The Effect of Alendronate, Calcium, and Vitamin D on Bone Mineral Density in HIV Infected Patients

NCT ID: NCT00061256

Last Updated: 2009-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2006-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Alendronate is a drug that is used to treat osteoporosis. The purpose of this study is to examine whether alendronate in combination with calcium and vitamin D is safe and effective for treating bone loss in people with HIV.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Decreased bone mineral density (BMD) has been identified in up to 50% of HIV infected men, with severe osteoporosis in up to 21% of these men. The mechanisms underlying these bone abnormalities remain unclear. Bisphosphonates are potent bone resorption inhibitors and have been shown to be effective in treating osteoporosis. While several bisphosphonates are approved for the treatment of osteoporosis in women, alendronate is the only bisphosphonate approved for treatment in men. This study hypothesizes that alendronate will be able to reverse decreased BMD secondary to inhibition of bone resorption in HIV infected patients treated with potent antiretroviral therapy, and that these patients will be able to tolerate alendronate without any significant toxicities. The study will also examine the efficacy of once-weekly alendronate with daily calcium and vitamin D in both men and women with HIV.

Patients will participate in this study for 48 weeks. Patients will be randomly assigned to receive either alendronate or placebo. All patients will receive calcium and vitamin D. Dual energy x-ray absorptiometry (DEXA) scans will be used to evaluate bone density at each visit. After study entry, patients will have visits at Weeks 2, 12, 24, 36, and 48. During these visits, blood will be drawn and a pregnancy test may be performed. Patients must fast for at least 8 hours prior to the entry visit and for the visits at Weeks 2, 12, 24, and 48.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

HIV Infections

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Alendronate

Intervention Type DRUG

Calcium carbonate

Intervention Type DRUG

Vitamin D

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* HIV-1 infection
* Lumbar spine DEXA scan confirming decreased BMD within 90 days prior to study entry
* CD4 cell count 100 cells/mm3 or more within 30 days prior to study entry
* Stable antiretroviral regimen for at least 12 weeks prior to study entry
* No plans to alter antiretroviral therapy or to initiate structured/strategic treatment interruptions
* No plans to significantly alter exercise habits or diet for the duration of the study
* Documentation of two consecutive measurements of viral load of 5000 copies/ml or less within 90 days prior to study entry, with at least one of the two values obtained within 30 days prior to study entry
* Willing to use acceptable methods of contraception
* For women with the absence of menses for at least 6 months, serum prolactin level in the normal range within 60 days prior to study entry
* For women taking estrogen therapy, stable estrogen regimen for at least 24 weeks prior to study entry, with no plan to change estrogen dose for the duration of the study
* Serum calcium between 8 mg/dl and 11 mg/dl within 30 days prior to study entry

Exclusion Criteria

* Men with untreated low total serum testosterone levels within 60 days prior to study entry, or men with plans to initiate testosterone replacement during the study
* Cannot receive vitamin D or calcium supplements
* Daily vitamin or dietary supplements that include 10,000 IU or greater of vitamin A within 90 days prior to study entry
* Hyperparathyroidism, vitamin D deficiency, or oral thrush within 60 days prior to study entry
* Any current or past conditions that predispose to disorders involving the esophagus. Participants with a history of mild or controlled reflux may be enrolled.
* Esophagitis within 6 months prior to study entry
* Pregnant or breastfeeding
* Paget's disease
* Spinal fracture (thoracic or lumbar spine) within 60 days prior to study entry
* Atraumatic bone fracture at any time since 18 years of age
* Spinal fracture at any time in the past
* Inability to stand or sit upright for at least 30 minutes
* Use of systemic glucocorticoids for a cumulative duration of longer than 4 weeks within 6 months immediately prior to study entry
* Use of medications for treatment of osteoporosis within 12 months prior to study entry
* Allergy/hypersensitivity to any component of alendronate, the components of the tablet, or bisphosphonate compounds
* Active drug or alcohol dependence which, in the opinion of the investigator, would interfere with adherence to study requirements or would endanger the patient's health while on study
* Hospitalization for alcohol-related liver disease at any time in the past
* Current use of systemic cytotoxic chemotherapy
* Acute illness within 30 days prior to study entry which, in the opinion of the investigator, would interfere with participation in the study
* History of hepatitis C virus infection
* For participants using anabolic steroids, use of steroids for less than 6 months prior to entry or plans to change current regimen during the course of the study; if a steroid regimen has been discontinued, it must have been discontinued at least 6 months prior to entry
Minimum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Grace McComsey, MD

Role: STUDY_CHAIR

Division of Infectious Diseases, Case Western Reserve University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Alabama-Birmingham

