Dose Response and Receptor Selectivity of Beta-blocker Effects on Bone Metabolism

NCT ID: NCT02467400

Last Updated: 2019-02-06

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

EARLY_PHASE1

Total Enrollment

165 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-01

Study Completion Date

2018-04-01

Brief Summary

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This study is designed to answer the question as to whether the sympathetic nervous system is an important determinant of bone metabolism in humans.

Detailed Description

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In postmenopausal women, who have increased sympathetic outflow, to test the hypothesis that treatment with low doses of a non-selective β-blocker (propranolol) will increase serum markers of bone formation and reduce markers of bone resorption (Aim 1a); and using increasingly β1-AR (adrenergic receptor) selective blockers (atenolol and nebivolol), to better define the β-adrenergic receptor selectivity (β1 versus β2) in the regulation of bone turnover by sympathetic outflow in humans.

Conditions

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Osteoporosis, Age-Related

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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placebo

Sugar pill 2/day for 20 weeks; The once daily groups will receive a placebo as the second dose

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

placebo

Atenolol

Atenolol 50 mg 1/day for 20 weeks

Group Type ACTIVE_COMPARATOR

Atenolol

Intervention Type DRUG

beta blocker

Nebivolol

Nebivolol 5 mg/day for 20 weeks

Group Type ACTIVE_COMPARATOR

Nebivolol

Intervention Type DRUG

beta blocker

Propranolol 40 mg

Propranolol 20 mg bid for 20 weeks

Group Type ACTIVE_COMPARATOR

Propranolol

Intervention Type DRUG

beta blocker

Propranolol 80 mg

Propranolol 40 mg bid for 20 weeks

Group Type ACTIVE_COMPARATOR

Propranolol

Intervention Type DRUG

beta blocker

Interventions

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Atenolol

beta blocker

Intervention Type DRUG

Nebivolol

beta blocker

Intervention Type DRUG

Propranolol

beta blocker

Intervention Type DRUG

placebo

placebo

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* at least 5 yrs since their last menses
* Follicle Stimulating Hormone (FSH) \> 20 IU/L

Exclusion Criteria

* Abnormality in any of the screening laboratory studies
* Presence of significant liver or renal disease
* Malignancy (including myeloma)
* Malabsorption
* Diabetes
* Hypoparathyroidism
* Hyperparathyroidism
* Acromegaly
* Cushing's syndrome
* Hypopituitarism
* Severe chronic obstructive pulmonary disease
* Undergoing treatment with any medications that affect bone turnover, including the following:
* adrenocorticosteroids (\> 3 months at any time or \> 10 days within the previous yr)
* anticonvulsant therapy (within the previous year)
* pharmacological doses of thyroid hormone (causing decline of thyroid stimulating hormone below normal)
* calcium supplementation of \> 1200 mg/d (within the preceding 3 months)
* bisphosphonates (within the past 3 yrs)
* denosumab
* estrogen (E) therapy within the past year
* treatment with a selective E receptor modulator within the past year
* teriparatide within the past yr
* anti-hypertensive therapy

* Clinical history of osteoporotic fracture (vertebral, hip, or distal forearm
* Recent (within the past 6 months) fracture
* Serum 25-hydroxyvitamin D levels of \< 20 ng/ml
* Resting blood pressure \>140/90 mm Hg or those with hypotension (systolic blood pressure \<110 mm Hg), heart rate \< 60 bpm
* History of asthma
Minimum Eligible Age

50 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Sundeep Khosla, M.D.

Professor of Medicine and Physiology, College of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sundeep Khosla, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

References

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Khosla S, Drake MT, Volkman TL, Thicke BS, Achenbach SJ, Atkinson EJ, Joyner MJ, Rosen CJ, Monroe DG, Farr JN. Sympathetic beta1-adrenergic signaling contributes to regulation of human bone metabolism. J Clin Invest. 2018 Nov 1;128(11):4832-4842. doi: 10.1172/JCI122151. Epub 2018 Oct 2.

Reference Type DERIVED
PMID: 30153111 (View on PubMed)

Other Identifiers

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14-004305

Identifier Type: -

Identifier Source: org_study_id

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