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A Study of Oral Recombinant Salmon Calcitonin (rsCT) to Prevent Postmenopausal Osteoporosis

Primary Purpose

Osteopenia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oral calcitonin at dinnertime
Oral placebo at dinnertime
Oral calcitonin at bedtime
Oral placebo at bedtime
Sponsored by
Tarsa Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Osteopenia focused on measuring Osteoporosis, Osteopenia, Osteoporosis, Postmenopausal, Bone Diseases, Metabolic, Bone Diseases, Musculoskeletal Diseases, Salmon calcitonin, Calcitonin

Eligibility Criteria

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

Inclusion Criteria:

  • Female and at least 45 years of age.
  • Must have undergone the onset of spontaneous or surgical menopause more than 5 years prior to entry. Spontaneous menopause is defined as 12 months of spontaneous amenorrhea. Surgical menopause is defined as ≥ 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy.
  • Serum follicle-stimulating hormone (FSH) levels must be ≥ 30 mIU/mL.
  • A body mass index (BMI) of not greater than 35 (BMI

    =weight [kg]/height[m]2).

  • Bone mineral density (BMD) T-score between -1.0 and - 2.5 at the total hip, femoral neck, trochanter, or lumbar spine.
  • Additional risk factors such that the 10 year risk of a major osteoporotic fracture or hip fracture risk is at least as great as a 65-year-old woman of the same race and BMI of 25 kg/m2 as determined by the FRAX algorithm .
  • No clinically significant abnormal findings in the medical history or physical exam that would preclude participation in the investigator's opinion.
  • No clinically significant abnormal laboratory values at the screening assessment.
  • Subjects must give written informed consent after reading the Subject Information and Consent Form and having had the opportunity to discuss the study with the investigator.

Exclusion Criteria:

  • History of an osteoporotic fracture, defined as a fracture at the wrist, hip, or humerus occurring from a fall at standing height or less.
  • BMD T-Score at any site ≤ -2.5.
  • Current treatment (or within 3 months prior to randomization) with hormone replacement therapy.
  • History of metabolic and other bone diseases, including osteogenesis imperfecta, osteomalacia, and Paget's disease.
  • Vitamin D insufficiency defined as a 25 hydroxyvitamin D level < 20 ng/mL (50 nmol/L).
  • Prior use of calcitonin, ever.
  • Prior use of any bisphosphonate, ever.
  • Prior use of denosumab, fluoride, or strontium, ever.
  • Prior use of parathyroid hormone analogs, ever.
  • Any condition or disease that may interfere with the ability to have a dual energy x-ray absorptiometry (DXA) scan or to evaluate a DXA scan, for example, severe osteoarthritis of the spine, spinal fusion, pedicle screws, history of vertebroplasty, or degenerative disease that results in insufficient number of evaluable lumbar vertebrae, bilateral hip replacements.
  • Use of anabolic steroids or androgens within 6 months preceding randomization.
  • Use of vitamin D metabolites and analogs, (e.g., calcitriol) within 3 months preceding randomization). Note: Vitamin D supplementation is not exclusionary.
  • Use of estrogen or estrogen-related drugs (including selective estrogen receptor molecules), for example, tamoxifen, tibolone, or raloxifene within 3 months preceding randomization.
  • Chronic systemic treatment with glucocorticoids.
  • Clinically relevant abnormal history, physical findings, or laboratory values at the pre-study screening assessment that could interfere with the objectives of the study or the safety of the subject.
  • Presence of acute or chronic illness or history of chronic illness which, in the judgment of the investigator, makes participation in the study medically inappropriate.
  • Known acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) seropositivity.
  • Uncontrolled hypertension, significant gastrointestinal abnormalities, uncontrolled diabetes mellitus, significant coronary heart disease, any psychotic mental illness, chronic allergic rhinitis, asthma, uncorrected endocrine dysfunction, or significantly impaired hepatic, respiratory, or renal function.
  • Participation in any other clinical study within the previous month.
  • History of drug or alcohol abuse, or intake of more than 30 units of alcohol weekly.
  • Possibility that the subject will not cooperate with the requirements of the protocol.
  • Known sensitivity to sCT.
  • Shift workers-individuals who are at work during overnight hours.

Sites / Locations

  • Diablo Clinical Research, Inc.
  • Innovative Research of West Florida, Inc.
  • Bethesda Health Research
  • Clinical Pharmacology Study Group
  • Michigan Bone and Mineral Clinic
  • The Osteoporosis Center at St. Luke's Hospital
  • Comprehensive Clinical Research
  • University of Pittsburgh - Department of Neurology
  • Puget Sound Osteoporosis Center
  • University of Wisconsin Hospital and Clinics

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Oral calcitonin at dinner-or bedtime

Oral placebo at dinner- or bedtime

Arm Description

Intervention: Oral calcitonin at dinnertime or oral calcitonin at bedtime. Postmenopausal subjects with osteopenia were treated for one year (also with vitamin D and calcium supplements) to determine if oral calcitonin tablets would prevent the loss of bone mineral density compared with placebo. Randomization to active or placebo was done 2:1. After randomization, further randomization was done to divide each arm into two groups, one in which dosing was at dinnertime and the other in which dosing was at bedtime to determine if food affected efficacy or safety.

