Trial Outcomes & Findings for A Comparison of Subject-administered Romosozumab With Healthcare Provider-administered Romosozumab for Osteoporosis (NCT NCT03432533)

NCT ID: NCT03432533

Last Updated: 2020-11-23

Results Overview

Percent change from baseline in BMD at the lumbar spine as measured by dual-energy x-ray absorptiometry (DXA).

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

283 participants

Primary outcome timeframe

Baseline, Month 6

Results posted on

2020-11-23

Participant Flow

Participants were enrolled at 36 centers in Poland, United Kingdom, and United States.

Participants were randomized in a 1:1 ratio.

Participant milestones

Participant milestones
Measure
Romosozumab 210 mg QM: PFS
During the open-label treatment period, participants received 210 mg romosozumab subcutaneously (SC) once a month (QM) by health care provider (HCP) administration with pre-filled syringe (PFS).
Romosozumab 210 mg QM: AI/Pen
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with autoinjector (AI)/pen.
Overall Study
STARTED
141
142
Overall Study
Completed 6-Month Treatment Period
136
137
Overall Study
COMPLETED
126
131
Overall Study
NOT COMPLETED
15
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Romosozumab 210 mg QM: PFS
During the open-label treatment period, participants received 210 mg romosozumab subcutaneously (SC) once a month (QM) by health care provider (HCP) administration with pre-filled syringe (PFS).
Romosozumab 210 mg QM: AI/Pen
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with autoinjector (AI)/pen.
Overall Study
Lost to Follow-up
1
2
Overall Study
Withdrawal by Subject
14
9

Baseline Characteristics

Participants with an assessment at baseline.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Romosozumab 210 mg QM: PFS
n=141 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=142 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Total
n=283 Participants
Total of all reporting groups
Age, Continuous
70.3 years
STANDARD_DEVIATION 7.1 • n=141 Participants
69.5 years
STANDARD_DEVIATION 8.4 • n=142 Participants
69.9 years
STANDARD_DEVIATION 7.8 • n=283 Participants
Sex: Female, Male
Female
141 Participants
n=141 Participants
142 Participants
n=142 Participants
283 Participants
n=283 Participants
Sex: Female, Male
Male
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=141 Participants
1 Participants
n=142 Participants
4 Participants
n=283 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
138 Participants
n=141 Participants
141 Participants
n=142 Participants
279 Participants
n=283 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Race (NIH/OMB)
Asian
1 Participants
n=141 Participants
1 Participants
n=142 Participants
2 Participants
n=283 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=141 Participants
1 Participants
n=142 Participants
2 Participants
n=283 Participants
Race (NIH/OMB)
White
139 Participants
n=141 Participants
140 Participants
n=142 Participants
279 Participants
n=283 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=141 Participants
0 Participants
n=142 Participants
0 Participants
n=283 Participants
Lumbar Spine Bone Mineral Density (BMD) T-Score
-2.69 T-score
STANDARD_DEVIATION 1.03 • n=141 Participants
-2.85 T-score
STANDARD_DEVIATION 1.00 • n=142 Participants
-2.77 T-score
STANDARD_DEVIATION 1.02 • n=283 Participants
Total Hip BMD T-Score
-2.29 T-score
STANDARD_DEVIATION 0.73 • n=141 Participants
-2.30 T-score
STANDARD_DEVIATION 0.77 • n=142 Participants
-2.29 T-score
STANDARD_DEVIATION 0.75 • n=283 Participants
Femoral Neck BMD T-Score
-2.54 T-score
STANDARD_DEVIATION 0.63 • n=141 Participants
-2.49 T-score
STANDARD_DEVIATION 0.65 • n=142 Participants
-2.52 T-score
STANDARD_DEVIATION 0.64 • n=283 Participants
Participants With Pre-Existing Anti-Romosozumab Antibodies
Binding Antibody Positive at or Before BL
3 Participants
n=139 Participants • Participants with an assessment at baseline.
0 Participants
n=141 Participants • Participants with an assessment at baseline.
3 Participants
n=280 Participants • Participants with an assessment at baseline.
Participants With Pre-Existing Anti-Romosozumab Antibodies
Neutralizing Antibody Positive at or Before BL
0 Participants
n=139 Participants • Participants with an assessment at baseline.
0 Participants
n=141 Participants • Participants with an assessment at baseline.
0 Participants
n=280 Participants • Participants with an assessment at baseline.