Birmingham, Alabama, United States

Site Status

UCLA School of Medicine

Los Angeles, California, United States

Site Status

University of California, San Diego

San Diego, California, United States

Site Status

San Francisco General Hospital

San Francisco, California, United States

Site Status

Stanford Univ

Stanford, California, United States

Site Status

Georgetown University Medical Center

Washington D.C., District of Columbia, United States

Site Status

Northwestern University

Chicago, Illinois, United States

Site Status

Cook County Hospital Core Center

Chicago, Illinois, United States

Site Status

Indiana Univ Hosp

Indianapolis, Indiana, United States

Site Status

Methodist Hosp of Indiana

Indianapolis, Indiana, United States

Site Status

Wishard Hosp

Indianapolis, Indiana, United States

Site Status

Univ of Minnesota

Minneapolis, Minnesota, United States

Site Status

Nebraska Health System

Omaha, Nebraska, United States

Site Status

Chelsea Clinic

New York, New York, United States

Site Status

NYU/Bellevue

New York, New York, United States

Site Status

AIDS Community Health Center

Rochester, New York, United States

Site Status

Univ of Rochester Med Ctr

Rochester, New York, United States

Site Status

Univ of North Carolina

Chapel Hill, North Carolina, United States

Site Status

Case Western Reserve Univ

Cleveland, Ohio, United States

Site Status

MetroHealth Medical Center

Cleveland, Ohio, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

University of Pennsylvania, Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Rhode Island Hosp

Providence, Rhode Island, United States

Site Status

Stanley Street Treatment and Resource

Providence, Rhode Island, United States

Site Status

The Miriam Hosp

Providence, Rhode Island, United States

Site Status

Comprehensive Care Clinic

Nashville, Tennessee, United States

Site Status

Univ of Texas, Galveston

Galveston, Texas, United States

Site Status

University of Washington (Seattle)

Seattle, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Tebas P, Powderly WG, Claxton S, Marin D, Tantisiriwat W, Teitelbaum SL, Yarasheski KE. Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy. AIDS. 2000 Mar 10;14(4):F63-7. doi: 10.1097/00002030-200003100-00005.

Reference Type BACKGROUND
PMID: 10770534 (View on PubMed)

Reid IR. The roles of calcium and vitamin D in the prevention of osteoporosis. Endocrinol Metab Clin North Am. 1998 Jun;27(2):389-98. doi: 10.1016/s0889-8529(05)70011-6.

Reference Type BACKGROUND
PMID: 9669144 (View on PubMed)

Orwoll E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, Adami S, Weber K, Lorenc R, Pietschmann P, Vandormael K, Lombardi A. Alendronate for the treatment of osteoporosis in men. N Engl J Med. 2000 Aug 31;343(9):604-10. doi: 10.1056/NEJM200008313430902.

Reference Type BACKGROUND
PMID: 10979796 (View on PubMed)

Schnitzer T, Bone HG, Crepaldi G, Adami S, McClung M, Kiel D, Felsenberg D, Recker RR, Tonino RP, Roux C, Pinchera A, Foldes AJ, Greenspan SL, Levine MA, Emkey R, Santora AC 2nd, Kaur A, Thompson DE, Yates J, Orloff JJ. Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Alendronate Once-Weekly Study Group. Aging (Milano). 2000 Feb;12(1):1-12.

Reference Type BACKGROUND
PMID: 10746426 (View on PubMed)

Mondy K, Tebas P. Emerging bone problems in patients infected with human immunodeficiency virus. Clin Infect Dis. 2003 Apr 1;36(Suppl 2):S101-5. doi: 10.1086/367566.

Reference Type BACKGROUND
PMID: 12652379 (View on PubMed)

McComsey GA, Kendall MA, Tebas P, Swindells S, Hogg E, Alston-Smith B, Suckow C, Gopalakrishnan G, Benson C, Wohl DA. Alendronate with calcium and vitamin D supplementation is safe and effective for the treatment of decreased bone mineral density in HIV. AIDS. 2007 Nov 30;21(18):2473-82. doi: 10.1097/QAD.0b013e3282ef961d.

Reference Type DERIVED
PMID: 18025884 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601011.html

Click here for more information about alendronate.

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601032.html

Click here for more information about calcium carbonate.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

DAIDS-ES ID 10089

Identifier Type: -

Identifier Source: secondary_id

ACTG A5163

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Network Osteoporosis Study
NCT00209469 UNKNOWN PHASE2/PHASE3
The Forteo Alendronate Comparator Trial
NCT02416271 COMPLETED PHASE4