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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03164928
Registration number
NCT03164928
Ethics application status
Date submitted
8/05/2017
Date registered
24/05/2017
Titles & IDs
Public title
Safety and Efficiency of Denosumab in Pediatric Subjects With Glucocorticoid-induced Osteoporosis
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Scientific title
A Phase 3 Randomized, Double-blind, Placebo-controlled, Parallel-group Study to Evaluate the Safety and Efficacy of Denosumab in Pediatric Subjects With Glucocorticoid-induced Osteoporosis
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Secondary ID [1]
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2016-003083-39
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Secondary ID [2]
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20140444
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Evaluate the Safety and Efficacy of Denosumab in Pediatric Subjects With
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Glucocorticoid-induced Osteoporosis
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Condition category
Condition code
Musculoskeletal
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Osteoporosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Denosumab
Other interventions - Placebo
Other: Placebo - SC Q6M placebo
Experimental: Denosumab - 1 mg/kg BW (up to a maximum of 60 mg) SC Q6M
Treatment: Drugs: Denosumab
1mg/kg BW (up to a maximum of 60 mg) SC Q6M
Other interventions: Placebo
SC Q6M placebo
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Change From Baseline in Lumbar Spine BMD Z-score as Assessed by Dual-energy X-ray Absorptiometry (DXA) at 12 Months
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Assessment method [1]
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Lumbar spine BMD was assessed by DXA and analyzed by analysis of covariance (ANCOVA) including treatment (denosumab vs placebo), baseline age, and baseline BMD z-score. DXA results were converted to z-scores, indicating number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify lumbar spine BMD improvement.
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Timepoint [1]
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Baseline and 12 Months
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Secondary outcome [1]
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Change From Baseline in Lumbar Spine BMD Z-score as Assessed by DXA at 6, 18, 24, and 36 Months
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Assessment method [1]
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Lumbar spine BMD was assessed by DXA and analyzed by repeated measures analysis with randomization group, visit, baseline age, and baseline BMD z-score as fixed effects. Treatment-by-visit was included as an interaction term. DXA results were converted to z-scores, indicating number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify lumbar spine BMD improvement.
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Timepoint [1]
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Baseline and 6, 18, 24, and 36 Months
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Secondary outcome [2]
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Change From Baseline in Proximal Femur BMD Z-score as Assessed by DXA at 6, 12, 18, 24, and 36 Months
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Assessment method [2]
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Proximal femur (total hip and femoral neck) BMD was assessed by DXA and analyzed by repeated measures analysis with randomization group, visit, baseline age, and baseline BMD z-score as fixed effects. Treatment-by-visit was included as an interaction term. DXA results were converted to z-scores, indicating number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify proximal femur BMD improvement.
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Timepoint [2]
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Baseline and 6, 12, 18, 24, and 36 Months
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Secondary outcome [3]
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Number of Participants With X-ray Confirmed Long-bone Fractures and/or Vertebral Fractures at 12, 24, and 36 Months
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Assessment method [3]
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Number of participants who have at least one long bone fracture or vertebral fracture, and number of participants who have more than one long bone fracture or vertebral fracture.
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Timepoint [3]
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Month 12, 24, and 36
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Secondary outcome [4]
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Number of Participants With Improving Vertebral Fractures at 12, 24, and 36 Months
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Assessment method [4]
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Number of participants with improving vertebral fractures. An improving fracture is defined as one showing signs of healing/repair from baseline as assessed by X-ray.
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Timepoint [4]
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Month 12, 24, and 36
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Secondary outcome [5]
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Number of Participants With New and Worsening Vertebral and Non-vertebral Fractures at 12, 24, and 36 Months
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Assessment method [5]
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Number of participants who have at least one vertebral fracture or non-vertebral fracture, and number of participants who have more than one vertebral fracture or non-vertebral fracture.
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Timepoint [5]
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Month 12, 24, and 36
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Secondary outcome [6]
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Change From Baseline in Child Health Questionnaire-Parent Form-50 (CHQ-PF-50) Physical Summary Score at 12, 24, and 36 Months
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Assessment method [6]
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The CHQ-PF-50 is a 50-item questionnaire to be completed by the parents or guardians of children between 5 and 18 years of age. The physical summary score ranges from 0-100 with higher scores indicating better physical health.
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Timepoint [6]
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Baseline and month 12, 24, and 36
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Secondary outcome [7]
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Change From Baseline in CHQ-PF-50 Psychological Summary Score at 12, 24, and 36 Months
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Assessment method [7]
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The CHQ-PF-50 is a 50-item questionnaire to be completed by the parents or guardians of children between 5 and 18 years of age. The psychological summary score ranges from 0-100 with higher scores indicating better psychological health.