Intervention: oral placebo at dinnertime or oral placebo at bedtime

Outcomes

Primary Outcome Measures

Percentage Change From Baseline to Week 54 of Lumbar Spine Bone Mineral Density of Active Compared to Placebo.

Secondary Outcome Measures

Percentage Change From Baseline to Week 54 of Plasma CTx-1 Following rsCT Compared to Placebo.

Full Information

First Posted
February 7, 2011
Last Updated
September 5, 2014
Sponsor
Tarsa Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01292187
Brief Title
A Study of Oral Recombinant Salmon Calcitonin (rsCT) to Prevent Postmenopausal Osteoporosis
Official Title
A Randomized, Double-blind, Placebo-controlled Clinical Trial Evaluating the Safety and Efficacy of Oral Recombinant Salmon Calcitonin (rsCT) in the Prevention of Postmenopausal Osteoporosis in Women at Increased Risk of Fracture
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
January 2011 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
July 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tarsa Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary purpose of this study was to evaluate the efficacy of oral calcitonin (rsCT)tablets in the prevention of bone loss in postmenopausal women with lower bone mineral density at increased risk of fracture. The secondary purpose of this study was to determine if there is any food effect by comparing the efficacy and safety of oral calcitonin tablets administered at dinner or at bedtime.
Detailed Description
This was a randomized, double-blind, placebo-controlled Phase 2 study conducted entirely in the US. The subjects were all post-menopausal women whose 10-year risk of major osteoporotic fracture was assessed using the World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX®) algorithm within the first 3 visits. Eligible, consenting subjects were then enrolled and began a 2- week single-blind placebo run-in phase to determine tolerability. After the run-in phase, continuing subjects were randomized in a 2:1 ratio to receive oral calcitonin or placebo. All subjects took 600 mg calcium citrate and 1000 IU vitamin D once daily with breakfast beginning with the run-in phase. The duration of treatment including the run-in phase was 54 weeks. Bone mineral density (BMD) and C-terminal telopeptide of type 1 collagen (CTx-1) were determined at Baseline and Weeks 28 and 54 after randomization. The % change from baseline in lumbar spine BMD was calculated and compared: active to placebo. The change from baseline in plasma CTx-1 was also calculated and compared likewise. To confirm that there is no effect of meal timing on this product, subjects in both arms were further randomized to take the active or placebo on an empty stomach at bedtime or with the meal at dinnertime.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteopenia
Keywords
Osteoporosis, Osteopenia, Osteoporosis, Postmenopausal, Bone Diseases, Metabolic, Bone Diseases, Musculoskeletal Diseases, Salmon calcitonin, Calcitonin

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Oral calcitonin at dinner-or bedtime
Arm Type
Experimental
Arm Description
Intervention: Oral calcitonin at dinnertime or oral calcitonin at bedtime. Postmenopausal subjects with osteopenia were treated for one year (also with vitamin D and calcium supplements) to determine if oral calcitonin tablets would prevent the loss of bone mineral density compared with placebo. Randomization to active or placebo was done 2:1. After randomization, further randomization was done to divide each arm into two groups, one in which dosing was at dinnertime and the other in which dosing was at bedtime to determine if food affected efficacy or safety.
Arm Title
Oral placebo at dinner- or bedtime
Arm Type
Experimental
Arm Description
Intervention: oral placebo at dinnertime or oral placebo at bedtime
Intervention Type
Drug
Intervention Name(s)
Oral calcitonin at dinnertime
Other Intervention Name(s)
Oral rsCT
Intervention Description
Oral calcitonin at dinnertime.
Intervention Type
Drug
Intervention Name(s)
Oral placebo at dinnertime
Other Intervention Name(s)
Placebo
Intervention Description
Oral placebo at dinnertime.
Intervention Type
Drug
Intervention Name(s)
Oral calcitonin at bedtime
Other Intervention Name(s)
Oral rsCT
Intervention Description
Oral calcitonin at bedtime
Intervention Type
Drug
Intervention Name(s)
Oral placebo at bedtime
Other Intervention Name(s)
Placebo
Intervention Description
Oral placebo at bedtime
Primary Outcome Measure Information:
Title
Percentage Change From Baseline to Week 54 of Lumbar Spine Bone Mineral Density of Active Compared to Placebo.
Time Frame
Baseline, Week 54
Secondary Outcome Measure Information:
Title
Percentage Change From Baseline to Week 54 of Plasma CTx-1 Following rsCT Compared to Placebo.
Time Frame
Baseline, Week 54

