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Effects of Zoledronic Acid and Raloxifene on Bone Turnover Markers in Postmenopausal Women With Low Bone Mineral Density

Primary Purpose

Osteoporosis

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Raloxifene
Zoledronic acid
Placebo oral pills
Placebo intravenous (i.v.) infusion
Sponsored by
Novartis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoporosis focused on measuring Osteoporosis, Post-menopausal, Bone mineral density

Eligibility Criteria

45 Years - 80 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Females, between 45 and 80 years (inclusive) of age, considered post-menopausal according to one of the following guidelines:
  • Cessation of menses for 18 months in women < 50 years of age
  • Cessation of menses for 12 months in women age 50 years or over
  • Documented bilateral oophorectomy at least 1 year previously
  • Documented T score of less than or equal to -1.5 on dual energy X-ray absorptiometry (DXA) scan at the lumbar spine, total hip or femoral neck within 24 months prior to screening, and clinically indicated for treatment with bisphosphonates (BPs) for osteopenia or osteoporosis
  • Signed informed consent prior to initiation of any study procedure

Exclusion Criteria:

  • Prior treatment with i.v. bisphosphonates within the last 2 years
  • Previous use of oral bisphosphonates within the past 2 years (unless used for less than 8 weeks*).
  • *NOTE: If used less than 8 weeks, the washout period is 6 months.
  • Treatment with raloxifene, calcitonin, tibolone or hormone replacement therapy. The washout period for these medications is 6 months prior to randomization.
  • Any treatment with strontium renalate, sodium fluoride or parathyroid hormone
  • Use of systemic high dose corticosteroids at an average dose of ≥ 7.5 mg per day of oral prednisone or equivalent for a period of three months or more within the previous year
  • Treatment with any investigational drug within 30 days prior to randomization
  • Any woman of child bearing potential
  • Patients with fractures occurring within three months prior to randomization
  • History of hypersensitivity to bisphosphonates
  • History of non-traumatic uveitis or iritis, within 2 years prior to study entry.
  • A history of invasive malignancy of any organ system, treated or untreated, within the past 12 months prior to screening; excluding, basal cell or squamous cell carcinoma of the skin, colonic polyps with non-invasive malignancy which have been removed, Ductal Carcinoma in-situ (DCIS) that has been surgically removed, and Carcinoma in-situ (CIS) of the uterine cervix that has been surgically removed.
  • Previous major solid organ transplant recipient or on a transplant waiting list
  • History of hyperparathyroidism, hypoparathyroidism, Osteogenesis imperfecta, Paget's disease or any metabolic bone disease other than osteoporosis
  • Any medical condition which would interfere with the action of the study drug or limit life expectancy to less than 6 months
  • Any medical or psychiatric condition which, in the opinion of the investigator, would preclude the participant from adhering to the protocol or completing the trial
  • Active dental infection, unhealed dental extraction or planned oral surgery within 3 month prior to randomization.
  • Calculated creatinine clearance < 30 mL/min
  • Greater than 2+ protein on urine dipstick without evidence of contamination or bacteriuria (may be repeated one time, at least a day apart).
  • Serum calcium > 2.75 mmol/L (11.0 mg/dL) or < 2.08 mmol/L (8.3 mg/dL) at screening
  • AST, ALT or serum alkaline phosphatase greater than twice the upper limit of normal

Sites / Locations

  • Women's Health Research
  • Associated Pharma Research Center
  • Jacksonville Center for Clinical Research
  • Women's Physicians of Jacksonville
  • Tampa Clinical Research
  • Springfield Clinic
  • Consultants in Women's Health Care
  • Alegent Health
  • Specialty Medical and Research Center
  • UMDNJ-Robert Wood Johnson Medical Center
  • Columbia University
  • Kernodle Clinic, Inc.
  • The Portland Clinic
  • Oregon Health and Science University
  • Texas Institute for Clinical Research
  • Valley Women's Health Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Zoledronic Acid

Raloxifene

Arm Description

Zoledronic acid 5 mg (single i.v. infusion) + daily oral placebo for 6 months (zoledronic acid group)

Placebo (single i.v. infusion) + oral raloxifene 60 mg/day for 6 months (raloxifene group)

Outcomes

Primary Outcome Measures

Change From Baseline in Urine N-telopeptide of Type 1 Collagen (NTx.)
The primary efficacy variable was the change from baseline in urine NTx (corrected by creatinine). The primary analysis time point was at 6 months of treatment. The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.

