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Effect of Teriparatide on Hip Fracture Healing

2015年4月10日 更新者:Eli Lilly and Company

Effect of Teriparatide on Femoral Neck Fracture Healing

The purpose of this study is to see whether teriparatide, given for 6 months versus placebo, will improve the healing of hip (femoral neck) fractures that are repaired during surgery using certain types of orthopedic screws. The study will enroll men and postmenopausal women at least 50 years of age with a recent hip (femoral neck) fracture caused by low-trauma (for example, fall from standing height or less).

調査の概要

詳細な説明

This is a 12-month, Phase 3, prospective, randomized, parallel, double-blind, placebo-controlled, multicenter, multinational study to evaluate the effect of 6 months of treatment with teriparatide on fracture healing in participants who have sustained a recent low-trauma, unilateral, femoral neck fracture stabilized by internal fixation. The study has 3 periods:

  1. A screening period that must be completed in ≤ 14 days after operative treatment of the femoral neck fracture
  2. A 6-month double-blind treatment period [teriparatide 20 µg or placebo given once daily by SC injection]
  3. A 6-month observation period.

The primary objective is to assess the effect of 6 months of treatment with teriparatide 20 µg/day versus placebo on the proportion of men and postmenopausal women of at least 50 years of age with no revision surgery 12 months after internal fixation of a low-trauma femoral neck fracture.

All participants will receive supplements of calcium and vitamin D beginning at screening and continuing for 12 months.

研究の種類

介入

入学 (実際)

122

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Arizona
      • Phoenix、Arizona、アメリカ、85027
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      • Tucson、Arizona、アメリカ、85712
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    • California
      • La Mesa、California、アメリカ、91942
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      • Laguna Hills、California、アメリカ、92653
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      • Lancaster、California、アメリカ、93534
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      • Pasadena、California、アメリカ、91101
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    • Connecticut
      • Danbury、Connecticut、アメリカ、06810
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    • Florida
      • Boca Raton、Florida、アメリカ、33486
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      • Bradenton、Florida、アメリカ、34209
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      • Miami、Florida、アメリカ、33136
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      • Orlando、Florida、アメリカ、32804
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    • Idaho
      • Idaho Falls、Idaho、アメリカ、83404
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    • Michigan
      • Royal Oak、Michigan、アメリカ、48073
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    • Missouri
      • Columbia、Missouri、アメリカ、65212
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      • Springfield、Missouri、アメリカ、65804
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    • Montana
      • Billings、Montana、アメリカ、59101
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      • Great Falls、Montana、アメリカ、59405
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    • Nebraska
      • Omaha、Nebraska、アメリカ、68131
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    • North Carolina
      • Asheville、North Carolina、アメリカ、28801
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    • North Dakota
      • Fargo、North Dakota、アメリカ、58103
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    • Pennsylvania
      • York、Pennsylvania、アメリカ、17405
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    • Texas
      • Houston、Texas、アメリカ、77043
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      • San Antonio、Texas、アメリカ、78229
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    • Utah
      • Salt Lake City、Utah、アメリカ、84108
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      • Haifa、イスラエル、31096
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      • Jerusalem、イスラエル、91240
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      • Ahmedabad、インド、532004
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      • Attavar, Mangalore、インド、575001
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      • Bangalore、インド、560 054
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      • Hyderabaad、インド、500033
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      • Nagpur、インド、444001
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      • Vadodara、インド、390018
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      • Tartu、エストニア、51014
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    • New South Wales
      • Penrith、New South Wales、オーストラリア、2751
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    • Victoria
      • Heidelberg、Victoria、オーストラリア、3081
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      • St Albans、Victoria、オーストラリア、3021
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    • Western Australia
      • Nedlands、Western Australia、オーストラリア、6009
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    • Ontario
      • Newmarket、Ontario、カナダ、L3Y 2P9
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      • St. Catharines、Ontario、カナダ、L2R 5J7
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    • Quebec
      • St-Jerome、Quebec、カナダ、J7Z 5T3
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      • Malmo、スウェーデン、205 02
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      • Mölndal、スウェーデン、43180
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      • Stockholm、スウェーデン、SE-118 83
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      • Alcira、スペイン、46600
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      • Barcelona、スペイン、08025
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      • Girona、スペイン、17007
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      • Guadalajara、スペイン、19002
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      • Marbella、スペイン、29600
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      • Pozuelo De Alarcon、スペイン、28223
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      • Aarhus、デンマーク、8000
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      • Hillerod、デンマーク、Dk-3400
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      • Kobenhavn、デンマーク、2400
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      • Koege、デンマーク、4600
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      • Christchurch、ニュージーランド、8022
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      • Takapuna、ニュージーランド、0622
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      • Wellington South、ニュージーランド、6021
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      • Toensberg、ノルウェー、NO-3103
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      • Oulu、フィンランド、90229
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      • Turku、フィンランド、SF-20520
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      • San Juan、プエルトリコ、00936-5067
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      • Riga、ラトビア、1005
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      • Kaunas、リトアニア、44320
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      • Klaipeda、リトアニア、92228
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      • Vilnius、リトアニア、04130
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      • Jhonghe City、台湾、235
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      • Kaohsiung、台湾、824
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      • Taichung、台湾、40705
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      • Taichung City、台湾、40201
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      • Taipei、台湾、220
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      • Seongnam-Si、大韓民国、463-707
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      • Seoul、大韓民国、135 720
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      • Aichi、日本、465-8620
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      • Chiba、日本、275-8580
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      • Fukuoka、日本、831-0016
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      • Fukushima、日本、961
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      • Gunma、日本、371-0014
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      • Hiroshima、日本、739-0696
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      • Ibaraki、日本、305-0854
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      • Japan、日本、399-8292
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      • Kagawa、日本、765-8507
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      • Nagano、日本、390-8510
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      • Niigata、日本、950-1197
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      • Ohita、日本、874-0011
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      • Osaka、日本、586-8521
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      • Saga、日本、840
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      • Shimane、日本、697-8511
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      • Shizuoka、日本、411-8611
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Toyama、日本、939-1395
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Toyko、日本、208-0011
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Yamaguchi、日本、754-0002
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Yamanashi、日本、400-8506
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Hong Kong、香港
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