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female and at least 45 years of age. Must have undergone the onset of spontaneous or surgical menopause more than 5 years prior to entry. Spontaneous menopause is defined as 12 months of spontaneous amenorrhea. Surgical menopause is defined as ≥ 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy. Serum follicle-stimulating hormone (FSH) levels must be ≥ 30 mIU/mL. A body mass index (BMI) of not greater than 35 (BMI =weight [kg]/height[m]2). Bone mineral density (BMD) T-score between -1.0 and - 2.5 at the total hip, femoral neck, trochanter, or lumbar spine. Additional risk factors such that the 10 year risk of a major osteoporotic fracture or hip fracture risk is at least as great as a 65-year-old woman of the same race and BMI of 25 kg/m2 as determined by the FRAX algorithm . No clinically significant abnormal findings in the medical history or physical exam that would preclude participation in the investigator's opinion. No clinically significant abnormal laboratory values at the screening assessment. Subjects must give written informed consent after reading the Subject Information and Consent Form and having had the opportunity to discuss the study with the investigator. Exclusion Criteria: History of an osteoporotic fracture, defined as a fracture at the wrist, hip, or humerus occurring from a fall at standing height or less. BMD T-Score at any site ≤ -2.5. Current treatment (or within 3 months prior to randomization) with hormone replacement therapy. History of metabolic and other bone diseases, including osteogenesis imperfecta, osteomalacia, and Paget's disease. Vitamin D insufficiency defined as a 25 hydroxyvitamin D level < 20 ng/mL (50 nmol/L). Prior use of calcitonin, ever. Prior use of any bisphosphonate, ever. Prior use of denosumab, fluoride, or strontium, ever. Prior use of parathyroid hormone analogs, ever. Any condition or disease that may interfere with the ability to have a dual energy x-ray absorptiometry (DXA) scan or to evaluate a DXA scan, for example, severe osteoarthritis of the spine, spinal fusion, pedicle screws, history of vertebroplasty, or degenerative disease that results in insufficient number of evaluable lumbar vertebrae, bilateral hip replacements. Use of anabolic steroids or androgens within 6 months preceding randomization. Use of vitamin D metabolites and analogs, (e.g., calcitriol) within 3 months preceding randomization). Note: Vitamin D supplementation is not exclusionary. Use of estrogen or estrogen-related drugs (including selective estrogen receptor molecules), for example, tamoxifen, tibolone, or raloxifene within 3 months preceding randomization. Chronic systemic treatment with glucocorticoids. Clinically relevant abnormal history, physical findings, or laboratory values at the pre-study screening assessment that could interfere with the objectives of the study or the safety of the subject. Presence of acute or chronic illness or history of chronic illness which, in the judgment of the investigator, makes participation in the study medically inappropriate. Known acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) seropositivity. Uncontrolled hypertension, significant gastrointestinal abnormalities, uncontrolled diabetes mellitus, significant coronary heart disease, any psychotic mental illness, chronic allergic rhinitis, asthma, uncorrected endocrine dysfunction, or significantly impaired hepatic, respiratory, or renal function. Participation in any other clinical study within the previous month. History of drug or alcohol abuse, or intake of more than 30 units of alcohol weekly. Possibility that the subject will not cooperate with the requirements of the protocol. Known sensitivity to sCT. Shift workers-individuals who are at work during overnight hours.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David S. Krause, MD
Organizational Affiliation
Chief Medical Officer - Tarsa Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Diablo Clinical Research, Inc.
City
Walnut Creek
State/Province
California
ZIP/Postal Code
94598
Country
United States
Facility Name
Innovative Research of West Florida, Inc.
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
Facility Name
Bethesda Health Research
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20817
Country
United States
Facility Name
Clinical Pharmacology Study Group
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01610
Country
United States
Facility Name
Michigan Bone and Mineral Clinic
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48236
Country
United States
Facility Name
The Osteoporosis Center at St. Luke's Hospital
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63107
Country
United States
Facility Name
Comprehensive Clinical Research
City
Berlin
State/Province
New Jersey
ZIP/Postal Code
08009
Country
United States
Facility Name
University of Pittsburgh - Department of Neurology
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Puget Sound Osteoporosis Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98144
Country
United States
Facility Name
University of Wisconsin Hospital and Clinics
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53705
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.tarsatherapeutics.com
Description
Related Info.

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A Study of Oral Recombinant Salmon Calcitonin (rsCT) to Prevent Postmenopausal Osteoporosis

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