Secondary Outcome Measures

Change From Baseline in Urine NTx at 2 Months
The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.
Change From Baseline in Urine NTx at 4 Months
The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 2 Months
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 4 Months
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 6 Months
Overall Principal Investigator Satisfaction Assessed by Satisfaction Questionnaire
The investigator was asked to complete satisfaction questionnaires at baseline (Visit 2/Day 1) when each patient's i.v. drug administration occurred. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Overall Nurse Satisfaction Assessed by Satisfaction Questionnaire
The study coordinator (nurse) was asked to complete satisfaction questionnaires at baseline (Visit 2/Day 1) when each patient's i.v. drug administration occurred. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Overall Patient Satisfaction Assessed by Satisfaction Questionnaire
Patients were asked to complete the satisfaction questionnaire at baseline. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Patient Preference at 6 Months for Annual i.v Therapy or Daily Oral Regimens
At the end-of-study visit, Month 6, patients were asked to complete a questionnaire to assess preference for the different treatment modalities (annual i.v. infusion vs. daily oral capsule). The possible answers to question were: "once a year i.v. infusion," "once daily pill," or "both are equal."

Full Information

First Posted
February 1, 2007
Last Updated
March 25, 2011
Sponsor
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT00431444
Brief Title
Effects of Zoledronic Acid and Raloxifene on Bone Turnover Markers in Postmenopausal Women With Low Bone Mineral Density
Official Title
A Multi-center, Randomized, Double-blind, Double-dummy Study in Postmenopausal Women With Low Bone Mineral Density to Compare the Effects of a Single Dose of i.v. Zoledronic Acid 5 mg, With Daily Oral Raloxifene 60 mg OD on Bone Turnover Markers
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Completed
Study Start Date
January 2007 (undefined)
Primary Completion Date
July 2008 (Actual)
Study Completion Date
July 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Novartis

4. Oversight

5. Study Description

Brief Summary
This study will compare the effects of Zoledronic acid and Raloxifene in reducing bone turnover markers in postmenopausal women with low bone mineral density over 6 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoporosis
Keywords
Osteoporosis, Post-menopausal, Bone mineral density

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
110 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Zoledronic Acid
Arm Type
Active Comparator
Arm Description
Zoledronic acid 5 mg (single i.v. infusion) + daily oral placebo for 6 months (zoledronic acid group)
Arm Title
Raloxifene
Arm Type
Active Comparator
Arm Description
Placebo (single i.v. infusion) + oral raloxifene 60 mg/day for 6 months (raloxifene group)
Intervention Type
Drug
Intervention Name(s)
Raloxifene
Intervention Type
Drug
Intervention Name(s)
Zoledronic acid
Other Intervention Name(s)
Reclast, Aclasta
Intervention Type
Drug
Intervention Name(s)
Placebo oral pills
Intervention Type
Drug
Intervention Name(s)
Placebo intravenous (i.v.) infusion
Primary Outcome Measure Information:
Title
Change From Baseline in Urine N-telopeptide of Type 1 Collagen (NTx.)
Description
The primary efficacy variable was the change from baseline in urine NTx (corrected by creatinine). The primary analysis time point was at 6 months of treatment. The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.
Time Frame
Baseline and 6 months
Secondary Outcome Measure Information:
Title
Change From Baseline in Urine NTx at 2 Months
Description
The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.
Time Frame
Baseline and 2 months
Title
Change From Baseline in Urine NTx at 4 Months
Description
The results are reported as nanomoles (nM) of bone collagen equivalents (BCE) per millimole (mM) of urine creatinine.
Time Frame
Baseline and 4 months
Title
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 2 Months
Time Frame
Baseline and 2 months
Title
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 4 Months
Time Frame
Baseline and 4 months
Title
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (BSAP) at 6 Months
Time Frame
Baseline and 6 months
Title
Overall Principal Investigator Satisfaction Assessed by Satisfaction Questionnaire
Description
The investigator was asked to complete satisfaction questionnaires at baseline (Visit 2/Day 1) when each patient's i.v. drug administration occurred. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Time Frame
Immediately after infusion procedure
Title
Overall Nurse Satisfaction Assessed by Satisfaction Questionnaire
Description
The study coordinator (nurse) was asked to complete satisfaction questionnaires at baseline (Visit 2/Day 1) when each patient's i.v. drug administration occurred. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Time Frame
Immediately after infusion procedure
Title
Overall Patient Satisfaction Assessed by Satisfaction Questionnaire
Description
Patients were asked to complete the satisfaction questionnaire at baseline. The questionnaire assessed overall satisfaction with the i.v. infusion procedure. The possible answers to the question were: "not at all," "a little," "somewhat," "quite," or "completely."
Time Frame
Immediately after infusion procedure
Title
Patient Preference at 6 Months for Annual i.v Therapy or Daily Oral Regimens
Description
At the end-of-study visit, Month 6, patients were asked to complete a questionnaire to assess preference for the different treatment modalities (annual i.v. infusion vs. daily oral capsule). The possible answers to question were: "once a year i.v. infusion," "once daily pill," or "both are equal."
Time Frame
At 6 month visit

