CT-Based Changes in Bone and Marrow Among Patients on Oral Steroids

NCT ID: NCT04518722

Last Updated: 2026-01-09

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

RECRUITING

Total Enrollment

12 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-12-01

Study Completion Date

2026-01-31

Brief Summary

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The goal of this study is to assess the feasibility of emerging CT-based tools to measure changes in central and peripheral bone density, micro-structure, and marrow adipose tissue (MAT) among patients treated with oral steroids.

Detailed Description

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This study aims to prove that emerging CT-based tools are suitable to measure changes in central and peripheral bone density, geometry, micro-structure, and marrow adipose tissue (MAT) among patients treated with oral steroids. To do this, investigators will recruit 10 non-smokers (defined as \< 10 pack-year smoking history) age 25-45 years with a diagnosis of severe, persistent asthma who either chronically use oral steroids or do not use any oral steroids. Participants will undergo dual-energy X-ray absorptiometry (DXA), dual-energy mid-tibia CT, high-resolution single-energy ankle CT, and low-radiation hip CT scans at baseline and 6-month follow-up visits. The images obtained will be used to analyze cross-sectional differences in central and peripheral bone density, geometry, micro-structure, and MAT between patients using oral steroids versus those who do not use any oral steroids. Differences in imaging at baseline and six-month follow visits will be used to analyze longitudinal bone changes among patients with oral steroid treatment.

Conditions

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Asthma Bone Density, Low Oral Steroid-Dependent Asthma (Disorder)

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Interventions

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CT Scan

Dual-energy mid-tibia CT, high-resolution single energy MDCT imaging of the distal tibia (ankle), and low radiation hip CT scans

Intervention Type RADIATION

DXA Scan

Basic DXA scans will be performed to measure areal BMD and body composition measures at the whole body, spine, and hip

Intervention Type RADIATION

Steroid Intake Questionnaire

Questionnaire designed to quantify lifetime oral glucocorticoid intake

Intervention Type OTHER

Other Intervention Names

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CAT Scan Bone Density Scan

Eligibility Criteria

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Inclusion Criteria

* Inclusion (all subjects):

* Diagnosis of severe, persistent asthma (defined as using both a long-acting beta-agonist AND a high-dose inhaled steroid)
* Age 25-45
* Inclusion (oral steroid group):

* Chronic treatment with oral steroids for at least 45 days but less than 1 year

Exclusion Criteria

* Exclusion (all subjects):

* Pregnant or breastfeeding
* History of any cancer, excluding non-melanoma skin cancer
* Currently receiving dialysis
* History of any lower extremity fracture
* Hip or knee replacement
* Non-ambulatory
* Greater than 10 pack-year smoking history
* BMI \> 50
* Age \< 25 or \> 45
* Current or past use of FDA-approved medication for osteoporosis:

Bisphosphonates (Alendronate/Fosamax, Ibandronate/Boniva, Risedronate/Actonel/Atelvia, Zoledronic Acid/Reclast) Calcitonin (Fortical, Miacalcin) Selective Estrogen Receptor Modulator (Raloxifene/Evista) Parathyroid Hormone Analogue (Teriparatide/Forteo) Monoclonal Antibody (Denosumab/Prolia)
Minimum Eligible Age

25 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Iowa

OTHER

Sponsor Role lead

Responsible Party

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Punam K Saha

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Punam K Saha, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Locations

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University of Iowa

Iowa City, Iowa, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Taylor M Haynes, MS

Role: CONTACT

319-356-1785

Punam K Saha, PhD

Role: CONTACT

319-335-5959

Facility Contacts

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Taylor M Haynes, MS

Role: primary

319-356-1785

Kimberly Sprenger, RN

Role: backup

319-353-8862

References

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Reference Type BACKGROUND
PMID: 1386728 (View on PubMed)

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Parfitt AM. Implications of architecture for the pathogenesis and prevention of vertebral fracture. Bone. 1992;13 Suppl 2:S41-7. doi: 10.1016/8756-3282(92)90196-4.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Li C, Jin D, Chen C, Letuchy EM, Janz KF, Burns TL, Torner JC, Levy SM, Saha PK. Automated cortical bone segmentation for multirow-detector CT imaging with validation and application to human studies. Med Phys. 2015 Aug;42(8):4553-65. doi: 10.1118/1.4923753.

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Saha PK, Liu Y, Chen C, Jin D, Letuchy EM, Xu Z, Amelon RE, Burns TL, Torner JC, Levy SM, Calarge CA. Characterization of trabecular bone plate-rod microarchitecture using multirow detector CT and the tensor scale: Algorithms, validation, and applications to pilot human studies. Med Phys. 2015 Sep;42(9):5410-25. doi: 10.1118/1.4928481.

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Chen C, Zhang X, Guo J, Jin D, Letuchy EM, Burns TL, Levy SM, Hoffman EA, Saha PK. Quantitative imaging of peripheral trabecular bone microarchitecture using MDCT. Med Phys. 2018 Jan;45(1):236-249. doi: 10.1002/mp.12632. Epub 2017 Nov 23.

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Bredella MA, Daley SM, Kalra MK, Brown JK, Miller KK, Torriani M. Marrow Adipose Tissue Quantification of the Lumbar Spine by Using Dual-Energy CT and Single-Voxel (1)H MR Spectroscopy: A Feasibility Study. Radiology. 2015 Oct;277(1):230-5. doi: 10.1148/radiol.2015142876. Epub 2015 May 19.

Reference Type BACKGROUND
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Other Identifiers

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202009045

Identifier Type: -

Identifier Source: org_study_id

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