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Trial registered on ANZCTR
Registration number
ACTRN12615001027505
Ethics application status
Approved
Date submitted
18/05/2015
Date registered
1/10/2015
Date last updated
10/02/2022
Date data sharing statement initially provided
10/02/2022
Date results provided
10/02/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Nitrates on Bone Density
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Scientific title
Efficacy of nitrates on bone mineral density in postmenopausal women with osteopenia
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Secondary ID [1]
286735
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Nil
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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:
Osteoporosis
295097
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Condition category
Condition code
Musculoskeletal
295343
295343
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0
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Osteoporosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1, isosorbide mononitrate 20mg daily, immediate release, oral for 1 year then no intervention for 1 year
Arm 2, isosorbide mononitrate 30mg daily, sustained release, oral for 1 year then no intervention for 1 year
Arm 3, isosorbide mononitrate 60mg daily, sustained release, oral for 1 year then no intervention for 1 year
Arm 4, nitroglycerin 25 mg daily, transdermal for 1 year then no intervention for 1 year
Arm 5, nitroglycerin 50 mg daily, transdermal for 1 year then no intervention for 1 year
Treatment adherence will be monitored in the trial by count of tablet or patches returned at the 6 month and 1 year visits.
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Intervention code [1]
291890
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Treatment: Drugs
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Intervention code [2]
292894
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Prevention
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Comparator / control treatment
Arm 6 Placebo, tablet daily for 1 year then no intervention for 1 year
Arm 7 Placebo, patch daily for 1 year then no intervention for 1 year
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in lumbar spine bone mineral density assessed on DXA scans
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Assessment method [1]
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Timepoint [1]
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1 year
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Secondary outcome [1]
314752
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Change in total hip bone mineral density assessed on DXA scans
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Assessment method [1]
314752
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Timepoint [1]
314752
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1 year
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Secondary outcome [2]
314753
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Change in femoral neck bone mineral density assessed on DXA scans
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Assessment method [2]
314753
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Timepoint [2]
314753
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1 year
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Secondary outcome [3]
314754
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Change in total body bone mineral density assessed on DXA scans
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Assessment method [3]
314754
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Timepoint [3]
314754
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1 year
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Secondary outcome [4]
314755
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Change in markers of bone turnover (procollagen type-I N-terminal propeptide, P1NP, and Beta-C-terminal telopeptide of type I collagen, CTX, assessed using via serum assay)
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Assessment method [4]
314755
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Timepoint [4]
314755
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1 year
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Secondary outcome [5]
314757
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Change in markers of bone turnover (procollagen type-I N-terminal propeptide, P1NP, and Beta-C-terminal telopeptide of type I collagen, CTX, assessed using via serum assay)
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Assessment method [5]
314757
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Timepoint [5]
314757
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2 years
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Secondary outcome [6]
314758
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Change in lumbar spine bone mineral density assessed on DXA scans
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Assessment method [6]
314758
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Timepoint [6]
314758
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2 years
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Secondary outcome [7]
314759
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Change in total hip bone mineral density assessed on DXA scans
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Assessment method [7]
314759
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Timepoint [7]
314759
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2 years
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Secondary outcome [8]
314760
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Change in femoral neck bone mineral density assessed on DXA scans
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Assessment method [8]
314760
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Timepoint [8]
314760
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2 years
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Secondary outcome [9]
314761
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Change in total body bone mineral density assessed on DXA scans
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Assessment method [9]
314761
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Timepoint [9]
314761
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2 years
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Eligibility
Key inclusion criteria
1. Postmenopausal women aged >55 years
2. Bone mineral density T score at the lumbar spine, femoral neck or total hip between -1 and -2.5
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Minimum age
55
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Bone mineral density T score <-2.5 at the total hip, femoral neck or lumbar spine
2. Current use of nitrate agents, or phosphodiesterase-5 inhibitors
3. Concurrent major systemic illness including untreated hypothyroidism or hyperthyroidism, chronic liver disease, chronic renal failure, malignancy, and active major gastrointestinal disease
4. Known congenital heart disease or hypotension, systolic blood pressure < 100 mmHg
5. Metabolic bone disease
6. Previous fragility fracture of the hip or clinical spine fracture
7. Current or past use of bisphosphonate therapy within 12 months, or any past zoledronate use
8. Use of oral glucocorticoid drugs equivalent to an average dose of at least prednisone 2.5mg/day during the preceding 6 months
9. Use of hormone replacement therapy within 12 months
10. Known nitrate hypersensitivity
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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)
Numbered containers
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation with blocks of varying size.