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Timepoint [7]
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Baseline and Month 12, 24, and 36
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Secondary outcome [8]
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Change From Baseline in Childhood Health Assessment Questionnaire (CHAQ) Disability Index Score at 12, 24, and 36 Months
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Assessment method [8]
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The CHAQ was developed to measure the physical functioning in children 6 months to 18 years of age. It consists of 54 questions related to the child's ability to perform various activities of daily living. Depending on the question asked, each question is scored either 0 to 3 based on the level of difficulty experienced by the child or 0-1 based on whether the child required assistance from another person or used an aid or other device. All CHAQ questions were scored and converted to a total index score ranging from 0-3, where higher scores indicate greater disability.
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Timepoint [8]
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Baseline and Month 12, 24, and 36
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Secondary outcome [9]
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Change From Baseline in Wong-Baker FACES Pain Rating Scale (WBFPRS) at 12, 24, and 36 Months
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Assessment method [9]
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The WBFPRS is a horizontal pain scale for children 3-18 years which consists of 6 faces that range from a smiling "no hurt" face with a score of 0 to a crying "hurts worst" face with a score of 10.
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Timepoint [9]
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Baseline and Month 12, 24, and 36
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Secondary outcome [10]
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Change From Baseline in Growth Velocity Z-score (Height) at 12, 24, and 36 Months
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Assessment method [10]
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Growth velocity was determined by calculating age-adjusted z-scores for height, weight, and body mass index (BMI). Z-scores represent the number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify increased growth velocity.
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Timepoint [10]
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Baseline and Month 12, 24, and 36
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Secondary outcome [11]
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Change From Baseline in Growth Velocity Z-score (Weight) at 12, 24, and 36 Months
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Assessment method [11]
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Growth velocity was determined by calculating age-adjusted z-scores for height, weight, and BMI. Z-scores represent the number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify increased growth velocity.
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Timepoint [11]
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Baseline and Month 12, 24, and 36
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Secondary outcome [12]
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Change From Baseline in Growth Velocity Z-score (BMI) at 12, 24, and 36 Months
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Assessment method [12]
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Growth velocity was determined by calculating age-adjusted z-scores for height, weight, and BMI. Z-scores represent the number of standard deviations from the reference population's mean, with 0 denoting the mean. Positive changes from baseline signify increased growth velocity.
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Timepoint [12]
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Baseline and Month 12, 24, and 36
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Secondary outcome [13]
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Mean Serum Concentration of Denosumab
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Assessment method [13]
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Timepoint [13]
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Day 1, Day 10, Day 30, Month 3, Month 6, Month 12, and Month 18
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Eligibility
Key inclusion criteria
* Male or female subjects, age 5 to 17 years, inclusive, at the time of informed consent.
* Clinical diagnosis of GiOP as defined by the following (and consistent with the International Society for Clinical Densitometry definition of osteoporosis in children and adolescents [Bishop et al, 2014])
* A confirmed diagnosis of non-malignant condition(s) requiring treatment with systemic GC (including, but not limited to, chronic rheumatologic, gastrointestinal, neurologic, respiratory, and/or nephrological conditions)
* Subjects who are on systemic GC only as replacement therapy for adrenal insufficiency are not eligible for the study - Treatment with systemic GC (intravenous or oral) of any duration for the underlying non-malignant condition(s) within the 12 months prior to screening
* Evidence of at least 1 vertebral compression fracture of Genant grade 1 or higher, as assessed by the central imaging vendor on lateral spine X-rays performed at screening or within 2 months prior to screening; OR, in the absence of vertebral compression fractures, presence of both clinically significant fracture history (ie, = 2 long-bone fractures by age 10 years or = 3 long-bone fractures at any age up to 17 years) and lumbar spine BMD Z-score = -2.0, as assessed by the central imaging vendor.