PRIMARY outcome

Timeframe: Baseline, Month 6

Population: Primary Analysis Population: participants with lumbar spine BMD values at baseline and \>=1 postbaseline visit at Month 6.

Percent change from baseline in BMD at the lumbar spine as measured by dual-energy x-ray absorptiometry (DXA).

Outcome measures

Outcome measures
Measure
Romosozumab 210 mg QM: PFS
n=135 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=134 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Percent Change From Baseline in Lumbar Spine BMD at Month 6
9.2 percent change
Standard Error 0.4
9.0 percent change
Standard Error 0.5

SECONDARY outcome

Timeframe: Baseline, Month 6

Population: Primary Analysis Population: participants with lumbar spine BMD values at baseline and \>=1 postbaseline visit at Month 6.

Percent change from baseline in BMD for total hip as measured by DXA.

Outcome measures

Outcome measures
Measure
Romosozumab 210 mg QM: PFS
n=135 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=134 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Percent Change From Baseline in Total Hip BMD at Month 6
3.7 percent change
Standard Error 0.6
3.6 percent change
Standard Error 0.3

SECONDARY outcome

Timeframe: Baseline, Month 6

Population: Primary Analysis Population: participants with lumbar spine BMD values at baseline and \>=1 postbaseline visit at Month 6.

Percent change from baseline in BMD at femoral neck as measured by DXA.

Outcome measures

Outcome measures
Measure
Romosozumab 210 mg QM: PFS
n=135 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=134 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Percent Change From Baseline in Femoral Neck BMD at Month 6
3.4 percent change
Standard Error 0.7
3.6 percent change
Standard Error 0.5

SECONDARY outcome

Timeframe: up to Month 9 (-7/+3 days)

Population: Safety Analysis Set: all randomized participants who received at least 1 dose of study drug

AE: any untoward medical occurrence irrespective of a causal relationship with the study treatment. SAE: any untoward medical occurrence that meets at least 1 of the following criteria: results in death; is immediately life-threatening; requires in-patient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; is a medically important serious event. Adverse device effect: any AE related to the use of a combination product or medical device. TEAEs are those AEs occurring after first dose of study drug.

Outcome measures

Outcome measures
Measure
Romosozumab 210 mg QM: PFS
n=141 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=142 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TEAEs: All
94 participants
96 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TEAEs: SAEs
7 participants
4 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TEAEs: Leading to Study Drug Discontinuation (DC)
7 participants
15 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TEAEs: Fatal
0 participants
0 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
Treatment-Related (TR) TEAEs: All
38 participants
59 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TR TEAEs: SAEs
0 participants
0 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TR TEAEs: Leading to Study Drug DC
6 participants
10 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
TR TEAEs: Fatal
0 participants
0 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
Device-Related (DR) TEAEs: All
18 participants
30 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
DR TEAEs: SAEs
0 participants
0 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
DR TEAEs: Leading to Study Drug DC
0 participants
5 participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), Device-Related AEs, Discontinuations Due to AEs, and Deaths
DR TEAEs: Fatal
0 participants
0 participants

SECONDARY outcome

Timeframe: up to Month 9 (-7/+3 days)

Population: Safety Analysis Set: all randomized participants who received at least 1 dose of study drug as well as baseline and postbaseline antibody results.