50年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Community dwelling men and postmenopausal women who were ambulatory before sustaining a low-trauma, unilateral femoral neck fracture (displaced or nondisplaced)
  • Other than femoral neck fracture, be free of incapacitating conditions and have a life expectancy of at least 2 years
  • Have received or are eligible for treatment with internal fixation (sliding hip screw or multiple cancellous screws) for the femoral neck fracture (the surgical procedure itself is not performed as part of this study)
  • Have given written informed consent (participant or proxy) after being informed of the risks, medications, and study procedures

Exclusion Criteria:

  • Increased baseline risk of osteosarcoma
  • History of unresolved skeletal diseases affecting bone metabolism other than primary osteoporosis
  • Abnormally elevated serum calcium at screening
  • Abnormally elevated serum intact parathyroid hormone (PTH) (1-84) at screening
  • Severe vitamin D deficiency at screening
  • Active liver disease or jaundice
  • Significantly impaired renal function
  • Abnormal thyroid function not corrected by therapy
  • History of malignant neoplasm in the 5 years prior to screening
  • History of bone marrow or solid organ transplantation
  • History of symptomatic nephrolithiasis or urolithiasis in the 1 year prior to screening
  • Previous treatment with the following bone active drugs is allowed but must be discontinued at screening: oral bisphosphonates, selective estrogen receptor modulators (SERMs), calcitonin, estrogen (oral, transdermal, or injectable), progestin, estrogen analog, estrogen agonist, estrogen antagonist or tibolone, and active vitamin D3 analogs. Androgen or other anabolic steroid use must be discontinued, except for use of physiologic replacement testosterone
  • Previous treatment with the following bone active drugs is exclusionary, if the stated treatment durations have been met: strontium ranelate for any duration, intravenous bisphosphonates in the 12 months preceding screening, and/or denosumab in the 6 months preceding screening
  • Prior treatment with PTH, teriparatide, or other PTH analogs, or prior participation in any other clinical trial studying PTH, teriparatide, or other PTH analogs
  • Local or systemic treatment with bone morphogenic proteins or any other growth factor
  • Previous fracture(s) or bone surgery in the currently fractured hip
  • Soft-tissue infection at the operation site
  • Treatment with bone grafting or osteotomies
  • Treatment with augmentation using any type of degradable cement, hydroxyapatite-coated implants, or with noninvasive interventions
  • Associated major injuries of a lower extremity including fractures of the foot, ankle, tibia, fibula, knee, femur, femoral head or pelvis; dislocations of the ankle, knee or hip

