergency Care
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Saint Petersburg, Russian Federation, 191025
- LLC Medical Technologies
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Ankara, Turkey, 06590
- Ankara Universitesi Tip Fakultesi
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Erzurum, Turkey, 25240
- Ataturk Universitesi Tip Fakultesi
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Istanbul, Turkey, 34890
- Marmara Universitesi Pendik Egitim Arastirma Hastanesi
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Izmir, Turkey, 35100
- Ege Universitesi Tip Fakultesi
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Dnipro, Ukraine, 49100
- CI Dnipropetrovsk Regional Children Clinical Hospital of Dnipropetrovsk Regional Council
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Kharkiv, Ukraine, 61075
- Communal Institution of Healthcare Kharkiv City Clinical Children Hospital 16
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Kyiv, Ukraine, 01025
- National Childrens Specialized Hospital OHMATDYT
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California
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Los Angeles, California, United States, 90027
- Childrens Hospital of Los Angeles
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Delaware
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Wilmington, Delaware, United States, 19803
- AI Dupont Hospital for Children
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Indiana
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Indianapolis, Indiana, United States, 46202
- Indiana University Hospital
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Minnesota
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Minneapolis, Minnesota, United States, 55454
- University of Minnesota Masonic Childrens Hospital Discovery Clinic
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Ohio
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Cleveland, Ohio, United States, 44109
- MetroHealth Medical Center
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Columbus, Ohio, United States, 43205
- Nationwide Childrens Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female subjects, age 5 to 17 years, inclusive, at the time of informed consent.
- Clinical diagnosis of GiOP as defined by the following (and consistent with the International Society for Clinical Densitometry definition of osteoporosis in children and adolescents [Bishop et al, 2014])
- A confirmed diagnosis of non-malignant condition(s) requiring treatment with systemic GC (including, but not limited to, chronic rheumatologic, gastrointestinal, neurologic, respiratory, and/or nephrological conditions)
- Subjects who are on systemic GC only as replacement therapy for adrenal insufficiency are not eligible for the study - Treatment with systemic GC (intravenous or oral) of any duration for the underlying non-malignant condition(s) within the 12 months prior to screening
Evidence of at least 1 vertebral compression fracture of Genant grade 1 or higher, as assessed by the central imaging vendor on lateral spine X-rays performed at screening or within 2 months prior to screening; OR, in the absence of vertebral compression fractures, presence of both clinically significant fracture history (ie, ≥ 2 long-bone fractures by age 10 years or ≥ 3 long-bone fractures at any age up to 17 years) and lumbar spine BMD Z-score ≤ -2.0, as assessed by the central imaging vendor.
• Subject's legally acceptable representative has provided informed consent when the subject is legally too young to provide informed consent and the subject has provided assent based on local regulations and/or guidelines prior to any study-specific activities/procedures being initiated
- A confirmed diagnosis of non-malignant condition(s) requiring treatment with systemic GC (including, but not limited to, chronic rheumatologic, gastrointestinal, neurologic, respiratory, and/or nephrological conditions)
- Subjects who are on systemic GC only as replacement therapy for adrenal insufficiency are not eligible for the study
- Treatment with systemic GC (intravenous or oral) of any duration for the underlying non malignant condition(s) within the 12 months prior to screening
- Prepubertal children should be expected to require significant GC use during the study, per investigator opinion
Exclusion criteria will include the following:
- Current hyperthyroidism (unless well controlled on stable antithyroid therapy)
- Current clinical hypothyroidism (unless well controlled on stable thyroid replacement therapy)
- History of hyperparathyroidism
- Current hypoparathyroidism
- Duchenne muscular dystrophy with symptomatic cardiac abnormality
- Current malabsorption
- Active infection or history of infections
History of malignancy
- Any causes of primary or secondary osteoporosis (other than GC use), or previous exposure to non-GC medications, which the investigator considers to have been a major factor contributing to the patient's fracture(s)
- Current adrenal insufficiency as the sole indication for GC therapy
- Duchenne muscular dystrophy with symptomatic cardiac abnormality
- Current malabsorption (in children with serum albumin -lower limit of normal [LLN], malabsorption should be clinically ruled out by the investigator to confirm eligibility)
- Known intolerance to calcium or vitamin D supplements
- Active infection or history of infections, defined as follows:
- Any active infection for which systemic anti-infectives were used within 4 weeks prior to screening
- Serious infection, defined as requiring hospitalization or intravenous anti infectives within 8 weeks prior to screening
- Recurrent or chronic infection or other active infection that, in the opinion of the investigator, might compromise the safety of the subject
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Other: Placebo
SC Q6M placebo
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SC Q6M placebo
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Experimental: Denosumab
1 mg/kg BW (up to a maximum of 60 mg) SC Q6M
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1mg/kg BW (up to a maximum of 60 mg) SC Q6M
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline in lumbar spine BMD Z-score as assessed by DXA at 12 months
Time Frame: 12 months
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Change from baseline in lumbar spine BMD Z-score (bone mineral density) as assessed by DXA (dual-energy X-ray absorptiometry) at 12 months.
