Trial Outcomes & Findings for Use of NPSP558 in the Treatment of Hypoparathyroidism (NCT NCT00732615)

NCT ID: NCT00732615

Last Updated: 2021-06-03

Results Overview

The triple efficacy endpoint criteria were defined as at least a 50% reduction from the baseline in oral calcium dose and at least a 50% reduction from the baseline in active vitamin D dose and an albumin-corrected total serum calcium concentration that was maintained or normalized compared to the baseline value (≥ 7.5 mg/dL) and did not exceed the upper limit of the laboratory normal range. The analysis of primary efficacy endpoint was based on investigator prescribed data.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

124 participants

Primary outcome timeframe

Week 24 of dosing

Results posted on

2021-06-03

Participant Flow

124 Subjects were enrolled between 12/2008 and 9/2011 at 28 clinical sites in North America, Western Europe and Hungary.

Subjects underwent a screening and stabilization period (optimization) of up to 16 weeks prior to enrollment. Please note: Data for 10 subjects were excluded.

Participant milestones

Participant milestones
Measure
Placebo
Matching Placebo: Placebo for subcutaneous injection
NPSP558
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily
Overall Study
STARTED
40
84
Overall Study
COMPLETED
33
79
Overall Study
NOT COMPLETED
7
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo
Matching Placebo: Placebo for subcutaneous injection
NPSP558
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily
Overall Study
Withdrawal by Subject
3
1
Overall Study
Lost to Follow-up
0
1
Overall Study
Adverse Event
0
2
Overall Study
Physician Decision
3
0
Overall Study
Non-Compliance, Subject/Physician Dec.
1
1

Baseline Characteristics

Use of NPSP558 in the Treatment of Hypoparathyroidism

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=40 Participants
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=84 Participants
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily
Total
n=124 Participants
Total of all reporting groups
Age, Customized
< 45 years
13 Participants
n=5 Participants
35 Participants
n=7 Participants
48 Participants
n=5 Participants
Age, Customized
45 to 64 years
23 Participants
n=5 Participants
45 Participants
n=7 Participants
68 Participants
n=5 Participants
Age, Customized
> = 65 years
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Sex: Female, Male
Female
33 Participants
n=5 Participants
65 Participants
n=7 Participants
98 Participants
n=5 Participants
Sex: Female, Male
Male
7 Participants
n=5 Participants
19 Participants
n=7 Participants
26 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
40 Participants
n=5 Participants
82 Participants
n=7 Participants
122 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
39 Participants
n=5 Participants
80 Participants
n=7 Participants
119 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Region of Enrollment
North America
21 Participants
n=5 Participants
43 Participants
n=7 Participants
64 Participants
n=5 Participants
Region of Enrollment
Europe
12 Participants
n=5 Participants
25 Participants
n=7 Participants
37 Participants
n=5 Participants
Region of Enrollment
Hungary
7 Participants
n=5 Participants
16 Participants
n=7 Participants
23 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Week 24 of dosing

Population: Intent to Treat (ITT) population, which includes all randomized subjects who received at least 1 dose of study drug and had at least 1 post-baseline efficacy assessment.

The triple efficacy endpoint criteria were defined as at least a 50% reduction from the baseline in oral calcium dose and at least a 50% reduction from the baseline in active vitamin D dose and an albumin-corrected total serum calcium concentration that was maintained or normalized compared to the baseline value (≥ 7.5 mg/dL) and did not exceed the upper limit of the laboratory normal range. The analysis of primary efficacy endpoint was based on investigator prescribed data.

Outcome measures

Outcome measures
Measure
Placebo
n=40 Participants
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=84 Participants
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily.
The Percentage of Subjects Who Met the Triple Efficacy Endpoint Criteria at Week 24.
2.5 percentage of participants
Interval 0.1 to 13.2
54.8 percentage of participants
Interval 43.5 to 65.7

SECONDARY outcome

Timeframe: 24 Weeks

Population: Intent to Treat (ITT) population subjects with Baseline and Week 24 data

The analysis of this endpoint was based on investigator prescribed data.

Outcome measures

Outcome measures
Measure
Placebo
n=33 Participants
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=79 Participants
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily.
Percentage Changes From Baseline in Daily Calcium Dose at Week 24.
2.4 percentage change from baseline
Standard Deviation 38.37
-51.8 percentage change from baseline
Standard Deviation 45.71

SECONDARY outcome

Timeframe: 24 Weeks

Population: Intent to Treat (ITT) population subjects with Baseline and Week 24 data.

Subjects Who Achieved Independence from Active Vitamin D Usage and with Calcium Dose of 500 mg/day or less. This analysis was based on Investigator Prescribed Data.

Outcome measures

Outcome measures
Measure
Placebo
n=33 Participants
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=79 Participants
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily.
Proportion of Subjects Who Achieved Independence From Active Vitamin D and an Oral Calcium Dose of ≤ 500 mg/Day at Week 24.
6.1 percentage of participants
43.0 percentage of participants

SECONDARY outcome

Timeframe: 8 Weeks

Population: Intent to Treat (ITT) population.

Clinical symptoms were a selected group of adverse events that occurred during study weeks 16 through 24. The group of terms were defined by key opinion leaders and documented in study protocol.

