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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05347082
Other study ID # 120.2021
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date April 29, 2021
Est. completion date February 20, 2022

Study information

Verified date April 2022
Source Hospital Regional 1o de Octubre
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Recently, an increase in the prevalence of hyperparathyroidism and hypovitaminosis D in postmenopause women has been occurring in Mexico and the world. Chronic exposure to the parathyroid hormone (PTH) is catabolic for the bone, worsening the state of osteoporosis. However, it is unclear whether these conditions could significantly improve bone mineral density (BMD). In the present work, it was shown that the resolution of hyperparathyroidism in postmenopausal women improves osteoporosis.


Description:

This study was an open clinical trial conducted in Mexican women diagnosed with postmenopausal osteoporosis and hyperparathyroidism associated or not with hypovitaminosis D from the climacteric clinic of the regional hospital "1o de Octubre" of the Institute of Security and Social Services for State Workers (ISSSTE). An integral clinical evaluation with PTH and vitamin D measurement was first done to determine the frequency of primary hyperparathyroidism and hypovitaminosis D. Likewise, a thyroid ultrasound was done. Then, 8000 IU of vitamin D were orally administrated for four weeks. Statical analysis was performed using PAST 3.0 and GraphPad Prism 8.4.3. software. The arithmetic median (µ) and standard deviation (S.D.) were calculated using Excel-Word. Graphics were constructed with GraphPad Prism 8.4.3 and tables with Excel-Word. Categorical variables were analysed with chi-squared or Fisher exact test depending on the number of participants in each cell. Normality was determined using the Shapiro-Wilk test. To compare two paired samples, the Wilcoxon signed-rank test was utilized. To perform correlations, the Spearman correlation coefficient was used. The assigned α value for this study was <0.05. In all cases, if a Montecarlo permutation was available, the exact p-value was taken instead of the raw p-value.


Recruitment information / eligibility

Status Completed
Enrollment 47
Est. completion date February 20, 2022
Est. primary completion date December 29, 2021
Accepts healthy volunteers No
Gender Female
Age group N/A and older
Eligibility Inclusion Criteria: - Acceptance to participate in the study with informed consent. - Postmenopausal osteoporosis or osteopenia. - Primary or secondary hyperparathyroidism. - Insufficiency or deficiency of vitamin D. - Multi-treated postmenopausal osteoporosis. - Postmenopausal osteoporosis without treatment. Exclusion Criteria: - Different osteoporosis aetiology not related to oestrogenic deficiency. - Thyroid pathology. - Previous treatment with vitamin D, thiazide diuretics, lithium, Teriparatide or glucocorticoids. - Known allergies to vitamin D. - Addison's disease, pheochromocytoma, and depressive disorders.

Study Design


Intervention

Drug:
Cholecalciferol
Tablets of 4000 IU

Locations

Country Name City State
Mexico Peri-postmenopause and bone metabolism clinic. Regional Hospital October 1st ISSSTE Mexico City

Sponsors (3)

Lead Sponsor Collaborator
Hospital Regional 1o de Octubre National Polytechnic Institute, Mexico, Universidad Nacional Autonoma de Mexico

Country where clinical trial is conducted

Mexico, 

References & Publications (23)

Chang B, Quan Q, Li Y, Qiu H, Peng J, Gu Y. Treatment of Osteoporosis, with a Focus on 2 Monoclonal Antibodies. Med Sci Monit. 2018 Dec 3;24:8758-8766. doi: 10.12659/MSM.912309. Review. — View Citation

Chen LX, Zhou ZR, Li YL, Ning GZ, Zhang TS, Zhang D, Feng SQ. Comparison of Bone Mineral Density in Lumbar Spine and Fracture Rate among Eight Drugs in Treatments of Osteoporosis in Men: A Network Meta-Analysis. PLoS One. 2015 May 26;10(5):e0128032. doi: 10.1371/journal.pone.0128032. eCollection 2015. — View Citation

Contreras-Manzano A, Villalpando S, Robledo-Pérez R. Vitamin D status by sociodemographic factors and body mass index in Mexican women at reproductive age. Salud Publica Mex. 2017 Sep-Oct;59(5):518-525. doi: 10.21149/8080. — View Citation

Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R; National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014 Oct;25(10):2359-81. doi: 10.1007/s00198-014-2794-2. Epub 2014 Aug 15. Erratum in: Osteoporos Int. 2015 Jul;26(7):2045-7. — View Citation

Davis S, Martyn-St James M, Sanderson J, Stevens J, Goka E, Rawdin A, Sadler S, Wong R, Campbell F, Stevenson M, Strong M, Selby P, Gittoes N. A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures. Health Technol Assess. 2016 Oct;20(78):1-406. Review. Erratum in: Health Technol Assess. 2018 Mar;20(78):407-424. — View Citation

Goltzman D. Functions of vitamin D in bone. Histochem Cell Biol. 2018 Apr;149(4):305-312. doi: 10.1007/s00418-018-1648-y. Epub 2018 Feb 12. Review. — View Citation

Grey A, Lucas J, Horne A, Gamble G, Davidson JS, Reid IR. Vitamin D repletion in patients with primary hyperparathyroidism and coexistent vitamin D insufficiency. J Clin Endocrinol Metab. 2005 Apr;90(4):2122-6. Epub 2005 Jan 11. — View Citation

Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE. Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab. 2005 Jun;90(6):3215-24. Epub 2005 Mar 29. — View Citation

Leder BZ, Tsai JN, Uihlein AV, Wallace PM, Lee H, Neer RM, Burnett-Bowie SA. Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial. Lancet. 2015 Sep 19;386(9999):1147-55. doi: 10.1016/S0140-6736(15)61120-5. Epub 2015 Jul 2. — View Citation

Lips P, van Schoor NM. The effect of vitamin D on bone and osteoporosis. Best Pract Res Clin Endocrinol Metab. 2011 Aug;25(4):585-91. doi: 10.1016/j.beem.2011.05.002. Review. — View Citation

Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001 Aug;22(4):477-501. Review. — View Citation

Lundgren E, Hagström EG, Lundin J, Winnerbäck K, Roos J, Ljunghall S, Rastad J. Primary hyperparathyroidism revisited in menopausal women with serum calcium in the upper normal range at population-based screening 8 years ago. World J Surg. 2002 Aug;26(8):931-6. Epub 2002 Jun 6. — View Citation

Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997 Mar;121(3):287-94. — View Citation

Manson JE, Hsia J, Johnson KC, Rossouw JE, Assaf AR, Lasser NL, Trevisan M, Black HR, Heckbert SR, Detrano R, Strickland OL, Wong ND, Crouse JR, Stein E, Cushman M; Women's Health Initiative Investigators. Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med. 2003 Aug 7;349(6):523-34. — View Citation

Neuprez A, Bruyère O, Collette J, Reginster JY. Vitamin D inadequacy in Belgian postmenopausal osteoporotic women. BMC Public Health. 2007 Apr 26;7:64. — View Citation

Paggiosi MA, Peel N, McCloskey E, Walsh JS, Eastell R. Comparison of the effects of three oral bisphosphonate therapies on the peripheral skeleton in postmenopausal osteoporosis: the TRIO study. Osteoporos Int. 2014 Dec;25(12):2729-41. doi: 10.1007/s00198-014-2817-z. Epub 2014 Jul 30. — View Citation

Recker RR, Kendler D, Recknor CP, Rooney TW, Lewiecki EM, Utian WH, Cauley JA, Lorraine J, Qu Y, Kulkarni PM, Gaich CL, Wong M, Plouffe L Jr, Stock JL. Comparative effects of raloxifene and alendronate on fracture outcomes in postmenopausal women with low bone mass. Bone. 2007 Apr;40(4):843-51. Epub 2006 Dec 19. — View Citation

Rolighed L, Rejnmark L, Sikjaer T, Heickendorff L, Vestergaard P, Mosekilde L, Christiansen P. Vitamin D treatment in primary hyperparathyroidism: a randomized placebo controlled trial. J Clin Endocrinol Metab. 2014 Mar;99(3):1072-80. doi: 10.1210/jc.2013-3978. Epub 2014 Jan 13. — View Citation

Souberbielle JC, Bienaimé F, Cavalier E, Cormier C. Vitamin D and primary hyperparathyroidism (PHPT). Ann Endocrinol (Paris). 2012 Jun;73(3):165-9. doi: 10.1016/j.ando.2012.04.008. Epub 2012 Jun 5. Review. — View Citation

Tucci JR. Vitamin D therapy in patients with primary hyperparathyroidism and hypovitaminosis D. Eur J Endocrinol. 2009 Jul;161(1):189-93. doi: 10.1530/EJE-08-0901. Epub 2009 Apr 21. — View Citation

Watson J, Wise L, Green J. Prescribing of hormone therapy for menopause, tibolone, and bisphosphonates in women in the UK between 1991 and 2005. Eur J Clin Pharmacol. 2007 Sep;63(9):843-9. Epub 2007 Jun 28. — View Citation

Wihlborg A, Bergström K, Gerdhem P, Bergström I. Parathyroid Hormone Disturbances in Postmenopausal Women with Distal Forearm Fracture. World J Surg. 2022 Jan;46(1):128-135. doi: 10.1007/s00268-021-06331-w. Epub 2021 Oct 13. — View Citation

Yuan F, Peng W, Yang C, Zheng J. Teriparatide versus bisphosphonates for treatment of postmenopausal osteoporosis: A meta-analysis. Int J Surg. 2019 Jun;66:1-11. doi: 10.1016/j.ijsu.2019.03.004. Epub 2019 Mar 16. Review. — View Citation

* Note: There are 23 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Number of Participants with Remission of Hyperparathyroidism Clinical remission of hyperparathyroidism was evaluated after treatment. 4 weeks
Primary Number of Participants with Remission of Hypovitaminosis D Clinical remission of vitamin D deficiency or insufficiency were evaluated after treatment. 4 weeks.
Primary Change from baseline hip T score at 4 weeks Osteoporosis in the hip was determined by a T score greater than -2.5 and osteopenia was determined by a T score between -1 to -2.4. 4 weeks
Primary Change from baseline lumbar spine T score at 4 weeks Osteoporosis in the lumbar spine was determined by a T-score greater than -2.5 and osteopenia was determined by a T-score between -1 and -2.4. 4 weeks
Secondary Change from baseline general T score at 4 weeks Osteoporosis was determined by a T-score greater than -2.5 either in the hip or in the lumbar spine and osteopenia was determined by a T-score between -1 and -2.4 either in the hip or in the lumbar spine. 4 weeks
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