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Females, between 45 and 80 years (inclusive) of age, considered post-menopausal according to one of the following guidelines: Cessation of menses for 18 months in women < 50 years of age Cessation of menses for 12 months in women age 50 years or over Documented bilateral oophorectomy at least 1 year previously Documented T score of less than or equal to -1.5 on dual energy X-ray absorptiometry (DXA) scan at the lumbar spine, total hip or femoral neck within 24 months prior to screening, and clinically indicated for treatment with bisphosphonates (BPs) for osteopenia or osteoporosis Signed informed consent prior to initiation of any study procedure Exclusion Criteria: Prior treatment with i.v. bisphosphonates within the last 2 years Previous use of oral bisphosphonates within the past 2 years (unless used for less than 8 weeks*). *NOTE: If used less than 8 weeks, the washout period is 6 months. Treatment with raloxifene, calcitonin, tibolone or hormone replacement therapy. The washout period for these medications is 6 months prior to randomization. Any treatment with strontium renalate, sodium fluoride or parathyroid hormone Use of systemic high dose corticosteroids at an average dose of ≥ 7.5 mg per day of oral prednisone or equivalent for a period of three months or more within the previous year Treatment with any investigational drug within 30 days prior to randomization Any woman of child bearing potential Patients with fractures occurring within three months prior to randomization History of hypersensitivity to bisphosphonates History of non-traumatic uveitis or iritis, within 2 years prior to study entry. A history of invasive malignancy of any organ system, treated or untreated, within the past 12 months prior to screening; excluding, basal cell or squamous cell carcinoma of the skin, colonic polyps with non-invasive malignancy which have been removed, Ductal Carcinoma in-situ (DCIS) that has been surgically removed, and Carcinoma in-situ (CIS) of the uterine cervix that has been surgically removed. Previous major solid organ transplant recipient or on a transplant waiting list History of hyperparathyroidism, hypoparathyroidism, Osteogenesis imperfecta, Paget's disease or any metabolic bone disease other than osteoporosis Any medical condition which would interfere with the action of the study drug or limit life expectancy to less than 6 months Any medical or psychiatric condition which, in the opinion of the investigator, would preclude the participant from adhering to the protocol or completing the trial Active dental infection, unhealed dental extraction or planned oral surgery within 3 month prior to randomization. Calculated creatinine clearance < 30 mL/min Greater than 2+ protein on urine dipstick without evidence of contamination or bacteriuria (may be repeated one time, at least a day apart). Serum calcium > 2.75 mmol/L (11.0 mg/dL) or < 2.08 mmol/L (8.3 mg/dL) at screening AST, ALT or serum alkaline phosphatase greater than twice the upper limit of normal
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Women's Health Research
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
Facility Name
Associated Pharma Research Center
City
Buena Park
State/Province
California
ZIP/Postal Code
90620
Country
United States
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20036
Country
United States
Facility Name
Jacksonville Center for Clinical Research
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32216
Country
United States
Facility Name
Women's Physicians of Jacksonville
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32256
Country
United States
Facility Name
Tampa Clinical Research
City
Tampa
State/Province
Florida
ZIP/Postal Code
33624
Country
United States
Facility Name
Springfield Clinic
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62703
Country
United States
Facility Name
Consultants in Women's Health Care
City
St Louis
State/Province
Missouri
ZIP/Postal Code
63131
Country
United States
Facility Name
Alegent Health
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68152
Country
United States
Facility Name
Specialty Medical and Research Center
City
Pahrump
State/Province
Nevada
ZIP/Postal Code
89048
Country
United States
Facility Name
UMDNJ-Robert Wood Johnson Medical Center
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Kernodle Clinic, Inc.
City
Burlington
State/Province
North Carolina
ZIP/Postal Code
27215
Country
United States
Facility Name
The Portland Clinic
City
Portland
State/Province
Oregon
ZIP/Postal Code
97205
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Texas Institute for Clinical Research
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Valley Women's Health Clinic
City
Renton
State/Province
Washington
ZIP/Postal Code
98055
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21796066
Citation
Bachmann G, Kriegman A, Goncalves J, Kianifard F, Warren M, Simon JA. Effect of zoledronic acid compared with raloxifene on bone turnover markers in postmenopausal women with low bone density. Menopause. 2011 Aug;18(8):851-6. doi: 10.1097/gme.0b013e31820b80f1.
Results Reference
derived

Learn more about this trial

Effects of Zoledronic Acid and Raloxifene on Bone Turnover Markers in Postmenopausal Women With Low Bone Mineral Density

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