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Study to Compare the Efficacy and Safety of DenosumAb Versus Placebo in Males With Osteoporosis

Primary Purpose

Low Bone Mass, Low Bone Mineral Density, Males With Osteoporosis

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
60 mg denosumab
Placebo
Sponsored by
Amgen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Low Bone Mass focused on measuring men, male, denosumab, BMD, lumbar spine, ADAMO, The ADAMO Trial, male osteoporosis, osteoporosis in men, males with low bone mineral density

Eligibility Criteria

30 Years - 85 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Bone Mineral Density (BMD) values (g/cm2) assessed by the local site at either the lumbar spine OR femoral neck that occur within the ranges specified in the protocol OR For subjects with a history of a major osteoporotic fracture (clinical vertebral, hip, humerus and distal radius fractures) occurring more than 6 months prior to screening, BMD values (g/cm2) assessed by the local site, at either the lumbar spine OR femoral neck that occur within the ranges specified in the protocol.
  • At least 2 lumbar vertebrae, at least 1 hip and at least one forearm must be evaluable by Dual X ray Absorptiometry (DXA).
  • Ambulatory males 30 to 85 years of age inclusive at the start of screening.
  • Provide the appropriate written informed consent before any study specific procedure.

Exclusion Criteria:

  • BMD values (g/cm2) as specified in the protocol in subjects with or without a history of major osteoporotic fractures, based on the particular scanner that is used.
  • Any disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.
  • Any severe or more than 1 moderate vertebral fractures on screening spinal x ray
  • Any vertebral fracture diagnosed within the 6 months prior to screening
  • Any clinical fracture within the last 6 months prior to screening
  • For males with a partner of childbearing potential: Subject refuses to use 2 highly effective methods of contraception for the duration of the study and for 10 months after the last dose of study medication.
  • For males with a partner who is pregnant: Subject refuses to use a condom for the duration of the study and for 10 months after the last dose of study medication.
  • Previous participation in clinical trials with denosumab or administration of commercial denosumab.
  • Currently enrolled in or has not yet completed at least 1 month since ending other investigational device or drug trial(s), or subject is receiving other investigational agent(s).
  • Vitamin D deficiency [25(OH) vitamin D level < 20 ng/mL (< 49.9 nmol/L)]. Vitamin D replenishment will be permitted and subjects may be re-screened; see Section 7.
  • Hyper- or hypothyroidism; however, stable subjects, in the investigator's opinion, on thyroid hormone replacement therapy are allowed.
  • Hyper- or hypoparathyroidism. Intact parathyroid hormone (iPTH) values outside of the reference range as determined by the central laboratory
  • Elevated transaminases. Serum aspartate aminotransferase; serum glutamate-oxaloacetic transaminase > 2.5 x upper limit of normal. Serum alanine aminotransferase; serum glutamate pyruvate transaminase > 2.5 x upper limit of normal (both as determined by the central laboratory).
  • Significantly impaired renal function as determined by a derived glomerular filtration rate (using the Modification of Diet in Renal Disease formula) of less than or equal to 30 mL/min/1.73 m2 calculated by the central laboratory.
  • Hypo- or hypercalcemia based on the central laboratory reference ranges for albumin-adjusted serum calcium.
  • Known to have tested positive for human immunodeficiency virus, hepatitis C virus, hepatitis B surface antigen or cirrhosis of the liver.
  • Malignancy (except fully resected cutaneous basal cell or squamous cell carcinoma) within the last 5 years.
  • Any metabolic bone disease, eg osteomalacia, osteogenesis imperfecta, rheumatoid arthritis, Paget's disease, Cushing's disease or, hyperprolactinemia which may interfere with the interpretation of the findings OR evidence of malabsorption syndromes which might interfere with absorption of vitamin D.
  • Received any solid organ or bone marrow transplant or is on chronic immunosuppression for any reason.
  • Any laboratory abnormality, which in the opinion of the investigator or Amgen, will prevent the subject from completing the study or interfere with the interpretation of the study results.
  • Administration of intravenous bisphosphonate, or fluoride (except for dental treatment) or strontium ranelate.
  • Oral bisphosphonate treatment:
  • greater than or equal to 3 months cumulatively in the past 2 years, OR
  • greater than or equal to 1 month in the past year, OR
  • Any use during the 3-month period prior to randomization
  • Administration of any of the following treatments 3 months prior to screening:
  • Anabolic steroids or testosterone
  • Glucocorticosteroids (greater than or equal to 5 mg prednisone equivalent per day for more than 10 days or a total cumulative dose of greater than or equal to 50 mg)
  • Calcitonin
  • Calcitriol or vitamin D derivatives [vitamin D contained in supplements or multivitamins is allowed]
  • Other bone active drugs including anti-convulsives (except benzodiazepines) and heparin
  • Chronic systemic ketoconazole, adrenocorticotrophic hormone (ACTH), cinacalcet, aluminum, lithium, protease inhibitors, methotrexate, gonadotropin-releasing hormone agonists.
  • Androgen deprivation therapy
  • Known sensitivity to mammalian cell derived drug products.
  • Known intolerance to calcium or vitamin D supplements.
  • Height, weight or girth which may preclude accurate DXA measurements.
  • Bilateral hip replacements
  • Any physical or psychiatric disorder which, in the opinion of the investigator or Amgen, will prevent the subject from completing the study or interfere with the interpretation of the study results.
  • Evidence of alcohol or substance-abuse within the last 12 months which the investigator believes would interfere with understanding of or completion of the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Placebo Comparator

