Denosumab in Enhancement of Bone Bonding of Hip Prosthesis in Postmenopausal Women

NCT ID: NCT01926158

Last Updated: 2018-04-30

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

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-31

Study Completion Date

2017-12-31

Brief Summary

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This randomized clinical trial will evaluate the efficacy of an antiresorptive osteoporosis drug (denosumab) in prevention of periprosthetic bone loss and in promotion of implant osseointegration (bone bonding) in postmenopausal women after total hip replacement. The investigators assume that denosumab prevents periprosthetic bone loss and enhances bone bonding of the hip stem in postmenopausal women.

Detailed Description

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This is a randomized, double-blind and placebo-controlled trial to evaluate the efficacy of denosumab on the biologic incorporation of cementless hip prosthesis. The study population consists of sixty-eight postmenopausal female patients, who are scheduled to have cementless total hip replacement (THA) for primary hip osteoarthritis. The patients will be randomly assigned to receive a subcutaneous injection of denosumab 60 mg or placebo four weeks before surgery and 22 weeks after surgery. The primary hypothesis is that denosumab is effective in preventing periprosthetic bone loss in the proximal femur as measured by DXA. The secondary hypothesis is that denosumab is effective in enhancement of bone bonding (osseointegration) of cementless femoral stems, as measured by model-based radiostereometric analysis.

Conditions

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Hip Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Denosumab

Subcutaneous injection of denosumab 60 mg 4 weeks before surgery and 22 weeks after surgery

Group Type EXPERIMENTAL

Denosumb

Intervention Type DRUG

Prefilled syringe of 1 mL denosumab solution

Placebo

Subcutaneous injection of placebo 4 weeks before surgery and 22 weeks after surgery

Group Type PLACEBO_COMPARATOR

Placebo (for denosumab)

Intervention Type DRUG

Interventions

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Denosumb

Prefilled syringe of 1 mL denosumab solution

Intervention Type DRUG

Placebo (for denosumab)

Intervention Type DRUG

Other Intervention Names

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Brand name: Prolia Prefilled syringe of 1 mL placebo solution

Eligibility Criteria

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Inclusion Criteria

* Postmenopausal women, age: ≥ 60 years to ≤ 85 years at randomization
* Degenerative primary hip osteoarthritis as the indication of hip replacement
* Signed informed consent

Exclusion Criteria

* Presence of severe osteoporosis (T-score less than -4.0 and a previous fracture)
* Presence of Dorr C-type geometric change of the proximal femur
* Evidence of secondary osteoporosis
* Clinical or laboratory evidence of hepatic disease
* Laboratory evidence of hypocalcaemia
* Vitamin D deficiency (serum 25-OH(D) \< 12 ng/mL)
* Disorders of parathyroid function
* Uncontrolled hyperthyroidism or hypothyroidism
* History of malignancy, radiotherapy or chemotherapy for malignancy (except basal cell carcinoma of the skin) within the last 5 years
* History of osteonecrosis of the jaw
* History of recent tooth extraction or other dental surgery and/or invasive dental work planned in the next 2 years
* Severe asthma or chronic obstructive pulmonary disease
* History of solid organ or bone marrow transplant
* Use within 12 months of drugs that affect bone metabolism such as ant-osteoporotic agents (including SERMS), estrogens, testosterone, and anti-epileptics:

* Cumulative dose of 500 mg prednisone or equivalent within the last 6 months
* Ever use of oral or iv bisphosphonates
* Ever use of strontium ranelate or fluoride
* Use of the following medications:

* chronic systemic ketoconazole
* androgens
* cinacalcet
* aluminum
* lithium
* protease inhibitors
* gonadotropin-releasing hormone agonists
* Rheumatoid arthritis or any other inflammatory arthritis
* History of skeletal disorder, such as Paget's disease or osteomalacia
* Alcohol abuse
* General

* Mental, neurological or other conditions that may affect the ability to perform functional or clinical assessments required by the protocol
* Subjects with known sensitivity or intolerance to any of the products to be administered (calcium and D-vitamin supplements, denosumab)
* Subject will not be available for protocol-required study visits, to the best of the subject's and investigator's knowledge
* Any other condition that, in the judgement of the investigator, may compromise the ability of the subject to give written informed consent and/or to comply with all required study procedures
Minimum Eligible Age

60 Years

Maximum Eligible Age

85 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role collaborator

Turku University Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hannu T Aro, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Turku University Hospital

Locations

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Turku University Hospital

Turku, , Finland

Site Status

Countries

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Finland

References

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Aro HT, Alm JJ, Moritz N, Makinen TJ, Lankinen P. Low BMD affects initial stability and delays stem osseointegration in cementless total hip arthroplasty in women: a 2-year RSA study of 39 patients. Acta Orthop. 2012 Apr;83(2):107-14. doi: 10.3109/17453674.2012.678798. Epub 2012 Apr 11.

Reference Type BACKGROUND
PMID: 22489886 (View on PubMed)

Moritz N, Alm JJ, Lankinen P, Makinen TJ, Mattila K, Aro HT. Quality of intertrochanteric cancellous bone as predictor of femoral stem RSA migration in cementless total hip arthroplasty. J Biomech. 2011 Jan 11;44(2):221-7. doi: 10.1016/j.jbiomech.2010.10.012. Epub 2010 Nov 11.

Reference Type BACKGROUND
PMID: 21074160 (View on PubMed)

Alm JJ, Makinen TJ, Lankinen P, Moritz N, Vahlberg T, Aro HT. Female patients with low systemic BMD are prone to bone loss in Gruen zone 7 after cementless total hip arthroplasty. Acta Orthop. 2009 Oct;80(5):531-7. doi: 10.3109/17453670903316801.

Reference Type BACKGROUND
PMID: 19916684 (View on PubMed)

Makinen TJ, Alm JJ, Laine H, Svedstrom E, Aro HT. The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement. Bone. 2007 Apr;40(4):1041-7. doi: 10.1016/j.bone.2006.11.013. Epub 2007 Jan 17.

Reference Type BACKGROUND
PMID: 17239668 (View on PubMed)

Makinen TJ, Koort JK, Mattila KT, Aro HT. Precision measurements of the RSA method using a phantom model of hip prosthesis. J Biomech. 2004 Apr;37(4):487-93. doi: 10.1016/j.jbiomech.2003.09.004.

Reference Type BACKGROUND
PMID: 14996560 (View on PubMed)

Nazari-Farsani S, Finnila S, Moritz N, Mattila K, Alm JJ, Aro HT. Is Model-based Radiostereometric Analysis Suitable for Clinical Trials of a Cementless Tapered Wedge Femoral Stem? Clin Orthop Relat Res. 2016 Oct;474(10):2246-53. doi: 10.1007/s11999-016-4930-0. Epub 2016 Jun 22.

Reference Type RESULT
PMID: 27334320 (View on PubMed)

Other Identifiers

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2011-000628-14

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ISS 20109714

Identifier Type: -

Identifier Source: org_study_id

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