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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
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/11/2015
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Actual
20/09/2016
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Date of last participant enrolment
Anticipated
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Actual
30/10/2017
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Date of last data collection
Anticipated
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Actual
31/10/2018
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Sample size
Target
240
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Accrual to date
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Final
240
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Recruitment outside Australia
Country [1]
6886
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New Zealand
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State/province [1]
6886
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council of New Zealand
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Address [1]
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PO Box 5541,
Wellesley Street,
Auckland 1141
New Zealand
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Country [1]
291287
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Private Bag 92019,
Auckland, 1142
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
289965
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Address [1]
289965
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Country [1]
289965
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292853
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
292853
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Ministry of Health Ethics Department Freyberg Building Reception – Ground Floor 20 Aitken Street Wellington 6011
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Ethics committee country [1]
292853
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New Zealand
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Date submitted for ethics approval [1]
292853
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18/05/2015
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Approval date [1]
292853
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09/06/2015
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Ethics approval number [1]
292853
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Summary
Brief summary
Fractures occur in more than 50% of older women. Low bone density is a strong risk factor for fracture, but 80% of fractures occur in women with only mildly low bone density. Currently, there are no acceptable evidenced-based treatments for these women. Small studies have suggested that organic nitrates, which are commonly used to treat heart disease, might increase bone density. We plan to systematically investigate their effects on bone density. We will undertake a 2-year randomised, placebo-controlled trial of 5 different doses of organic nitrates in post-menopausal women with mildly low bone density. Participants will receive organic nitrates or inactive treatment for 1 year and then will be followed without treatment for 1 year. The main outcome is the change in bone density. If the treatment is effective, the study will provide the evidence base for a large trial to be conducted to test whether these agents can prevent fractures.
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Trial website
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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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A/Prof Mark Bolland
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Address
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Department of Medicine
University of Auckland
Private Bag 92019
Auckland 1142
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Country
57350
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New Zealand
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Phone
57350
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64 9 373 7599
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Fax
57350
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64 9 373 7677
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Email
57350
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[email protected]
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Contact person for public queries
Name
57351
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Anne Horne
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Address
57351
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Department of Medicine
University of Auckland
Private Bag 92019
Auckland 1142
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Country
57351
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New Zealand
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Phone
57351
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64 9 373 7599
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Fax
57351
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64 9 373 7677
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Email
57351
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[email protected]
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Contact person for scientific queries
Name
57352
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Mark Bolland
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Address
57352
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Department of Medicine
University of Auckland
Private Bag 92019
Auckland 1142
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Country
57352
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New Zealand
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Phone
57352
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64 9 373 7599
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Fax
57352
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64 9 373 7677
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Email
57352
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[email protected]
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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?
All requested data from the trial
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When will data be available (start and end dates)?
From trial publication on pubmed (5/7/20) onwards with no end date
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Available to whom?
Researchers upon reasonable request
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Available for what types of analyses?
All analyses
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How or where can data be obtained?
By contacting lead author by email (
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Nitrates Do Not Affect Bone Density or Bone Turnover in Postmenopausal Women: A Randomized Controlled Trial.
2020
https://dx.doi.org/10.1002/jbmr.3982
N.B. These documents automatically identified may not have been verified by the study sponsor.
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