search
Back to results

To Test the Effect of Calcifediol Hy.D Supplementation on Muscle Function and Bone Quality in Younger Postmenopausal Women With Osteopenia

Primary Purpose

Osteopenia/Osteoporosis

Status
Completed
Phase
Phase 2
Locations
Switzerland
Study Type
Interventional
Intervention
Calcifediol
Vitamin D3
Placebo
Sponsored by
DSM Nutritional Products, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Osteopenia/Osteoporosis

Eligibility Criteria

50 Years - 70 Years (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Women age 50 to 70
  • Post-menopausal (defined as: at least 1 year after the last menstrual period)
  • community-dwelling and ambulatory without help
  • with documented osteopenia (BMD by DEXA t-score: < -1.0 and > -2.5 at the spine or hip) in the 6 months prior to enrolment or with documented osteoporosis (BMD by DEXA t-score: ≤ -2.5 at the spine or hip) and a FRAX score (online calculation tool of absolute 10 year fracture risk) below the Swiss age-dependent indication threshold for pharmacologic treatment for the 10-year risk of major osteoporotic fractures - at the screening visit and including DEXA (in the 6 months prior to enrolment) as part of the calculation
  • body mass index > 18.5 and < 30 kg/m2
  • 25(OH)D level < 24 µg/l (< 60 nmol/l)
  • understands German in reading and writing plus able to read, understand, and complete questionnaires and tests
  • willingness to limit additional vitamin D3 intake to 800 IU per day
  • willingness to limit calcium supplement intake to 500 mg/day
  • willingness to stop active vitamin D metabolites
  • participant understands the study procedures, alternative treatments available and risks involved with the study and voluntarily agrees to participate by giving a written informed consent
  • participant meets the routine clinical laboratory safety screening tests performed at screening visit
  • participant is able and willing to perform all study tests, attend all required office visits, and provide blood and urine samples
  • participant is able to swallow the study medication

Exclusion Criteria:

  • Consumption of more than 1'000 IU vitamin D on any day in the 4 weeks prior to enrollment.
  • Elevated serum calcium > 2.60 mmol/l adjusted for albumin if albumin ≤ 35 or ≥ 45g/l
  • estimated creatinine clearance < 30 ml/min (Cockcroft and Gault = 140 - age(yr)*weight(kg)/ serum Cr(mmol/l))×(1.04 for women)
  • severe visual or hearing impairment
  • malabsorption syndrome (celiac diseases, inflammatory bowel disease).
  • Pathologic fracture (excl. fractures due to osteoporosis) in the last year
  • Fracture due to osteoporosis in the last 10 years
  • Chemo therapy / Radiation due to cancer in the last year
  • Treatment which has an effect on calcium metabolism (e.g. PTH, calcitonin, chronic cortisone intake > 5mg/day for more than 4 weeks in the last 12 months (except for inhalation and sporadic infiltration))
  • Current treatment with a bisphosphonate
  • For participants of the ancillary study "Muscle Biopsy" only: Treatment which has an effect on blood coagulation (e.g. factor X inhibitor, thrombin inhibitor, NSAR, low-molecular heparin, inhibitor for platelet aggregation, vitamin K antagonist) and/or abnormal blood coagulation status .
  • Unwilling or unable to take study medication
  • Diseases with a risk of recurrent falling (e.g. Parkinson's disease/syndrome, Hemiplegia after stroke, symptomatic stenosis of the spinal canal, polyneuropathy, epilepsy, recurring vertigo, recurring syncope)
  • History of or current diseases that may enhance serum calcium: sarcoidosis, lymphoma, primary hyperparathyroidism
  • Individual that heavily consumes alcohol containing products defined as greater than (>) 3 drinks (beer, wine, or distilled spirits) of alcoholic beverages per day.
  • Individual is unlikely to adhere to the study procedures, to keep appointments, or is planning to relocate during the study.
  • Individuals who are planning a stay in a "sunny" location (e.g. winter sun resort) for more than one month during the course of the study
  • Medication which has an effect on 25-hydroxyvitamin D level (e.g. certain anticonvulsants (e.g. Phenobarbital, Carbamazepin, Phenytoin))
  • M. Paget (Ostitis deformans)
  • Inflammatory arthritis (e.g. rheumatoid arthritis, Reiter syndrome, psoriasis arthritis)
  • Participation in a study in the last 6 months, except for studies without drug-application, or any influence of the study-medication can be excluded