    Experimental

    Arm Label

    2

    1

    Arm Description

    Subjects will receive placebo for denosumab (SC injection every 6 months) for 1 year (double-blind phase) followed by 60 mg denosumab (SC injection every 6 months) for 1 year (open-label phase)

    60 mg denosumab (SC injection every 6 months) for 1 year (double-blind phase) followed by 60 mg denosumab(SC injection every 6 months) for 1 year (open-label phase). These subjects will be on denosumab for a total of 2 years.

    Outcomes

    Primary Outcome Measures

    Lumbar Spine Bone Mineral Density Percent Change From Baseline at Month 12

    Secondary Outcome Measures

    Total Hip Bone Mineral Density Percent Change From Baseline at Month 12
    Femoral Neck Bone Mineral Density Percent Change From Baseline at Month 12
    Trochanter Bone Mineral Density Percent Change From Baseline at Month 12
    Distal 1/3 Radius Bone Mineral Density Percent Change From Baseline at Month 12
    Serum Type 1 Collagen C-telopeptide (CTX) Percent Change From Baseline at Day 15

    Full Information

    First Posted
    September 17, 2009
    Last Updated
    September 20, 2018
    Sponsor
    Amgen
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00980174
    Brief Title
    Study to Compare the Efficacy and Safety of DenosumAb Versus Placebo in Males With Osteoporosis
    Official Title
    A Multicenter, Randomized, Double-Blind, Placebo Controlled Study to Compare the Efficacy and Safety of Denosumab Versus Placebo in Males With Low Bone Mineral Density
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    October 1, 2009 (Actual)
    Primary Completion Date
    June 21, 2011 (Actual)
    Study Completion Date
    May 23, 2012 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Amgen

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to assess how effective and safe denosumab is in a population of males with low bone mass at risk of fracture. The primary clinical hypothesis is that in men with low bone mineral density, the mean percent change in lumbar spine bone mineral density at 12 months in subjects receiving denosumab will be greater than in subjects receiving placebo. Denosumab is a fully human monoclonal antibody with a high affinity for Receptor Activator of Nuclear Factor (RANK) Ligand that can bind and neutralize the activity of human RANK Ligand similar to the action of endogenous osteoprotegerin.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Low Bone Mass, Low Bone Mineral Density, Males With Osteoporosis, Osteopenia, Osteoporosis
    Keywords
    men, male, denosumab, BMD, lumbar spine, ADAMO, The ADAMO Trial, male osteoporosis, osteoporosis in men, males with low bone mineral density

