Osteoporosis Clinical Trial
Official title:
Percutaneous Vertebroplasty Versus Conservative Treatment in Vertebral Compression Fracture Associated With Glucocorticoids-induced Osteoporosis: a Prospective Cohort Study
Based on the case reports and other literature, the investigators hypothesize that using PVP
for treating GIOPVCF is associated with increased risk of vertebral refractures and does not
provide further benefits compared to conservative treatments.
The overall objective of this prospective cohort study is to compare the efficacy of PVP and
conservative treatment for GIOPVCF. The evaluation of efficacy of therapy includes: 1) the
incidence of vertebral refractures; 2) therapeutic effects (pain relief and health-related
life quality) and 3) complications.
The results from study will be written in English and disseminated widely through scholarly
presentations, peer-reviewed publications, and other written communications.
Patient recruitment and informed consent The study will recruit patients with GIOPVCF after
consultation with inpatients and outpatients. The principal investigator of the study will
screen the clinical information and inform the patients whether they are eligible for the
study. After explaining the two therapeutic strategies (conservative treatment and PVP) and
signing the informed consent, the patients will be divided into conservative treatment or PVP
group based on their own decision.
The general information and medicine history of the participants are collected: age, gender,
original disease, the course of original disease, specific GCs that have been used, the
dosage/length of the GCs treatment, specific anti-osteoporosis medicine have been used and
the dosage and length of usage. The bone density of the patient will then be evaluated using
Dual-energy X-ray absorptiometry (DXA).
Withdrawal of individual subject Patients can withdraw from the study at any time for any
reason without any consequences. The investigator can also decide to release patients from
the study for medical reasons. For every patient who decides to withdraw from the study, the
reasons of withdrawal will be recorded.
Sample size calculation A p-value is less than significance level (α) of 0.05 is considered
as statistically significant. The statistical power (1-β) is defined as 80%. Based on the
survival analysis of primary endpoint , the incidence of refracture in the patients with
GIOPVCF is 48.6% after initial PVP operation and 17% after initial conservative treatment.
Thus, power analysis indicates the study requires 42 patients per group to achieve
statistical significance between two groups. Considering 20% of patients may be lost during
follow-up visits, the investigators will recruit 53 patients for each group.
Statistical analysis Standard statistical techniques will be used to describe characteristics
of patients in both groups. The investigators will compare baseline characteristics in the
two treatment groups and if incomparability appears, the investigators will in secondary
analysis adjust for differences. The incidence of vertebral refracture between groups will be
compared with the Kaplan Meier survival analysis. Baseline differences of pain relief and
health-related life quality between two groups will be assessed using student t test or
nonparametric tests. Changes of VAS, ODI, and EQ-5D within the group from baseline to every
follow-up time point will be compared using paired t test. A P value less than 0.05 is
considered as statistically significant. SPSS 17.0 statistical program (SPSS, Chicago, IL)
will be used for statistical analysis.
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