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:トリプル

武器と介入

参加者グループ / アーム
介入・治療
プラセボコンパレーター:プラセボ
1 日 1 回、皮下 (SC) 注射で 6 か月間投与
皮下注射による投与
経口投与
経口投与
実験的:テリパラチド
20 マイクログラム (µg) を皮下注射で 1 日 1 回 6 か月間投与
経口投与
経口投与
皮下注射による投与
他の名前:
  • フォルテオ
  • LY333334
  • フォルステオ

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
低外傷性大腿骨頸部骨折の内固定後 12 か月で再手術を受けていない参加者の割合
時間枠:12ヶ月
再手術(再手術)は、インデックス手術時に計画されたものを除き、インデックス手術の部位で実施または推奨された追加の外科的介入として定義されました。
12ヶ月

二次結果の測定

結果測定
メジャーの説明
時間枠
Percentage of Participants With Radiographic Evidence of Healing
時間枠:Randomization up to 12 months

The signs of femoral neck fracture healing included disappearance of the fracture line on radiographs. If a participant had radiographic evidence of healing at the 12-month visit, that participant was considered to have radiographic evidence of healing.

Percentage was calculated as: (number of participants with radiographic evidence of healing / total number of participants analyzed) * 100.

Randomization up to 12 months
Percentage of Participants With Pain Control During Ambulation
時間枠:Up to 12 months
The worst pain numeric rating scale (NRS) was used to assess the impact of pain on a participant's life. NRS Item 3 assessed the worst musculoskeletal pain severity during the walking test. Pain was measured by an 11-point Likert scale. The following cut-points were used to categorize the NRS responses: 0 = no pain, 1 to 4 = mild pain, 5 to 6 = moderate pain, and 7 to 10 = severe pain. Participants with an NRS score of <7 were categorized as having no severe fracture-site pain with ambulation and no worsening of NRS scores >2 from baseline. Percentage was calculated as: (Number of participants with pain control during ambulation / total number of participants) * 100.
Up to 12 months
Percentage of Participants Without Severe Fracture-Site Pain During 24 Hours Prior to Visit
時間枠:Up to 12 months
The worst pain NRS was used to assess the impact of pain on a participant's life. Fracture-site pain severity was assessed for pain in the 24 hours preceding a visit. Pain was measured by an 11-point Likert scale. Participants with an NRS score of <7 in the 24 hours preceding a visit and no worsening of NRS >2 from baseline were categorized as having no severe fracture-site pain. Percentage was calculated as: (number of participants with pain control during 24 hours preceding a visit / total number of participants) * 100.
Up to 12 months
Percentage of Participants Without Severe Fracture-Site Pain During Weight Bearing
時間枠:Up to 12 months
The worst pain NRS was used to assess the impact of pain on a participant's life. Fracture-site pain severity was assessed for pain on weight bearing. Pain was measured by an 11-point Likert scale. Participants with an NRS score of <7 during weight bearing and no worsening of NRS >2 from baseline were categorized as having no severe fracture-site pain. Percentage was calculated as: (number of participants with pain control during weight bearing / total number of participants) * 100.
Up to 12 months
Percentage of Participants With Functional Evidence of Healing
時間枠:12 Months

Functional healing was defined as ability to walk with a gait speed ≥ 0.05 meters/second (m/s) with a change from baseline ≥ -0.1 m/s. The walking test involved having the participant walk a distance of 7 meters (m) at a self-selected, comfortable pace. A 4-m portion of the test was timed to determine the participant's gait speed in m/s.

Percentage was calculated as: (number of participants with functional evidence of healing / total number of participants analyzed) * 100.

