Trial Outcomes & Findings for Fracture (FX) Improvement With Teriparatide: FiX-IT Study (NCT NCT01705587)

NCT ID: NCT01705587

Last Updated: 2017-12-12

Results Overview

The radiologic indices of fracture healing included (1) cortical continuity on two of four cortices, (2) persistence of alignment, (3) decreased conspicuity of fracture line, and (4) increased callus formation. For each of these indices, healing was graded on a scale of 1 to 4 with 1 = no change (less than 25%), 2 = minimum healing (25-50%), 3 = moderate healing (50-75%), and 4 = complete healing (greater than 75%). A composite score was calculated by summing the subscale scores for the 4 indices. Composite score scale ranged from 4 to 16 with higher scores indicating more complete healing. The primary grading was performed by a radiologist with expertise in musculoskeletal radiology, then independently repeated by a second radiologist, both of whom were blinded to the study allocation.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

13 participants

Primary outcome timeframe

6, 12 months of treatment

Results posted on

2017-12-12

Participant Flow

Participant milestones

Participant milestones
Measure
Immediate Teriparatide
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Overall Study
STARTED
7
6
Overall Study
COMPLETED
7
5
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Immediate Teriparatide
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Overall Study
Withdrawal by Subject
0
1

Baseline Characteristics

Fracture (FX) Improvement With Teriparatide: FiX-IT Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Immediate Teriparatide
n=7 Participants
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=6 Participants
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Total
n=13 Participants
Total of all reporting groups
Age, Continuous
78.0 years
STANDARD_DEVIATION 8.660 • n=5 Participants
69.8 years
STANDARD_DEVIATION 8.085 • n=7 Participants
74.2 years
STANDARD_DEVIATION 9.094 • n=5 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
6 Participants
n=7 Participants
13 Participants
n=5 Participants
Sex: Female, Male
Male
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
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 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
7 Participants
n=5 Participants
4 Participants
n=7 Participants
11 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
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 6, 12 months of treatment

The radiologic indices of fracture healing included (1) cortical continuity on two of four cortices, (2) persistence of alignment, (3) decreased conspicuity of fracture line, and (4) increased callus formation. For each of these indices, healing was graded on a scale of 1 to 4 with 1 = no change (less than 25%), 2 = minimum healing (25-50%), 3 = moderate healing (50-75%), and 4 = complete healing (greater than 75%). A composite score was calculated by summing the subscale scores for the 4 indices. Composite score scale ranged from 4 to 16 with higher scores indicating more complete healing. The primary grading was performed by a radiologist with expertise in musculoskeletal radiology, then independently repeated by a second radiologist, both of whom were blinded to the study allocation.

Outcome measures

Outcome measures
Measure
Immediate Teriparatide
n=7 Participants
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=6 Participants
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Radiologic Evidence of Bone Healing
6 mo
12.6 units on a scale
Standard Error 0.6
11.2 units on a scale
Standard Error 1.3
Radiologic Evidence of Bone Healing
12 mo
15.4 units on a scale
Standard Error 0.4
13.2 units on a scale
Standard Error 1.2

PRIMARY outcome

Timeframe: at 10 weeks for immediate teriparatide group

Population: Based on orthopedic surgeons' assessment, x-rays were not deemed necessary in over 30% of patients at week 10. Results presented are for those who had x-rays at 10 weeks to assess persistence of alignment for safety purposes.

Number of participants with persistence of alignment as determined by a radiologist.

Outcome measures

Outcome measures
Measure
Immediate Teriparatide
n=5 Participants
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=4 Participants
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Radiologic Evidence of Healing
5 Participants
4 Participants

SECONDARY outcome

Timeframe: at 2, 6, 24, and 48 weeks

Population: Data not collected at 2 and 6 weeks. Twenty-Four week (6 months) data is presented in 6 month outcomes, and 48 week (12 months) data as 12 month outcomes (See primary outcomes section above).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: at 6 and 12 months

Percent change in Bone Mineral Density (BMD) as assessed by dual x-ray absorptiometry (DXA) at the spine, contralateral hip, distal 1/3 radius, and femoral neck

Outcome measures

Outcome measures
Measure
Immediate Teriparatide
n=7 Participants
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=6 Participants
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Increased Bone Density
Spine-PA (6 months)
2.1 percentage change in BMD
Standard Error 1.5
-0.6 percentage change in BMD
Standard Error 1.3
Increased Bone Density
Spine-PA (12 months)
2.8 percentage change in BMD
Standard Error 2.0
5.4 percentage change in BMD
Standard Error 2.8
Increased Bone Density
Total Hip (6 months)
-1.6 percentage change in BMD
Standard Error 1.5
-0.8 percentage change in BMD
Standard Error 0.7
Increased Bone Density
Total Hip (12 months)
-0.3 percentage change in BMD
Standard Error 1.8
1.5 percentage change in BMD
Standard Error 2.7
Increased Bone Density
Femoral Neck (6 months)
-1.8 percentage change in BMD
Standard Error 2.1
-2.7 percentage change in BMD
Standard Error 1.0
Increased Bone Density
Femoral Neck (12 months)
-2.5 percentage change in BMD
Standard Error 3.0
-1.9 percentage change in BMD
Standard Error 3.6
Increased Bone Density
Distal 1/3 Radius (6 months)
-0.6 percentage change in BMD
Standard Error 1.9
-0.7 percentage change in BMD
Standard Error 1.1
Increased Bone Density
Distal 1/3 Radius (12 months)
-1.9 percentage change in BMD
Standard Error 1.7
-6.1 percentage change in BMD
Standard Error 2.1

SECONDARY outcome

Timeframe: at 12 months

Assessed by quality of life questionnaire (SF-36). There are 8 subscales each ranging from 0-100 with higher scores indicating better quality of life.