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Crossover Assignment
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    242 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    2
    Arm Type
    Placebo Comparator
    Arm Description
    Subjects will receive placebo for denosumab (SC injection every 6 months) for 1 year (double-blind phase) followed by 60 mg denosumab (SC injection every 6 months) for 1 year (open-label phase)
    Arm Title
    1
    Arm Type
    Experimental
    Arm Description
    60 mg denosumab (SC injection every 6 months) for 1 year (double-blind phase) followed by 60 mg denosumab(SC injection every 6 months) for 1 year (open-label phase). These subjects will be on denosumab for a total of 2 years.
    Intervention Type
    Drug
    Intervention Name(s)
    60 mg denosumab
    Other Intervention Name(s)
    denosumab
    Intervention Description
    60 mg denosumab (SC injection every 6 months)
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo for denosumab (SC injection every 6 months)
    Primary Outcome Measure Information:
    Title
    Lumbar Spine Bone Mineral Density Percent Change From Baseline at Month 12
    Time Frame
    From Baseline to 12 Months
    Secondary Outcome Measure Information:
    Title
    Total Hip Bone Mineral Density Percent Change From Baseline at Month 12
    Time Frame
    From Baseline to 12 Months
    Title
    Femoral Neck Bone Mineral Density Percent Change From Baseline at Month 12
    Time Frame
    From Baseline to 12 Months
    Title
    Trochanter Bone Mineral Density Percent Change From Baseline at Month 12
    Time Frame
    From Baseline to 12 Months
    Title
    Distal 1/3 Radius Bone Mineral Density Percent Change From Baseline at Month 12
    Time Frame
    From Baseline to 12 Months
    Title
    Serum Type 1 Collagen C-telopeptide (CTX) Percent Change From Baseline at Day 15
    Time Frame
    From Baseline to Day 15