12 Months
Percentage of Participants Able to Ambulate
時間枠:Up to 12 months
Ability to ambulate was defined as ambulatory with convalescent aid or without convalescent aid. Percentage was calculated as: (number of participants able to ambulate / number of total participants analyzed) * 100.
Up to 12 months
Percentage of Participants Who Regain Their Prefracture Ambulatory Status
時間枠:Up to 12 months
Prefracture ambulatory status was defined as either ambulatory with or without a walking aid. A participant was considered to have regained their prefracture ambulatory status if the participant's postsurgery ambulatory status was returned to or was improved from their pre-surgery ambulatory status. Percentage was calculated as = (number of participants who regained their ambulatory status / total number analyzed) * 100.
Up to 12 months
Mean Change From Baseline to 6 Months in Worst Fracture-Site Pain
時間枠:Baseline, 6 Months
The worst pain NRS was used to assess the impact of pain on a participant's life. Participants with an NRS score of <7 were categorized as having no severe fracture-site pain. Least Squares (LS) means was calculated using analysis of covariance (ANCOVA) and adjusted for baseline, treatment group, region, fracture type, and fixation type.
Baseline, 6 Months
Mean Change From Baseline to 6 Months in Gait Speed
時間枠:Baseline, up to 6 Months
The walking test involved having the participant walk a distance of 7 m at a self-selected, comfortable pace. A 4-m portion of the test was timed to determine the participant's gait speed in m/s. LS means was calculated using ANCOVA and adjusted for baseline, treatment group, region, fracture type, and fixation type.
Baseline, up to 6 Months
Time to Revision Surgery
時間枠:Baseline to revision surgery (up to 14.14 Months)
Time to revision surgery was defined as the time from initial hip fracture surgery to revision surgery, or recommendation for revision surgery if recommended but not performed. Time to revision surgery was censored at the date of the last contact.
Baseline to revision surgery (up to 14.14 Months)
Mean Change From Baseline to 6 Months on Short Form-12 (SF-12) Physical (PCS) and Mental Component Summary (MCS) Scores
時間枠:Baseline, up to 6 Months
SF-12 is a self-reported questionnaire covering a mental component score (MCS) and a physical component score (PCS), each scoring from a 0 to 100 (worst to best) scale. LS mean was calculated using ANCOVA and adjusted for baseline, treatment group, region, fracture type, fixation type, visit, and visit-by-treatment interaction.
Baseline, up to 6 Months
Mean Change From Baseline to 6 Months on Western Ontario McMaster Osteoarthritis Index (WOMAC)
時間枠:Baseline, up to 6 Months
WOMAC is: a self-reported questionnaire that consisted of 24 questions covering 3 health domains: Pain (5 items: during walking, using stairs, in bed, sitting or lying, and standing), Stiffness (2 items: after first waking and later in the day), and Physical Function. Each domain was scored by summing the individual items and transforming the scores into a 0 to 100 (best to worst) scale. LS mean was calculated using ANCOVA and adjusted for baseline, treatment group, region, fracture type, fixation type, visit, and visit-by-treatment interaction.
Baseline, up to 6 Months
Mean Change From Baseline to 6 Months on European Quality of Life Questionnaire (EQ-5D) Health State Score
時間枠:Baseline, up to 6 Months
The EQ-5D is a 5-item, self-reported, generic, multidimensional, health-related, quality-of-life instrument with 5 items. Overall health state score was also self-reported using a visual analogue scale (VAS) marked on a scale scored from 0 (worse imaginable health state) to 100 (best imaginable health state). LS mean was calculated using ANCOVA and adjusted for baseline, treatment group, and region.
Baseline, up to 6 Months

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2012年2月1日

一次修了 (実際)

2013年12月1日

研究の完了 (実際)

2013年12月1日

試験登録日

最初に提出

2011年11月14日

QC基準を満たした最初の提出物

2011年11月14日

最初の投稿 (見積もり)

2011年11月17日

学習記録の更新

投稿された最後の更新 (見積もり)

2015年4月16日

QC基準を満たした最後の更新が送信されました

2015年4月10日

最終確認日

2015年4月1日

詳しくは

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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