Outcome measures

Outcome measures
Measure
Immediate Teriparatide
n=7 Participants
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=4 Participants
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Quality of Life Improvements
Pain
72.9 units on a scale
Standard Error 9.7
59.4 units on a scale
Standard Error 21.2
Quality of Life Improvements
Physical functioning
49.3 units on a scale
Standard Error 6.5
65.0 units on a scale
Standard Error 20.3
Quality of Life Improvements
Physical health limitations
48.2 units on a scale
Standard Error 9.1
68.8 units on a scale
Standard Error 21.2
Quality of Life Improvements
Emotional health limitations
75.0 units on a scale
Standard Error 9.1
72.9 units on a scale
Standard Error 19.7
Quality of Life Improvements
Energy/Fatigue
54.5 units on a scale
Standard Error 7.4
59.4 units on a scale
Standard Error 15.0
Quality of Life Improvements
Emotional well-being
80.7 units on a scale
Standard Error 4.1
70.0 units on a scale
Standard Error 9.1
Quality of Life Improvements
Social functioning
92.9 units on a scale
Standard Error 4.6
65.6 units on a scale
Standard Error 23.6
Quality of Life Improvements
General health
66.1 units on a scale
Standard Error 6.2
67.2 units on a scale
Standard Error 12.1

SECONDARY outcome

Timeframe: intervals over 12-18 months depending on treatment group

Population: Funding unavailable for sample analysis.

upfront therapy group compared to delayed therapy group and no therapy group

Outcome measures

Outcome data not reported

Adverse Events

Immediate Teriparatide

Serious events: 3 serious events
Other events: 5 other events
Deaths: 0 deaths

Delayed Teriparatide

Serious events: 2 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Immediate Teriparatide
n=7 participants at risk
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=6 participants at risk
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Surgical and medical procedures
elective back surgery
0.00%
0/7
16.7%
1/6 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Ewings Sarcoma
0.00%
0/7
16.7%
1/6 • Number of events 1
Infections and infestations
Cellulitis
14.3%
1/7 • Number of events 1
0.00%
0/6
Blood and lymphatic system disorders
Abnormal coagulation profile
14.3%
1/7 • Number of events 1
0.00%
0/6
General disorders
Hematoma
14.3%
1/7 • Number of events 1
0.00%
0/6

Other adverse events

Other adverse events
Measure
Immediate Teriparatide
n=7 participants at risk
Open label teriparatide given immediately following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Delayed Teriparatide
n=6 participants at risk
Open label teriparatide given six months following surgical repair of fracture teriparatide: 20 microgram once-daily subcutaneous injection
Musculoskeletal and connective tissue disorders
Fall
14.3%
1/7 • Number of events 1
0.00%
0/6
Nervous system disorders
aphasia
14.3%
1/7 • Number of events 1
0.00%
0/6
Ear and labyrinth disorders
myringotomy
14.3%
1/7 • Number of events 1
0.00%
0/6
Musculoskeletal and connective tissue disorders
arthralgias
14.3%
1/7 • Number of events 1
0.00%
0/6
Infections and infestations
pneumonia
14.3%
1/7 • Number of events 1
0.00%
0/6
Eye disorders
macular degeneration
14.3%
1/7 • Number of events 1
0.00%
0/6
Surgical and medical procedures
cataract removal
14.3%
1/7 • Number of events 2
0.00%
0/6
Vascular disorders
deep vein thrombosis
0.00%
0/7
16.7%
1/6 • Number of events 1
General disorders
gingivitis
0.00%
0/7
16.7%
1/6 • Number of events 1
Surgical and medical procedures
periodontal gum surgery
0.00%
0/7
16.7%
1/6 • Number of events 1
Immune system disorders
allergic rhinitis
0.00%
0/7
16.7%
1/6 • Number of events 1
Vascular disorders
coronary artery disease
0.00%
0/7
16.7%
1/6 • Number of events 1
Surgical and medical procedures
cardiac catheterization
0.00%
0/7
16.7%
1/6 • Number of events 1
General disorders
dizziness
0.00%
0/7
16.7%
1/6 • Number of events 1
Infections and infestations
varicella zoster
0.00%
0/7
16.7%
1/6 • Number of events 1
Musculoskeletal and connective tissue disorders
thigh pain
0.00%
0/7
33.3%
2/6 • Number of events 2

Additional Information

Susan Greenspan, MD

University of Pittsburgh

Phone: 412-692-2477

Results disclosure agreements

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