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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00781261
Registration number
NCT00781261
Ethics application status
Date submitted
27/10/2008
Date registered
28/10/2008
Date last updated
14/01/2013
Titles & IDs
Public title
Osteonecrosis of the Hip and Bisphosphonate Treatment
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Scientific title
A Randomised Controlled Trial of Bisphosphonate Therapy in Osteonecrosis of the Hip
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Secondary ID [1]
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570989
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Universal Trial Number (UTN)
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Trial acronym
BONES
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Osteonecrosis
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Condition category
Condition code
Musculoskeletal
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Other muscular and skeletal disorders
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Cardiovascular
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Zoledronic Acid
Treatment: Drugs - Placebo
Placebo comparator: Control - Subjects in the control group will receive a placebo drug for a 1 year period
Active comparator: Zoledronic Acid - Subjects in this intervention group will be given 5mg Zoledronic acid as a single injection
Treatment: Drugs: Zoledronic Acid
Subjects in the intervention group B will be given 5mg Zoledronic acid as a single injection.
Treatment: Drugs: Placebo
Subjects in the control group will receive a placebo drug for a similar period
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Intervention code [1]
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Treatment: Drugs
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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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reducing pain and disability in the hip
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Assessment method [1]
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Timepoint [1]
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1 years
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Secondary outcome [1]
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reducing progression to femoral head collapse and the need for surgical intervention
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Assessment method [1]
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Timepoint [1]
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3 years
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Eligibility
Key inclusion criteria
1. aged between 18-90 years,
2. symptoms of pain and disability in at least one hip joint, or
3. positive MRI findings stage I or II on the ARCO classification
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Minimum age
18
Years
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Maximum age
90
Years
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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
1. previous hip joint surgery on the affected hip
2. severe pain and disability at rest if treating clinician has recommended surgery
3. radiographic or MRI findings suggestive for stage III and IV on the ARCO classification
4. any iv bisphosphonate within the prior 2 years or any prior use of bisphosphonate preparations, except according to the washout schedule:
* 2 years (if use > 48 weeks),
* 1 year (if used > 8 weeks but < 48 weeks)
* 6 months (if used > 2 weeks but < 8 weeks)
* 2 months (if used < 2 weeks)
5. active primary hyperparathyroidism
6. hypothyroidism, not appropriately controlled with long-term thyroxine therapy
7. history of iritis or uveitis, except due to trauma, and resolved for > 2 years prior to study
8. self-reported history of diabetic nephropathy or retinopathy (if diabetic, Hb A1c > 10%)
9. urine dipstick greater than or equal to 2+ protein at screening
10. AST or ALT greater than twice the upper limit of normal and/or alkaline phosphatase greater than twice the upper limit of normal
11. serum calcium > 2.75 mmol/L (11.0 mg/dL) or < 2.00 mmol/L (8.0 mg/dL)
12. serum 25-hydroxyvitamin D concentrations < 15 ng/L m) baseline renal insufficiency (calculated creatinine clearance less than 40 mL/min and serum creatinine greater than 175 mol/L) at V1
13. a history of invasive malignancy of any organ system, treated or untreated, in the past five years; excluding, basal cell or squamous cell carcinoma of the skin, colonic polyps with non-invasive malignancy which have been removed, ductal carcinoma in-situ (DCIS), and carcinoma in-situ (CIS) of the uterine cervix
14. any candidate patient with severe dental problems or current dental infections and/or any candidate patient with recent or impending dental surgery within three months of dosing
15. women of childbearing potential not using the contraception method(s) specified in this study (specify), as well as women who are breastfeeding
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Study design
Purpose of the study
Prevention
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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 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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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
1/08/2009
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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
1/12/2013
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
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Recruitment hospital [1]
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Royal North Shore Hospital, Department of Rheumatology - Sydney
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Recruitment hospital [2]
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Princess Alexandra Hospital - Brisbane
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Recruitment hospital [3]
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Royal Brisbane and Womens Hospital - Herston
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Recruitment hospital [4]
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The Queen Elizabeth Hospital - Adelaide
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Recruitment hospital [5]
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Cabrini Hospital - Melbourne
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Recruitment postcode(s) [1]
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2065 - Sydney
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Recruitment postcode(s) [2]
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4102 - Brisbane
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Recruitment postcode(s) [3]
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4029 - Herston
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Recruitment postcode(s) [4]
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5011 - Adelaide
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Recruitment postcode(s) [5]
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3144 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
University of Sydney
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Novartis
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Osteonecrosis of the hip is an important cause of musculoskeletal disability and finding therapeutic solutions has proven to be challenging. Osteonecrosis means death of bone which can occur from the loss of the blood supply or some other means. Although any age group may develop osteonecrosis, most patients are between 20 and 50 years old. The most common risk factor is a history of high steroid treatment for some medical condition. The next most common associated condition is a history of high alcohol use. There are some cases of osteonecrosis that occur in patients that are otherwise completely healthy with no detectable risk factors. In the earliest stage of the disease, x-rays appear normal and the diagnosis is made using MRI. The advanced stages of osteonecrosis begin when the dead bone starts to fail mechanically through a process of microfractures of the bone. As the disease progresses, the surface begins to collapse until, finally the integrity of the joint is destroyed. A wide range of surgical treatments with variable success rates have been proposed for the treatment of the osteonecrosis to preserve joint integrity, including core decompression, whereby the venous hypertension that ensues is lessened and revascularisation may be induced leading to bone repair. Nonsurgical treatment options are limited and usually result in a poor prognosis. Early stage disease can be treated with protected weight bearing and physiotherapy, however some studies have shown protected weight bearing to be associated with a greater than 85% rate of femoral head collapse. Unfortunately most studies indicate that the risk for disease progression is greater with nonsurgical treatment than with surgical intervention. There are no established pharmaceuticals for the prevention of treatment of osteonecrosis. Evidence is increasing that the nitrogen containing bisphosphonates may be beneficial in the treatment of osteonecrosis. One bisphosphonates (alendronate) has been evaluated in 60 patients diagnosed with osteonecrosis of the hip. Recent clinical studies have shown very promising results. All patients had symptomatic improvement after one year. Although the follow up time ranged from 3 months to 5 years, only 6 patients progressed to the point of needing surgery.
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Trial website
https://clinicaltrials.gov/study/NCT00781261
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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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Philip Sambrook, Prof
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Address
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University of Sydney
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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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Monique Macara
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Address
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Country
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Phone
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+61294631888
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00781261
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