Outcome measures

Outcome measures
Measure
Placebo
n=40 Participants
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=84 Participants
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily.
Percentage of Subjects With Any Clinical Symptoms of Hypocalcemia During Weeks 16-24.
37.5 percentage of participants
34.5 percentage of participants

Adverse Events

Placebo

Serious events: 4 serious events
Other events: 38 other events
Deaths: 0 deaths

NPSP558

Serious events: 9 serious events
Other events: 69 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo
n=40 participants at risk
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=84 participants at risk
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily
Metabolism and nutrition disorders
Hypocalcaemia
2.5%
1/40 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
2.4%
2/84 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Hypercalcaemia
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
2.4%
2/84 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Dehydration
2.5%
1/40 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Diarrhoea
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Pancreatitis
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Vomiting
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Diverticulitis
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Erysipelas
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Nervous system disorders
Cerebrovascular accident
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
1.2%
1/84 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Reproductive system and breast disorders
Epididymal tenderness
2.5%
1/40 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Respiratory, thoracic and mediastinal disorders
Asthma
2.5%
1/40 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
2.5%
1/40 • Number of events 1 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period

Other adverse events

Other adverse events
Measure
Placebo
n=40 participants at risk
Matching Placebo: Placebo for subcutaneous injection
NPSP558
n=84 participants at risk
NPSP558: Recombinant Human Parathyroid hormone (rhPTH\[1-84\]) 50, 75, or 100 mcg subcutaneously daily
Nervous system disorders
Paraesthesia
25.0%
10/40 • Number of events 16 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
35.7%
30/84 • Number of events 69 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Hypocalcaemia
22.5%
9/40 • Number of events 10 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
39.3%
33/84 • Number of events 54 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Muscle spasms
30.0%
12/40 • Number of events 21 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
29.8%
25/84 • Number of events 41 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Nausea
17.5%
7/40 • Number of events 9 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
20.2%
17/84 • Number of events 35 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Upper respiratory tract infection
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
9.5%
8/84 • Number of events 8 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
General disorders
Fatigue
20.0%
8/40 • Number of events 11 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
11.9%
10/84 • Number of events 25 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Sinusitis
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
7.1%
6/84 • Number of events 6 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Nervous system disorders
Headache
25.0%
10/40 • Number of events 20 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
26.2%
22/84 • Number of events 56 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Nervous system disorders
Hypoaesthesia
12.5%
5/40 • Number of events 6 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
19.0%
16/84 • Number of events 24 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Hypercalcaemia
10.0%
4/40 • Number of events 4 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
16.7%
14/84 • Number of events 17 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Tetany
10.0%
4/40 • Number of events 13 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
11.9%
10/84 • Number of events 24 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Metabolism and nutrition disorders
Hypomagnesaemia
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Arthralgia
12.5%
5/40 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
11.9%
10/84 • Number of events 18 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Pain in extremity
7.5%
3/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
10.7%
9/84 • Number of events 13 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Back pain
17.5%
7/40 • Number of events 8 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
9.5%
8/84 • Number of events 8 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Myalgia
7.5%
3/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
7.1%
6/84 • Number of events 13 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Neck pain
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Diarrhoea
10.0%
4/40 • Number of events 4 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
11.9%
10/84 • Number of events 13 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Vomiting
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
11.9%
10/84 • Number of events 12 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Paraesthesia oral
7.5%
3/40 • Number of events 6 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
8.3%
7/84 • Number of events 7 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Abdominal pain upper
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
8.3%
7/84 • Number of events 9 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Renal and urinary disorders
Hypercalciuria
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
7.1%
6/84 • Number of events 7 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Investigations
Blood 25-hydroxycholecalciferol decreased
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Psychiatric disorders
Anxiety
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Skin and subcutaneous tissue disorders
Hypoaesthesia facial
0.00%
0/40 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Vascular disorders
Hypertension
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
6.0%
5/84 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Nervous system disorders
Dizziness
7.5%
3/40 • Number of events 4 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Nervous system disorders
Dysgeusia
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Muscle Twitching
10.0%
4/40 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Musculoskeletal and connective tissue disorders
Muscle Tightness
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Gastrointestinal disorders
Gastrooesophageal Reflux Disease
7.5%
3/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Nasopharyngitis
12.5%
5/40 • Number of events 5 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Bronchitis
7.5%
3/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Cystitis
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Herpes Zoster
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Infections and infestations
Viral Infection
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
General disorders
Injection Site Haematoma
12.5%
5/40 • Number of events 6 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
General disorders
Pyrexia
7.5%
3/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
General disorders
Feeling Cold
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
General disorders
Oedema Peripheral
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Skin and subcutaneous tissue disorders
Alopecia
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Skin and subcutaneous tissue disorders
Hyperhidrosis
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Investigations
Urine Calcium Increased
5.0%
2/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Injury, poisoning and procedural complications
Contusion
5.0%
2/40 • Number of events 3 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Injury, poisoning and procedural complications
Excoriation
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
Injury, poisoning and procedural complications
Muscle Strain
5.0%
2/40 • Number of events 2 • 28 weeks
24 weeks on treatment plus 4 week follow-up period
0.00%
0/84 • 28 weeks
24 weeks on treatment plus 4 week follow-up period

Additional Information

Study Director

Shire

Phone: +1 866 842 5335

Results disclosure agreements

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

Restriction type: OTHER