Sites / Locations

  • Center on Aging and Mobility, Klinik für Geriatrie, UniversitätsSpital Zürich

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

Calcifediol Hy.D (25-hydroxyvitamin D)

Vitamin D3 (cholecalciferol)

Placebo

Arm Description

20 μg Calcifediol Hy.D (25-hydroxyvitamin D) (one capsule) per day for 6 months

3200 IU Vitamin D3 (cholecalciferol) (one capsule) per day for 6 months

1 Placebo capsule per day for 6 months

Outcomes

Primary Outcome Measures

Overall assessment of the "lower extremity function" test battery (difference in proportion of those who improved or maintained function compared to those who declined in function by treatment group)
The "lower extremity function" test battery consists of: 8-meter walk test, repeated sit-to-stand test and knee flexion and extension strength test). A repeated measures analysis across all four test battery components simultaneously documenting the difference in proportion of those who improved or maintained function compared to those who declined in function by treatment group (comprised endpoint on lower extremity function) will be performed. Calcifediol Hy.D will be compared with (1) placebo and compared with (2) 3200 Vitamin D3 IU per day -for the time points baseline 3 and 6 months. Outcomes of the individual tests are subject to the secondary outcome measures.

Secondary Outcome Measures

Gait speed measurement (8-meter walk)
Knee flexion and extension strength test
Repeated sit-to-stand test (reaction time)
Systolic and diastolic blood pressure
Timed up and go test (functional mobility)

Full Information

First Posted
August 14, 2015
Last Updated
April 29, 2019
Sponsor
DSM Nutritional Products, Inc.
Collaborators
University of Zurich, Tufts University
search

