Precision Medicine Approach for Osteoporosis - Follow Up Study

NCT06264609 | Enrolling By Invitation Phase 4 DMC FDA Drug

• 1 other identifier: 91026
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Osteoporosis is a health problem of major proportions. It affects more than 40 million Americans and results in more than 2 million fractures annually among Medicare patients alone. Hospital admissions for osteoporotic fractures exceed those of heart attacks, strokes and breast cancer combined. Osteoporosis is commonly considered a disease associated with menopause. This estrogen deficiency related bone loss is characterized by high bone turnover with increased resorption without commensurate changes in bone formation. It is in contrast to age-related bone loss, which starts as early as in the fourth decade of life and continues with increasing age. Age-related bone loss is usually associated with lower bone turnover and decreased bone formation is the main abnormality. Current therapies do not address age-related bone loss and the special needs of the age-related osteoporosis population is currently ignored. This is to a great degree due to difficulties associated with the bone biopsy necessary for unequivocal determination of bone turnover status. Thus, the current standard of care relies on starting with an antiresorber, which is of limited effectiveness in age-related osteoporosis, and in fact impedes the effectiveness of the appropriate anabolic medication. In a current ongoing study - Novel precision medicine approach to treatment of osteoporosis based on bone turnover. EIRB#70781; efforts are focused on addressing this particular problem. Our follow-up study seeks to achieve one specific aim: to compare effectiveness of Alendronate vs Teriparatide after participants have been switched at the end of treatment at year one, to the other drug at year two for the same duration of treatment.

Conditions

Osteoporosis

Outcome Measures

Primary Outcomes (1)

• Percent change in bone loss

  The primary endpoint for the follow up study will be bone loss as determined by the percent change in DXA absolute values of the lumbar spine, femoral neck, total hip and radius measured at baseline, at the end of the one-year trial; and at end of the one year follow up study. DXA is chosen because of its wide availability, low radioactivity exposure, and clinical use.

  12 months

Secondary Outcomes (1)

• Percent change in Bone Mass Density at the hip

  12 months

Other Outcomes (1)

• Trabecular bone score (TBS)

  12 months

Study Arms (3)

Group 1 Low Turnover - crossover

EXPERIMENTAL

Alendronate

Drug: Alendronate

Group 2 Low Turnover - crossover

EXPERIMENTAL

Teriparatide

Drug: Teriparatide

Group 2 Low Turnover - continuation

EXPERIMENTAL

Alendronate

Drug: Alendronate

Interventions

Teriparatide DRUG

Participants in Group 2 low turnover who received Alendronate in the main trial and if it is determined that the participant did not respond well to therapy; will be assigned to Teriparatide for 12 months.

Also known as: Grp 2

Group 2 Low Turnover - crossover

Alendronate DRUG

Participants in Group 1 low turnover, who have received Teriparatide in the main trial and if it is determined that the participant did not respond well to therapy; will be assigned to Alendronate for 12 months.

Also known as: Grp 1

Group 1 Low Turnover - crossover

Eligibility Criteria

• Age: 45 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosed Osteoporosis by DXA (BMD t-score = -2.5 with or without fragility fractures)
• Prior enrollment and completion of therapy in the "Novel precision medicine approach to treatment of osteoporosis based on bone turnover" trial.3) Premenopausal, menopausal, and post-menopausal females.
• years old and older.
• Normal levels of Vitamin D

You may not qualify if:

• Pregnant or trying to become pregnant or are breastfeeding
• Use of systemic anticoagulation (blood thinner)
• Planned or anticipated oral surgery within the next 12 months
• Planning to move out of the area within 18 months of the study
• Inability to stand or sit upright for at least 30 minutes
• Chronic alcoholism and/or drug addiction
• Prior radiation therapy (external beam or implant radiation) involving the skeleton (only if randomized to the bone forming drug (anabolic Forteo®))
• Systemic illnesses or organ diseases that may affect bone (except type 1 or type 2 diabetes mellitus)
• Clinical condition that may limit study participation (e.g., heart diseases (unstable angina), lung diseases (severe COPD), other infections)
• Abnormalities of the esophagus (tube connecting the mouth to the stomach) which delay esophageal emptying such as stricture (narrowing) or achalasia (a condition that prevents normal swallowing)
• Have other bone diseases that are not linked to age or menopause
• Have a history of malignancy (cancer), not including non-melanoma skin cancer.
• Vitamin D (Calcidiol) level below the normal range (below 20ng/mL).

Sponsors & Collaborators

• Paul F Netzel: lead

Study Sites (1)

University of Kentucky

Lexington, Kentucky, 40536, United States

Location

MeSH Terms

Conditions

Osteoporosis

Interventions

Alendronate; Teriparatide

Condition Hierarchy (Ancestors)

Bone Diseases, Metabolic; Bone Diseases; Musculoskeletal Diseases; Metabolic Diseases; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Diphosphonates; Organophosphonates; Organophosphorus Compounds; Organic Chemicals; Parathyroid Hormone; Peptide Hormones; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Peptides; Amino Acids, Peptides, and Proteins

Study Officials

• Paul Netzel, DNP

  University of Kentucky

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 9, 2024
• First Posted: February 20, 2024
• Study Start: February 1, 2024
• Primary Completion (Estimated): December 31, 2029
• Study Completion (Estimated): December 31, 2029
• Last Updated: April 1, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)