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    30 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Bone Mineral Density (BMD) values (g/cm2) assessed by the local site at either the lumbar spine OR femoral neck that occur within the ranges specified in the protocol OR For subjects with a history of a major osteoporotic fracture (clinical vertebral, hip, humerus and distal radius fractures) occurring more than 6 months prior to screening, BMD values (g/cm2) assessed by the local site, at either the lumbar spine OR femoral neck that occur within the ranges specified in the protocol. At least 2 lumbar vertebrae, at least 1 hip and at least one forearm must be evaluable by Dual X ray Absorptiometry (DXA). Ambulatory males 30 to 85 years of age inclusive at the start of screening. Provide the appropriate written informed consent before any study specific procedure. Exclusion Criteria: BMD values (g/cm2) as specified in the protocol in subjects with or without a history of major osteoporotic fractures, based on the particular scanner that is used. Any disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures. Any severe or more than 1 moderate vertebral fractures on screening spinal x ray Any vertebral fracture diagnosed within the 6 months prior to screening Any clinical fracture within the last 6 months prior to screening For males with a partner of childbearing potential: Subject refuses to use 2 highly effective methods of contraception for the duration of the study and for 10 months after the last dose of study medication. For males with a partner who is pregnant: Subject refuses to use a condom for the duration of the study and for 10 months after the last dose of study medication. Previous participation in clinical trials with denosumab or administration of commercial denosumab. Currently enrolled in or has not yet completed at least 1 month since ending other investigational device or drug trial(s), or subject is receiving other investigational agent(s). Vitamin D deficiency [25(OH) vitamin D level < 20 ng/mL (< 49.9 nmol/L)]. Vitamin D replenishment will be permitted and subjects may be re-screened; see Section 7. Hyper- or hypothyroidism; however, stable subjects, in the investigator's opinion, on thyroid hormone replacement therapy are allowed. Hyper- or hypoparathyroidism. Intact parathyroid hormone (iPTH) values outside of the reference range as determined by the central laboratory Elevated transaminases. Serum aspartate aminotransferase; serum glutamate-oxaloacetic transaminase > 2.5 x upper limit of normal. Serum alanine aminotransferase; serum glutamate pyruvate transaminase > 2.5 x upper limit of normal (both as determined by the central laboratory). Significantly impaired renal function as determined by a derived glomerular filtration rate (using the Modification of Diet in Renal Disease formula) of less than or equal to 30 mL/min/1.73 m2 calculated by the central laboratory. Hypo- or hypercalcemia based on the central laboratory reference ranges for albumin-adjusted serum calcium. Known to have tested positive for human immunodeficiency virus, hepatitis C virus, hepatitis B surface antigen or cirrhosis of the liver. Malignancy (except fully resected cutaneous basal cell or squamous cell carcinoma) within the last 5 years. Any metabolic bone disease, eg osteomalacia, osteogenesis imperfecta, rheumatoid arthritis, Paget's disease, Cushing's disease or, hyperprolactinemia which may interfere with the interpretation of the findings OR evidence of malabsorption syndromes which might interfere with absorption of vitamin D. Received any solid organ or bone marrow transplant or is on chronic immunosuppression for any reason. Any laboratory abnormality, which in the opinion of the investigator or Amgen, will prevent the subject from completing the study or interfere with the interpretation of the study results. Administration of intravenous bisphosphonate, or fluoride (except for dental treatment) or strontium ranelate. Oral bisphosphonate treatment: greater than or equal to 3 months cumulatively in the past 2 years, OR greater than or equal to 1 month in the past year, OR Any use during the 3-month period prior to randomization Administration of any of the following treatments 3 months prior to screening: Anabolic steroids or testosterone Glucocorticosteroids (greater than or equal to 5 mg prednisone equivalent per day for more than 10 days or a total cumulative dose of greater than or equal to 50 mg) Calcitonin Calcitriol or vitamin D derivatives [vitamin D contained in supplements or multivitamins is allowed] Other bone active drugs including anti-convulsives (except benzodiazepines) and heparin Chronic systemic ketoconazole, adrenocorticotrophic hormone (ACTH), cinacalcet, aluminum, lithium, protease inhibitors, methotrexate, gonadotropin-releasing hormone agonists. Androgen deprivation therapy Known sensitivity to mammalian cell derived drug products. Known intolerance to calcium or vitamin D supplements. Height, weight or girth which may preclude accurate DXA measurements. Bilateral hip replacements Any physical or psychiatric disorder which, in the opinion of the investigator or Amgen, will prevent the subject from completing the study or interfere with the interpretation of the study results. Evidence of alcohol or substance-abuse within the last 12 months which the investigator believes would interfere with understanding of or completion of the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    MD
    Organizational Affiliation
    Amgen
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    25607608
    Citation
    Langdahl BL, Teglbjaerg CS, Ho PR, Chapurlat R, Czerwinski E, Kendler DL, Reginster JY, Kivitz A, Lewiecki EM, Miller PD, Bolognese MA, McClung MR, Bone HG, Ljunggren O, Abrahamsen B, Gruntmanis U, Yang YC, Wagman RB, Mirza F, Siddhanti S, Orwoll E. A 24-month study evaluating the efficacy and safety of denosumab for the treatment of men with low bone mineral density: results from the ADAMO trial. J Clin Endocrinol Metab. 2015 Apr;100(4):1335-42. doi: 10.1210/jc.2014-4079. Epub 2015 Jan 21.
    Results Reference
    background
    PubMed Identifier
    22723310
    Citation
    Orwoll E, Teglbjaerg CS, Langdahl BL, Chapurlat R, Czerwinski E, Kendler DL, Reginster JY, Kivitz A, Lewiecki EM, Miller PD, Bolognese MA, McClung MR, Bone HG, Ljunggren O, Abrahamsen B, Gruntmanis U, Yang YC, Wagman RB, Siddhanti S, Grauer A, Hall JW, Boonen S. A randomized, placebo-controlled study of the effects of denosumab for the treatment of men with low bone mineral density. J Clin Endocrinol Metab. 2012 Sep;97(9):3161-9. doi: 10.1210/jc.2012-1569. Epub 2012 Jun 21.
    Results Reference
    background
    Links:
    URL
    http://www.amgentrials.com
    Description
    AmgenTrials clinical trials website

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    Study to Compare the Efficacy and Safety of DenosumAb Versus Placebo in Males With Osteoporosis

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