Osteoporosis Clinical Trial
Official title:
Investigational Vertebroplasty Efficacy and Safety Trial (INVEST)
Vertebroplasty is a procedure used to stabilize broken vertebrae, the bones that form the spine. This study will evaluate the effectiveness of vertebroplasty for the treatment of fractures due to osteoporosis.
Spontaneous, atraumatic compression fractures due to osteoporosis occur in more than 700,000
patients per year. Pain associated with these fractures may be excruciating, but before the
advent of percutaneous vertebroplasty, treatment options were limited. Analgesic
medications, bed rest, and bracing have been the mainstays of treatment, but each of these
therapies has substantial limitations.
Because of the dearth of viable treatment options for osteoporotic vertebral compression
fractures, the practice of percutaneous vertebroplasty, which involves injection of
polymethylmethacrylate (medical cement) into the fractured vertebra, has disseminated
rapidly. However, evidence for the efficacy of percutaneous vertebroplasty is currently
limited to uncontrolled, nonblinded, small case studies. Even though high rates of success
are reported, with up to 90% of patients achieving substantial pain relief, these case
studies have not accounted for numerous important potential biases, including the natural
tendency for compression fractures to heal spontaneously, regression toward the mean
(wherein patients seek medical attention when pain is maximum), and the placebo effect. This
study will examine the clinical efficacy of percutaneous vertebroplasty for treatment of
painful osteoporotic vertebral compression fractures.
Participants in this study will be randomly assigned to receive either percutaneous
vertebroplasty or a sham procedure (placebo control group). Participants may have up to 2
spinal levels treated. Participants will be enrolled in the study for 1 year and will have
study visits at entry and Months 1 and 12. There will also be phone visits at Days 1, 2, 3,
and 14 and Months 3 and 6. After Month 1, crossover from the placebo group to the
vertebroplasty group will be allowed.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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