• Subject's legally acceptable representative has provided informed consent when the subject is legally too young to provide informed consent and the subject has provided assent based on local regulations and/or guidelines prior to any study-specific activities/procedures being initiated
* A confirmed diagnosis of non-malignant condition(s) requiring treatment with systemic GC (including, but not limited to, chronic rheumatologic, gastrointestinal, neurologic, respiratory, and/or nephrological conditions)
* Subjects who are on systemic GC only as replacement therapy for adrenal insufficiency are not eligible for the study
* Treatment with systemic GC (intravenous or oral) of any duration for the underlying non malignant condition(s) within the 12 months prior to screening
* Prepubertal children should be expected to require significant GC use during the study, per investigator opinion
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Minimum age
5
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Maximum age
17
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria will include the following:
* Current hyperthyroidism (unless well controlled on stable antithyroid therapy)
* Current clinical hypothyroidism (unless well controlled on stable thyroid replacement therapy)
* History of hyperparathyroidism
* Current hypoparathyroidism
* Duchenne muscular dystrophy with symptomatic cardiac abnormality
* Current malabsorption
* Active infection or history of infections
* History of malignancy
* Any causes of primary or secondary osteoporosis (other than GC use), or previous exposure to non-GC medications, which the investigator considers to have been a major factor contributing to the patient's fracture(s)
* Current adrenal insufficiency as the sole indication for GC therapy
* Duchenne muscular dystrophy with symptomatic cardiac abnormality
* Current malabsorption (in children with serum albumin -lower limit of normal [LLN], malabsorption should be clinically ruled out by the investigator to confirm eligibility)
* Known intolerance to calcium or vitamin D supplements
* Active infection or history of infections, defined as follows:
* Any active infection for which systemic anti-infectives were used within 4 weeks prior to screening
* Serious infection, defined as requiring hospitalization or intravenous anti infectives within 8 weeks prior to screening
* Recurrent or chronic infection or other active infection that, in the opinion of the investigator, might compromise the safety of the subject
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
7/05/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
20/12/2023
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Sample size
Target
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Accrual to date
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Final
24
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Perth Childrens Hospital - Nedlands
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Recruitment postcode(s) [1]
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6909 - Nedlands
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Delaware
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Country [3]
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United States of America
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State/province [3]
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Indiana
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Country [4]
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United States of America
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State/province [4]
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Minnesota
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Country [5]
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United States of America
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State/province [5]
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Ohio
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Country [6]
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Belgium
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State/province [6]
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Bruxelles
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Country [7]
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Bulgaria
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State/province [7]
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Sofia
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Country [8]
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Canada
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State/province [8]
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Ontario
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Country [9]
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Canada
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State/province [9]
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Quebec
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Country [10]
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Colombia
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State/province [10]
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Antioquia
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Country [11]
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Colombia
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State/province [11]
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Cundinamarca
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Country [12]
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Colombia
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State/province [12]
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Santander
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Country [13]
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India
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State/province [13]
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Andhra Pradesh
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Country [14]
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India
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State/province [14]
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Delhi
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Country [15]
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India
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State/province [15]
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Karnataka
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Country [16]
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India
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State/province [16]
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Tamil Nadu
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Country [17]
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Italy
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State/province [17]
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Firenze
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Country [18]
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Italy
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State/province [18]
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Milan
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Italy
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State/province [19]
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Roma
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Country [20]
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Mexico
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State/province [20]
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Ciudad de Mexico
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Country [21]
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Peru
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State/province [21]
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Lima
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Country [22]
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Peru
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State/province [22]
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Arequipa
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Country [23]
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Peru
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State/province [23]
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Callao
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Country [24]
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Russian Federation
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State/province [24]
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Moscow
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Country [25]
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Russian Federation
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State/province [25]
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Novosibirsk
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Country [26]
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Russian Federation
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State/province [26]
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Saint Petersburg
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Country [27]
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Turkey
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State/province [27]
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Ankara
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Country [28]
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Turkey
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State/province [28]
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Erzurum
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Country [29]
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Turkey
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State/province [29]
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Istanbul
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Country [30]
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Turkey
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State/province [30]
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Izmir
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Country [31]
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Ukraine
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State/province [31]
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Dnipro
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Country [32]
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Ukraine
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State/province [32]
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Kharkiv
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Country [33]
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Ukraine
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State/province [33]
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Kyiv
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Amgen
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
To evaluate the effect of denosumab on lumbar spine bone mineral density (BMD) Z-score as assessed by dual-energy X-ray absorptiometry (DXA) at 12 months in children 5 to 17 year of age with Glucocorticoid (GC)-induced osteoporosis (GiOP).
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Trial website
https://clinicaltrials.gov/study/NCT03164928
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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MD
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Address
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Amgen
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF), Clinical study report (CSR)
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When will data be available (start and end dates)?
Data sharing requests relating to this study will be considered beginning 18 months after the study has ended and either 1) the product and indication have been granted marketing authorization in both the US and Europe or 2) clinical development for the product and/or indication discontinues and the data will not be submitted to regulatory authorities. There is no end date for eligibility to submit a data sharing request for this study.
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Available to whom?
Qualified researchers may submit a request containing the research objectives, the Amgen product(s) and Amgen study/studies in scope, endpoints/outcomes of interest, statistical analysis plan, data requirements, publication plan, and qualifications of the researcher(s). In general, Amgen does not grant external requests for individual patient data for the purpose of re-evaluating safety and efficacy issues already addressed in the product labelling. Requests are reviewed by a committee of internal advisors. If not approved, a Data Sharing Independent Review Panel will arbitrate and make the final decision. Upon approval, information necessary to address the research question will be provided under the terms of a data sharing agreement. This may include anonymized individual patient data and/or available supporting documents, containing fragments of analysis code where provided in analysis specifications. Further details are available at the link below.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://www.amgen.com/datasharing
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/28/NCT03164928/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/28/NCT03164928/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03164928