- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07587775
The Effect of Osteoporotic Medications on Vertebral Bone Quality Score
The goal of this clinical trial is to determine the change in VBQ score, T score, TBS, and Hounsfield Units (HU) after 3-6 months of treatment with abaloparatide in osteoporotic patients who will undergo spinal fusion and decompression for lumbar degenerative disease. The main question[s] it aims to answer is:
Does abaloparatide improve bone density in these patients, as defined by VBQ score compared to traditional methods such as DEXA and Hounsfield Units Does abaloparatide reduce the incidence of postoperative mechanical complications, including adjacent segment disease, subsidence, and proximal junctional kyphosis (PKJ)?
Participants will undergo a presurgical assessments and trained in clinic on the subcutaneous application of abaloparatide. Prior to treatment, patients will have baseline assessments, including a lumbar MRI, DEXA scan, and lumbar CT. Post-surgically, participants will administer abaloparatide and return to clinic after 3-6 months for follow-up assessments including a new MRI, lumbar CT, and DEXA scan. Patients will be followed for up to 2 years postoperatively to identify complications such as adjacent segment disease, pseudarthrosis, failure of instrumentation, and PJK.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
-
-
New York
-
Buffalo, New York, États-Unis, 14203
- University at Buffalo Neurosurgery
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
Diagnosis of Osteoporosis based on the following criteria:
- Fragility fracture (low trauma fracture similar to a fall from a standing position except for fracture to the skull, face, fingers, and toes)
- T score <-2.5
- T-score -1 to -2.5 with a high FRAX or high TBS adjusted FRAX (with a 10-year probability of major osteoporotic fracture ≥20% or a 10-year probability of hip fracture ≥3%)
- Fulfill criteria for treatment with anabolic therapy, as outlined in the American Association of Clinical Endocrinologist guidelines for the diagnosis and treatment of postmenopausal osteoporosis in women and Evidence-Based Guideline for the management of osteoporosis in men.
- Lumbar Degenerative Disease as evidenced by a diagnosis of spondylosis, spondylolisthesis, degenerative disc disease with spinal stenosis, and degenerative scoliosis
- Have or be willing to have a DEXA scan, lumbar MRI, and lumbar CT within 3 months of the start of Abaloparatide
- If on thyroid hormone replacement, having been on it for at least 6 months
Exclusion Criteria:
- Previous lumbar surgery
- Past medical history of: sarcoma, including osteosarcoma, paget disease or other skeletal malignancies, unexplained elevations of alkaline phosphatase, prior external beam radiation, and pre-existing hypercalcemia
- Diagnosis of secondary osteoporosis
- Vitamin D deficit
- History of prior treatment with TPTD and ABL
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Abaloparatide
3-6 months of self-administered abaloparatide in osteoporotic patients will undergo spinal fusion and decompression for lumbar degenerative disease
|
3-6 months of treatment with abaloparatide in osteoporotic patients who will undergo spinal fusion and decompression for lumbar degenerative disease
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Improvement in Bone Quality
Délai: 6 weeks post-op
|
Improvement in bone quality, using Vertebral Bone Quality
|
6 weeks post-op
|
|
Improvement in Bone Quality
Délai: 6 weeks post-op
|
Improvement in bone quality, using Hounsfield Units
|
6 weeks post-op
|
|
Improvement in Bone Quality
Délai: 6 weeks post-op
|
Improvement in bone quality, using DEXA (Dual-Energy X-ray ABsorptiometry)
|
6 weeks post-op
|
|
Improvement in Bone Quality
Délai: 6 months post-op
|
Improvement in bone quality, using Vertebral Bone Quality
|
6 months post-op
|
|
Improvement in Bone Quality
Délai: 6 months post-op
|
Improvement in bone quality, using Hounsfield Units
|
6 months post-op
|
|
Improvement in Bone Quality
Délai: 6 months post-op
|
Improvement in bone quality, using DEXA (Dual-Energy X-ray ABsorptiometry)
|
6 months post-op
|
|
Improvement in Bone Quality
Délai: 12 months post-op
|
Improvement in bone quality, using Vertebral Bone Quality
|
12 months post-op
|
|
Improvement in Bone Quality
Délai: 12 months post-op
|
Improvement in bone quality, using Hounsfield Units
|
12 months post-op
|
|
Improvement in Bone Quality
Délai: 12 months post-op
|
Improvement in bone quality, using DEXA (Dual-Energy X-ray ABsorptiometry)
|
12 months post-op
|
|
Improvement in Bone Quality
Délai: 24 months post-op
|
Improvement in bone quality, using Vertebral Bone Quality
|
24 months post-op
|
|
Improvement in Bone Quality
Délai: 24 months post-op
|
Improvement in bone quality, using Hounsfield Units
|
24 months post-op
|
|
Improvement in Bone Quality
Délai: 24 months post-op
|
Improvement in bone quality, using DEXA (Dual-Energy X-ray ABsorptiometry)
|
24 months post-op
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Surgical Complications
Délai: 6 weeks post-operatively
|
Presence of complications associated with fusion, such as Proximal Junctional Kyphosis (PJK), proximal junctional failure (PJF), pseudoarthrosis, subsidence, adjacent segment disease, mechanical failure, reoperation, and patient-reported outcomes.
|
6 weeks post-operatively
|
|
Surgical Complications
Délai: 6 months post-operatively
|
Presence of complications associated with fusion, such as PJK, PJF, pseudoarthrosis, subsidence, adjacent segment disease, mechanical failure, reoperation, and patient-reported outcomes.
|
6 months post-operatively
|
|
Surgical Complications
Délai: 12 months post-operatively
|
Presence of complications associated with fusion, such as PJK, PJF, pseudoarthrosis, subsidence, adjacent segment disease, mechanical failure, reoperation, and patient-reported outcomes.
|
12 months post-operatively
|
|
Surgical Complications
Délai: 24 months post-operatively
|
Presence of complications associated with fusion, such as PJK, PJF, pseudoarthrosis, subsidence, adjacent segment disease, mechanical failure, reoperation, and patient-reported outcomes.
|
24 months post-operatively
|
Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 20254288
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
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