Participants with a negative or no result at baseline (BL) developing anti-romosozumab antibodies postbaseline, including those who were binding antibody-positive or neutralizing antibody-positive postbaseline. 'Transient' positive results are those with a negative result at the participant's last time point tested within the study period.

Outcome measures

Outcome measures
Measure
Romosozumab 210 mg QM: PFS
n=139 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by HCP administration with PFS.
Romosozumab 210 mg QM: AI/Pen
n=142 Participants
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Number of Participants Developing Anti-Romosozumab Antibodies
Transient Neutralizing Antibody Positive Post-BL
0 Participants
2 Participants
Number of Participants Developing Anti-Romosozumab Antibodies
Binding Antibody Positive Post-BL
21 Participants
22 Participants
Number of Participants Developing Anti-Romosozumab Antibodies
Transient Binding Antibody Positive Post-BL
6 Participants
3 Participants
Number of Participants Developing Anti-Romosozumab Antibodies
Neutralizing Antibody Positive Post-BL
5 Participants
4 Participants

Adverse Events

Romosozumab 210 mg SC QM by PFS

Serious events: 7 serious events
Other events: 48 other events
Deaths: 0 deaths

Romosozumab 210 mg SC QM by AI/Pen

Serious events: 4 serious events
Other events: 64 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Romosozumab 210 mg SC QM by PFS
n=141 participants at risk
During the open-label treatment period, participants received 210 mg romosozumab SC, QM by HCP administration with PFS.
Romosozumab 210 mg SC QM by AI/Pen
n=142 participants at risk
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
Cardiac disorders
Myocardial infarction
0.00%
0/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.70%
1/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Gastrointestinal disorders
Colitis ischaemic
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Immune system disorders
Anaphylactic reaction
0.00%
0/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.70%
1/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Infections and infestations
Cellulitis
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Infections and infestations
Clostridium difficile infection
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Infections and infestations
Urinary tract infection
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Injury, poisoning and procedural complications
Forearm fracture
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Injury, poisoning and procedural complications
Humerus fracture
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Injury, poisoning and procedural complications
Wound
0.00%
0/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.70%
1/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Basal cell carcinoma
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Glioblastoma
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Nervous system disorders
Cerebrovascular accident
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.00%
0/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Vascular disorders
Deep vein thrombosis
0.71%
1/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
0.70%
1/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.

Other adverse events

Other adverse events
Measure
Romosozumab 210 mg SC QM by PFS
n=141 participants at risk
During the open-label treatment period, participants received 210 mg romosozumab SC, QM by HCP administration with PFS.
Romosozumab 210 mg SC QM by AI/Pen
n=142 participants at risk
During the open-label treatment period, participants received 210 mg romosozumab SC QM by self-administration with AI/pen.
General disorders
Injection site erythema
17.7%
25/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
24.6%
35/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
General disorders
Injection site pain
9.9%
14/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
14.8%
21/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
General disorders
Injection site swelling
7.8%
11/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
16.2%
23/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Infections and infestations
Nasopharyngitis
10.6%
15/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
7.0%
10/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Infections and infestations
Upper respiratory tract infection
1.4%
2/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
5.6%
8/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Musculoskeletal and connective tissue disorders
Arthralgia
5.0%
7/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
6.3%
9/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
Nervous system disorders
Headache
2.1%
3/141 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
6.3%
9/142 • up to Month 9 (-7/+3 days)
All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.

Additional Information

Study Director

Amgen Inc.

Phone: 866-572-6436

Results disclosure agreements

  • Principal investigator is a sponsor employee The Clinical Trial Agreement generally does not restrict an investigator's discussion of trial results after completion. The Agreement permits Amgen a limited period of time to review material discussing trial results (typically up to 45 days and possible extension). Amgen may remove confidential information, but authors have final control and approval of publication content. For multicenter studies, the investigator agrees not to publish any results before the first multi-center publication.
  • Publication restrictions are in place

Restriction type: OTHER