Trial Outcomes & Findings for Parathyroid Hormone (PTH) for Osteoporosis in Postmenopausal Women (NCT NCT00086619)

NCT ID: NCT00086619

Last Updated: 2013-10-30

Results Overview

Change from month 0 (pre-treatment) baseline serum aminoterminal propeptide of type I collagen (PINP), osteocalcin (OC), and C-terminal telopeptide (CTX), expressed as an area under the curve (AUC). Each marker measurement result was multiplied by the corresponding subject-specific elapsed study time interval using the trapezoidal rule, and these products were summed to generate a subject-specific AUC (months\*ng/ml) for the marker.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

80 participants

Primary outcome timeframe

Each index of bone turnover was measured at study month 0, 1.5, 3, 6, 7.5, 9, 12, 13.5, 15, and 18.

Results posted on

2013-10-30

Participant Flow

Postmenopausal women with low bone density were recruited from 2004-2007 to participate in this study at a single academic medical center. Recruitment letters were sent to women in the Greater Boston area and the trial was also posted on clinicaltrials.gov.

Must satisfy inclusion and exclusion criteria.

Participant milestones

Participant milestones
Measure
Constant Dose PTH
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Overall Study
STARTED
40
40
Overall Study
Completed Baseline Visit
34
36
Overall Study
Completed 12 Month Visit
26
26
Overall Study
COMPLETED
25
23
Overall Study
NOT COMPLETED
15
17

Reasons for withdrawal

Reasons for withdrawal
Measure
Constant Dose PTH
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Overall Study
Withdrawal by Subject
6
6
Overall Study
Adverse Event
8
10
Overall Study
Protocol Violation
1
1

Baseline Characteristics

Parathyroid Hormone (PTH) for Osteoporosis in Postmenopausal Women

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Constant Dose PTH
n=40 Participants
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
n=40 Participants
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Total
n=80 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
26 Participants
n=5 Participants
27 Participants
n=7 Participants
53 Participants
n=5 Participants
Age, Categorical
>=65 years
14 Participants
n=5 Participants
13 Participants
n=7 Participants
27 Participants
n=5 Participants
Age Continuous
63.3 years
STANDARD_DEVIATION 7.6 • n=5 Participants
62.1 years
STANDARD_DEVIATION 8.9 • n=7 Participants
62.7 years
STANDARD_DEVIATION 8.2 • n=5 Participants
Sex: Female, Male
Female
40 Participants
n=5 Participants
40 Participants
n=7 Participants
80 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
40 participants
n=5 Participants
40 participants
n=7 Participants
80 participants
n=5 Participants

PRIMARY outcome

Timeframe: Each index of bone turnover was measured at study month 0, 1.5, 3, 6, 7.5, 9, 12, 13.5, 15, and 18.

Population: Because this was a physiologic study evaluating the impact of stepwise increases in teriparatide, per protocol analysis was performed as was pre-specified in our analysis plan. Outcomes data were analyzed in women who remained on teriparatide throughout the first stepwise increase (i.e. until month 12 or later).

Change from month 0 (pre-treatment) baseline serum aminoterminal propeptide of type I collagen (PINP), osteocalcin (OC), and C-terminal telopeptide (CTX), expressed as an area under the curve (AUC). Each marker measurement result was multiplied by the corresponding subject-specific elapsed study time interval using the trapezoidal rule, and these products were summed to generate a subject-specific AUC (months\*ng/ml) for the marker.

Outcome measures

Outcome measures
Measure
Constant Dose PTH
n=26 Participants
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
n=26 Participants
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Changes in Indices of Bone Turnover
PINP
4418 months*(ng/ml - baseline ng/ml)
Standard Deviation 2732
3696 months*(ng/ml - baseline ng/ml)
Standard Deviation 1735
Changes in Indices of Bone Turnover
OC
956 months*(ng/ml - baseline ng/ml)
Standard Deviation 416
822 months*(ng/ml - baseline ng/ml)
Standard Deviation 312
Changes in Indices of Bone Turnover
CTX
22 months*(ng/ml - baseline ng/ml)
Standard Deviation 11
19 months*(ng/ml - baseline ng/ml)
Standard Deviation 9

SECONDARY outcome

Timeframe: baseline and 18 months (12 months in 4 subjects)

Population: Final BMD was measured after 18 months of study therapy in 48 subjects and measured after 12 months of study therapy in 4 others who thereafter dropped out prematurely. Of the latter 4, 3 were in the ascending dose arm and 1 was in the constant dose arm.

Percent change in BMD of the spine, femur, radius, and ulna, and subtotal body, calculated as 100\*\[(final - month 0)/month 0\] in subjects who took study therapy for at least 12 months.

Outcome measures

Outcome measures
Measure
Constant Dose PTH
n=26 Participants
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
n=26 Participants
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Change in Bone Mineral Density (BMD)
1/3 Radius BMD
-4.6 percent change
Standard Deviation 2.8
-3.1 percent change
Standard Deviation 3.3
Change in Bone Mineral Density (BMD)
Femoral neck BMD
1.7 percent change
Standard Deviation 3.0
3.5 percent change
Standard Deviation 2.7
Change in Bone Mineral Density (BMD)
Spine BMD
5.9 percent change
Standard Deviation 4.6
7.4 percent change
Standard Deviation 3.8
Change in Bone Mineral Density (BMD)
Subtotal BMD
-1.6 percent change
Standard Deviation 0.8
-0.9 percent change
Standard Deviation 0.5
Change in Bone Mineral Density (BMD)
Total hip BMD
1.4 percent change
Standard Deviation 3.1
1.3 percent change
Standard Deviation 2.5

Adverse Events

Constant Dose PTH

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Ascending Dose PTH

Serious events: 2 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Constant Dose PTH
n=40 participants at risk
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
n=40 participants at risk
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Endocrine disorders
Hypercalcemia requiring emergency room visit
0.00%
0/40
2.5%
1/40 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Diagnosed with lung cancer
0.00%
0/40
2.5%
1/40 • Number of events 1

Other adverse events

Other adverse events
Measure
Constant Dose PTH
n=40 participants at risk
Participants received constant dose synthetic hPTH 1-34 (30 mcg/day).
Ascending Dose PTH
n=40 participants at risk
Participants received ascending dose synthetic hPTH 1-34 (20-30-40 mcg/day).
Endocrine disorders
Mild hypercalcemia or hypercalciuria
7.5%
3/40 • Number of events 3
12.5%
5/40 • Number of events 5
Musculoskeletal and connective tissue disorders
Joint pain
0.00%
0/40
2.5%
1/40 • Number of events 1
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/40
2.5%
1/40 • Number of events 1
Gastrointestinal disorders
Nausea
2.5%
1/40 • Number of events 1
2.5%
1/40 • Number of events 1
Blood and lymphatic system disorders
Lower extremity edema
2.5%
1/40 • Number of events 1
0.00%
0/40

Additional Information

Robert Neer, MD

Massachusetts General Hospital

Phone: 617-726-6723

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place