1. Study Identification

Unique Protocol Identification Number
NCT02527668
Brief Title
To Test the Effect of Calcifediol Hy.D Supplementation on Muscle Function and Bone Quality in Younger Postmenopausal Women With Osteopenia
Official Title
To Test the Effect of Calcifediol Hy.D Supplementation on Muscle Function and Bone Quality in Younger Postmenopausal Women With Osteopenia: a Double-blind Randomized Placebo-controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2019
Overall Recruitment Status
Completed
Study Start Date
September 2015 (Actual)
Primary Completion Date
September 2018 (Actual)
Study Completion Date
December 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
DSM Nutritional Products, Inc.
Collaborators
University of Zurich, Tufts University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Young postmenopausal women with osteopenia / or women with osteoporosis and a FRAX score below pharmacologic treatment indication have limited treatment options in the prevention of osteoporosis/treatment of osteopenia. Further, there is a concern about long-term side effects of bisphosphonate treatment among young postmenopausal women, and hormone replacement therapy has been controversial. In a pilot study 20 microgram Calcifediol Hy.D improved several muscle related function in this target population within 4 months of treatment, which can help to prevent falls and associated bone fractures. Thus the main aim of this study is to test whether Calcifediol Hy.D at a daily dose of 20 μg / day improves muscle function (lower extremity test battery) compared with (1) placebo and compared with (2) 3200 Vitamin D3 IU per day, at 3 and 6 month follow-up. As a secondary and exploratory objective of this study, the investigators will compare the beforementioned doses on muscle strength and the quality of the bones, beside muscle mass, body composition and systolic and diastolic blood pressure measurements.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteopenia/Osteoporosis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Calcifediol Hy.D (25-hydroxyvitamin D)
Arm Type
Experimental
Arm Description
20 μg Calcifediol Hy.D (25-hydroxyvitamin D) (one capsule) per day for 6 months
Arm Title
Vitamin D3 (cholecalciferol)
Arm Type
Active Comparator
Arm Description
3200 IU Vitamin D3 (cholecalciferol) (one capsule) per day for 6 months
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
1 Placebo capsule per day for 6 months
Intervention Type
Dietary Supplement
Intervention Name(s)
Calcifediol
Other Intervention Name(s)
25-hydroxyvitamin D (Hy.D)
Intervention Description
One capsule orally of Calcifediol (20 µg) per day with a meal for a duration of 6 months
Intervention Type
Dietary Supplement
Intervention Name(s)
Vitamin D3
Other Intervention Name(s)
Cholecalciferol
Intervention Description
One capsule orally of Cholecalciferol (3200 IU) per day with a meal for a duration of 6 months
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
One capsule orally of a Placebo capsule per day with a meal for a duration of 6 months
Primary Outcome Measure Information:
Title
Overall assessment of the "lower extremity function" test battery (difference in proportion of those who improved or maintained function compared to those who declined in function by treatment group)
Description
The "lower extremity function" test battery consists of: 8-meter walk test, repeated sit-to-stand test and knee flexion and extension strength test). A repeated measures analysis across all four test battery components simultaneously documenting the difference in proportion of those who improved or maintained function compared to those who declined in function by treatment group (comprised endpoint on lower extremity function) will be performed. Calcifediol Hy.D will be compared with (1) placebo and compared with (2) 3200 Vitamin D3 IU per day -for the time points baseline 3 and 6 months. Outcomes of the individual tests are subject to the secondary outcome measures.
Time Frame
Baseline, 3 months, 6 months
Secondary Outcome Measure Information:
Title
Gait speed measurement (8-meter walk)
Time Frame
Baseline, 3 months, 6 months
Title
Knee flexion and extension strength test
Time Frame
Baseline, 3 months, 6 months
Title
Repeated sit-to-stand test (reaction time)
Time Frame
Baseline, 3 months, 6 months
Title
Systolic and diastolic blood pressure
Time Frame
Baseline, 3 months, 6 months
Title
Timed up and go test (functional mobility)
Time Frame
Baseline, 3 months, 6 months
Other Pre-specified Outcome Measures:
Title
Bone mineral density (DXA)
Description
spine, hip (both sides at baseline, side with lowest total femur BMD only at follow-up), radius
Time Frame
Baseline and 6 months
Title
Muscle mass (DXA)
Description
Upper and lower extremity, body composition
Time Frame
Baseline and 6 months
Title
Bone quality (Xtreme CT):
Description
Tibia (funding is pending), radius (funding is pending)
Time Frame
Baseline and 6 months
Title
Cognition (MoCa test score)
Description
MoCa: Montreal Cognitive Assessment
Time Frame
Baseline and 6 months
Title
Quality of life questionnaire
Description
EuroQol country specific TTM Index
Time Frame
Baseline, 3 months, 6 months
Title
Upper extremity test (grip strength)
Time Frame
Baseline, 3 months, 6 months
Title
Cardiovascular fitness (6-minute walking test)
Time Frame
Baseline, 3 months, 6 months
Title
Cardio vascular risk marker (NT-BNP)
Time Frame
Baseline, 3 months, 6 months
Title
Bone marker: P1NP
Time Frame
Baseline, 3 months, 6 months
Title
Bone marker: Osteocalcin
Time Frame
Baseline, 3 months, 6 months
Title
Bone marker: Sclerostin
Time Frame
Baseline, 3 months, 6 months
Title
Muscle marker: myostatin
Time Frame
Baseline, 3 months, 6 months
Title
Safety: Serum calcium adjusted for albumin
Time Frame
Screening, 3 months, 6 months
Title
Safety: Serum creatinine
Time Frame
Screening, 3 months, 6 months
Title
Safety: Urinary calcium/creatinine Ratio
Time Frame
Screening, 3 months, 6 months
Title
Safety: Blood pressure
Time Frame
Screening, 3 months, 6 months
Title
Safety: Pulse rate
Time Frame
Screening, 3 months, 6 months