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12 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline in lumbar spine BMD Z-score as assessed by DXA at 6, 18, 24, and 36 months.
Time Frame: 6, 18, 24, and 36 months
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Change from baseline in lumbar spine BMD Z-score (bone mineral density) as assessed by DXA (dual-energy X-ray absorptiometry) at 6, 18, 24, and 36 months.
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6, 18, 24, and 36 months
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Change from baseline in proximal femur BMD Z-score as assessed by DXA at 6, 12, 18, 24, and 36 months.
Time Frame: 6, 12, 18, 24, and 36 months
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Change from baseline in proximal femur BMD Z-score (bone mineral density) as assessed by DXA (dual-energy X-ray absorptiometry) at 6, 12, 18, 24, and 36 months.
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6, 12, 18, 24, and 36 months
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Change from baseline in CHQ-PF-50 Physical Summary Score at 12, 24, and 36 months.
Time Frame: 12, 24, 36 months
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Change from baseline in CHQ-PF-50 (Childhood Health Questionnaire - Parent Form-50) Physical Summary Score at 12, 24, and 36 months
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12, 24, 36 months
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Change from baseline in CHQ-PF-50 Psychological Summary Score at 12, 24, and 36 months
Time Frame: 12, 24, and 36 months
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Change from baseline in CHQ-PF-50 (Childhood Health Questionnaire - Parent Form-50) Psychological Summary Score at 12, 24, and 36 months
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12, 24, and 36 months
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Change from baseline in CHAQ Disability Index Score at 12, 24, and 36 months
Time Frame: 12, 24, and 36 months
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Change from baseline in CHAQ (Childhood Health Assessment Questionnaire) Disability Index Score at 12, 24, and 36 months
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12, 24, and 36 months
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Change from baseline WBFPRS at 12, 24, and 36 months
Time Frame: 12, 24, and 36 months
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Change from baseline WBFPRS (Wong-Baker Faces Pain Rating Scale) at 12, 24, and 36 months
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12, 24, and 36 months
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Change from baseline in growth velocity, determined by calculating age-adjusted Z-scores for height, weight, and Body Mass Index at 12, 24, and 36 months
Time Frame: 12, 24, and 36 months
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Change from baseline in growth velocity, determined by calculating age-adjusted Z-scores for height, weight, and Body Mass Index at 12, 24, and 36 months
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12, 24, and 36 months
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Serum concentration of denosumab on Days 1, 10, and 30, and at 3, 6, 12, and 18 months
Time Frame: Days 1, 10, and 30, and at 3, 6, 12, and 18 months
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Serum concentration of denosumab on Days 1, 10, and 30, and at 3, 6, 12, and 18 months
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Days 1, 10, and 30, and at 3, 6, 12, and 18 months
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Number of participants with X-ray confirmed long-bone fractures and new and worsening vertebral fractures during 12, 24, and 36 months
Time Frame: 12, 24, and 36 months
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Number of participants with X-ray confirmed long-bone fractures and new and worsening vertebral fractures during 12, 24, and 36 months compared to pre-treatment
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12, 24, and 36 months
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Number of participants with improving vertebral fractures at 12, 24, and 36 months compared to baseline
Time Frame: 12, 24, and 36 months
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Number of participants with improving vertebral fractures at 12, 24, and 36 months compared to pre-treatment (overall, among subjects with clinical fracture reduction, and among subjects with clinical fracture increase)
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12, 24, and 36 months
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Number of participants with new and worsening vertebral and nonvertebral fractures during 12, 24, and 36 months compared to pre-treatment.
Time Frame: 12, 24, and 36 months
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Number of subjects with pre-treatment, post-treatment, and post-withdrawal vertebral and nonvertebral fractures at 12, 24, and 36 months compared to pre-treatment.
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12, 24, and 36 months
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: MD, Amgen
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20140444
- 2016-003083-39 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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