This study looks at the effects of two medications, alendronate and parathyroid hormone, on bone mass and on bone formation and bone breakdown in women with osteoporosis. We will randomly select postmenopausal women who have osteoporosis to receive laboratory-produced human parathyroid hormone (hPTH), or alendronate, or both for 2.5 years. Study participants will return to the study center periodically to have their bone mass measured and to give blood and urine samples for tests of bone formation and breakdown and for other laboratory tests. Those who complete the study are eligible for one or two 12 month extension studies.
This is a randomized, prospective, open-label study in which osteoporotic postmenopausal women self-administer synthetic hPTH-(1-34), alendronate, or both, every day for 2.5 years. Participants initially come to Massachusetts General Hospital once a month, and subsequently once every 3-6 months, for measurements of serum and urine indices of bone formation and resorption, serum and urine toxicity tests, and DXA/QCT measurements of bone mass. One-third of the participants take hPTH-(1-34) daily, one-third take alendronate once daily, and one-third take both daily (Phase A, months 0-30). Participants who complete Phase A are eligible for a 12 month extension study (Phase B, months 30-42), during which any alendronate treatment is continued without change and any hPTH 1-34 treatment is stopped. Participants who complete Phase B are eligible for a second 12 month extension study (Phase C, months 42-54), during which any alendronate treatment is continued without change and every participant takes hPTH 1-34. During Phases B and C, these participants come to Massachusetts General Hospital once every 6 months for measurements of serum and urine indices of bone formation and resorption, serum and urine toxicity tests, and DXA/QCT measurements of bone mass.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
37 mcg once daily by self-administered sc injection
70 mg/week by oral route
Massachusetts General Hospital
Boston, Massachusetts, United States
change in spine bone mineral density
Time frame: study months 30 (phase A), 42 (phase B), 54 (phase C)
change in hip bone mineral density
Time frame: study months 30 (phase A), 42 (phase B), 54 (phase C)
change in forearm bone mineral density
Time frame: study months 30 (phase A), 42 (phase B), 54 (phase C)
change in total body bone mineral
Time frame: study months 30 (phase A), 42 (phase B), 54 (phase C)
change in femoral shaft bone mineral density
Time frame: study months 30 (phase A), 42 (phase B), 54 (phase C)
change in serum PINP
Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)
change in serum osteocalcin
Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)
change in serum NTX
Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)
incidence of hypercalcemia
Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)
incidence of hypercalciuria
Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)
incidence of symptoms
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Time frame: study months 0-30 (phase A), 30-42 (phase B), 42-54 (phase C)