Title
Ancillary studies: Analysis of expression of the vitamin D receptor (VDR) in skeletal muscle
Description
18 of 50 participants in active group I, active group II and control will be enrolled in the muscle biopsy ancillary study. The muscle biopsies (about 0.2 g) will be taken from mid-thigh at baseline and at 6 months follow-up. Biopsies will be taken at the Zurich site, frozen and send to the Tufts University Boston, USA for analysis. Analysis: Expression of the vitamin D receptor (VDR) in skeletal muscle
Time Frame
Baseline, 6 months
Title
Ancillary studies: Analysis of total cross-sectional area (CSA) of muscle fibers
Description
18 of 50 participants in active group I, active group II and control will be enrolled in the muscle biopsy ancillary study. The muscle biopsies (about 0.2 g) will be taken from mid-thigh at baseline and at 6 months follow-up. Biopsies will be taken at the Zurich site, frozen and send to the Tufts University Boston, USA for analysis. Analysis: Total cross-sectional area (CSA) of muscle fibers
Time Frame
Baseline, 6 months
Title
Ancillary studies: Dried blood spot
Description
Among all 150 participants, we compare 25(OH)D content in arterial finger tip blood and venous blood at baseline and at 3 months
Time Frame
Baseline, 3 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Women age 50 to 70 Post-menopausal (defined as: at least 1 year after the last menstrual period) community-dwelling and ambulatory without help with documented osteopenia (BMD by DEXA t-score: < -1.0 and > -2.5 at the spine or hip) in the 6 months prior to enrolment or with documented osteoporosis (BMD by DEXA t-score: ≤ -2.5 at the spine or hip) and a FRAX score (online calculation tool of absolute 10 year fracture risk) below the Swiss age-dependent indication threshold for pharmacologic treatment for the 10-year risk of major osteoporotic fractures - at the screening visit and including DEXA (in the 6 months prior to enrolment) as part of the calculation body mass index > 18.5 and < 30 kg/m2 25(OH)D level < 24 µg/l (< 60 nmol/l) understands German in reading and writing plus able to read, understand, and complete questionnaires and tests willingness to limit additional vitamin D3 intake to 800 IU per day willingness to limit calcium supplement intake to 500 mg/day willingness to stop active vitamin D metabolites participant understands the study procedures, alternative treatments available and risks involved with the study and voluntarily agrees to participate by giving a written informed consent participant meets the routine clinical laboratory safety screening tests performed at screening visit participant is able and willing to perform all study tests, attend all required office visits, and provide blood and urine samples participant is able to swallow the study medication Exclusion Criteria: Consumption of more than 1'000 IU vitamin D on any day in the 4 weeks prior to enrollment. Elevated serum calcium > 2.60 mmol/l adjusted for albumin if albumin ≤ 35 or ≥ 45g/l estimated creatinine clearance < 30 ml/min (Cockcroft and Gault = 140 - age(yr)*weight(kg)/ serum Cr(mmol/l))×(1.04 for women) severe visual or hearing impairment malabsorption syndrome (celiac diseases, inflammatory bowel disease). Pathologic fracture (excl. fractures due to osteoporosis) in the last year Fracture due to osteoporosis in the last 10 years Chemo therapy / Radiation due to cancer in the last year Treatment which has an effect on calcium metabolism (e.g. PTH, calcitonin, chronic cortisone intake > 5mg/day for more than 4 weeks in the last 12 months (except for inhalation and sporadic infiltration)) Current treatment with a bisphosphonate For participants of the ancillary study "Muscle Biopsy" only: Treatment which has an effect on blood coagulation (e.g. factor X inhibitor, thrombin inhibitor, NSAR, low-molecular heparin, inhibitor for platelet aggregation, vitamin K antagonist) and/or abnormal blood coagulation status . Unwilling or unable to take study medication Diseases with a risk of recurrent falling (e.g. Parkinson's disease/syndrome, Hemiplegia after stroke, symptomatic stenosis of the spinal canal, polyneuropathy, epilepsy, recurring vertigo, recurring syncope) History of or current diseases that may enhance serum calcium: sarcoidosis, lymphoma, primary hyperparathyroidism Individual that heavily consumes alcohol containing products defined as greater than (>) 3 drinks (beer, wine, or distilled spirits) of alcoholic beverages per day. Individual is unlikely to adhere to the study procedures, to keep appointments, or is planning to relocate during the study. Individuals who are planning a stay in a "sunny" location (e.g. winter sun resort) for more than one month during the course of the study Medication which has an effect on 25-hydroxyvitamin D level (e.g. certain anticonvulsants (e.g. Phenobarbital, Carbamazepin, Phenytoin)) M. Paget (Ostitis deformans) Inflammatory arthritis (e.g. rheumatoid arthritis, Reiter syndrome, psoriasis arthritis) Participation in a study in the last 6 months, except for studies without drug-application, or any influence of the study-medication can be excluded
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heike Bischoff-Ferrari, Prof, Dr.PH
Organizational Affiliation
Center on Aging and Mobility, Klinik für Geriatrie, UniversitätsSpital Zürich
Official's Role
Principal Investigator
Facility Information:
Facility Name
Center on Aging and Mobility, Klinik für Geriatrie, UniversitätsSpital Zürich
City
Zurich
ZIP/Postal Code
8091
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
36385193
Citation
Ceglia L, Rivas DA, Schlogl M, Fielding GB, Egli A, Bischoff-Ferrari HA, Dawson-Hughes B. Effect of vitamin D3 vs. calcifediol on VDR concentration and fiber size in skeletal muscle. J Bone Miner Metab. 2023 Jan;41(1):41-51. doi: 10.1007/s00774-022-01374-y. Epub 2022 Nov 16.
Results Reference
derived

Learn more about this trial

To Test the Effect of Calcifediol Hy.D Supplementation on Muscle Function and Bone Quality in Younger Postmenopausal Women With Osteopenia

We'll reach out to this number within 24 hrs