Osteoporosis Clinical Trial
Official title:
Can PTH Reverse Glucocorticoid-induced Osteoporosis
Glucocorticoids are potent anti-inflammatory and immunosuppressive agents. However,
prolonged use of these potent agents results in severe bone loss and osteoporotic fractures.
Parathyroid hormone (1-34), when given as a daily injection has been found to dramatically
increase bone mass in osteoporotic animals and postmenopausal women. The purpose of this
study is to determine whether 2 years of daily PTH (1-34) injections will increase bone mass
and reduce the development of new fractures. In addition, we will follow the study subjects
for 2 more years to determine which type of anti-resorptive agent is required to maintain
the newly formed bone.
We are enrolling postmenopausal women that are on chronic corticosteroid therapy (prednisone
etc.) and have bone loss (osteopenia by DXA) to be a part of this four-year-long study. The
patients will receive two-year therapy with either PTH (1-34) or placebo, and for the second
part of the study subjects receive either estrogen and placebo or alendronate and placebo.
We will measure bone gain by standard bone densitometry, special x-rays of the spine and
hip, and serum and urine bone markers.
| Status | Completed |
| Enrollment | 0 |
| Est. completion date | August 2001 |
| Est. primary completion date | |
| Accepts healthy volunteers | No |
| Gender | Female |
| Age group | N/A and older |
| Eligibility |
Inclusion Criteria: - Postmenopausal women on glucocorticoids (prednisone 5mg/d or greater - Osteopenia by T score of hip or lumbar spine of -2.0 - All study subjects must be on a stable dose of estrogen/progesterone or raloxifene - Ambulatory and able to come to the clinical center 9 times over 2 years - Willing to sign an informed consent Exclusion Criteria: - Generalized disease of the bone (other than glucocorticoid-induced osteoporosis), including hyperparathyroidism, hyperthyroidism, Paget's disease) - Diseases that affect bone metabolism (e.g. alcoholism, inflammatory bowel disease, malabsorption, renal disease (Cr2) or liver disease (transaminase level 2 times limit of normal) - Within the past 1 year, regular use of medications that are known to affect bone metabolism (e.g. anabolic steroids, anticoagulants, anticonvulsants, pharmacologic doses of vitamin D and vitamin A supplements). - History of drug abuse - Senile dementia, paraplegia and/or quadriplegia - Unstable rheumatic disease with clinically significant renal or central nervous system involvement. |
Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Treatment
| Country | Name | City | State |
|---|---|---|---|
| United States | San Francisco General Hospital | San Francisco | California |
| Lead Sponsor | Collaborator |
|---|---|
| National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
United States,
Lane NE, Sanchez S, Modin GW, Genant HK, Pierini E, Arnaud CD. Parathyroid hormone treatment can reverse corticosteroid-induced osteoporosis. Results of a randomized controlled clinical trial. J Clin Invest. 1998 Oct 15;102(8):1627-33. — View Citation
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