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Trial registered on ANZCTR
Registration number
ACTRN12621001521819
Ethics application status
Approved
Date submitted
15/09/2021
Date registered
9/11/2021
Date last updated
20/10/2022
Date data sharing statement initially provided
9/11/2021
Date results provided
9/11/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Development of an Oral Preparation of Zoledronic Acid for Use in Postmenopausal Osteoporosis/Osteopenia
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Scientific title
Development of an Oral Preparation of Zoledronic Acid for Use in Postmenopausal Osteoporosis/Osteopenia: Dose-Finding Study
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Secondary ID [1]
305255
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None
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Universal Trial Number (UTN)
U1111-1269-3016
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Trial acronym
N/A
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
Osteoporosis
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Osteopenia
323530
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Condition category
Condition code
Metabolic and Endocrine
321092
321092
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0
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Other endocrine disorders
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Musculoskeletal
321093
321093
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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 1:20mg enteric coated oral zoledronate capsule- one dose only at baseline.
Arm 2: 20mg enteric coated micro-capsulated oral zoledronate capsule- one dose only at baseline
Arm 3: 40mg enteric coated oral zoledronate capsule- one dose only at baseline
Arm 4: 20mg enteric coated micro-capsulated oral zoledronate capsule- one dose at baseline and one week
Arm 5: 20mg enteric coated oral zoledronate capsule, one capsule at baseline and 40mg at 1 week
Arm 6: 20mg enteric coated micro-capsulated oral zoledronate capsule at baseline, one week and two weeks.
The first dose will be administered on site under monitoring and in those who are getting further doses, the subsequent capsules are taken at home.
This is a dose ranging study and the outcomes will be compared to the effect of a standard 5mg intravenous dose of Zoledronate.
The first 5 participants recruited will join Arm 1, then the next 5 will be in arm 2 and so on until we establish the most effective dose.
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Intervention code [1]
321648
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Treatment: Drugs
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Comparator / control treatment
No control group. The bone marker response for each dose will be compared to the known effect of a 5mg intravenous dose of Zoledronate.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Percent change in plasma CTX on each dosing regimen
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Assessment method [1]
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Timepoint [1]
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1,3,6,9 and 12 months after baseline dosing complete. The percent change in CTX from baseline at month 1 is the primary endpoint of this study.
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Primary outcome [2]
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Percent change in plasma P1NP on each dosing regimen
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Assessment method [2]
328874
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Timepoint [2]
328874
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3,6,9,12 months after baseline dosing complete The percent change in P1NP from baseline at month 3 a primary endpoint of this study.
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Primary outcome [3]
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Frequency and severity of Acute Phase Reactions for each dosing regimen as assessed by a telephone contact asking specifically about self reported headache, nausea, muscle or joint aches, fever or any other reported symptoms.
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Assessment method [3]
328875
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Timepoint [3]
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3 days post completion of dose regimen and until symptoms resolve assessed by ongoing weekly telephone visits and at 3,6,9,12 months after baseline dosing complete.
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Secondary outcome [1]
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Percent change in Bone Mineral Density measurement using a Prodigy DXA scanner at 12 months at spine.
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Assessment method [1]
400735
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Timepoint [1]
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12 months after baseline dosing complete.
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Secondary outcome [2]
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Percent change in Bone Mineral Density measurement using a Prodigy DXA scanner at 12 months at total hip.
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Assessment method [2]
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Timepoint [2]
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12 months after baseline dosing complete
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Eligibility
Key inclusion criteria
Healthy women > 5 years post menopause, or >55 years of age if hysterectomised
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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?
Yes
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Key exclusion criteria
Renal impairment (eGFR less than 40 mL/minute)
Active upper gastro-intestinal disease or persistent dyspeptic symptoms
Hypocalcaemia
Risk factors for severe vitamin D deficiency (frail elderly, absence of regular times outdoors, veiling, South Asian/Middle Eastern/African origin not using vitamin D supplements. If any of these risk factors are present then calciferol 100,000 IU will be administered as a single dose at least 3 days before dosing with the trial medication.
Active dental disease likely to require invasive treatment during the trial period. The possibility of needing tooth fillings is not an exclusion.
Active inflammatory disease of the eye
History of an atypical femoral fracture, as defined by the ASBMR 2013
Untreated hypo- or hyperthyroidism
Active liver disease
Concurrent major systemic disease
Active malignancy (other than skin cancers) within the last 2 years
Any active metabolic bone disease
• Regular use of hormone replacement therapy within the previous 1 year
• Treatment with oral bisphosphonates in the previous 1 year
Previous treatment with zoledronate at any time
Current treatment with oral glucocorticoid drugs in a dose greater than or equal to 2.5 mg/day
Regular use of other bone-active drugs in the previous year ( e.g. teriparatide, raloxifene, tamoxifen, aromatase inhibitors)
Malabsorption syndromes
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Power
Previous studies conducted by our group in osteopenic postmenopausal women indicate that 5 participants provide a power of 90% to detect a change in CTX of this magnitude.
Analysis
Follow-up CTX values will be expressed as a percent of baseline and the mean percent change calculated and tested against zero by t-test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
20/05/2019
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Date of last participant enrolment
Anticipated
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Actual
21/12/2020
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Date of last data collection
Anticipated
21/12/2021
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Actual
25/06/2021
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Sample size
Target
30
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Accrual to date
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Final
30
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Auckland
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Address [1]
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Private Bag 92019, Auckland 1142, New Zealand.
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
The 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]
310649
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Address [1]
310649
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Country [1]
310649
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309399
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
309399
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133 Molesworth Street PO Box 5013 Wellington 6140
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Ethics committee country [1]
309399
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New Zealand
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Date submitted for ethics approval [1]
309399
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23/01/2019
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Approval date [1]
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27/03/2019
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Ethics approval number [1]
309399
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19/NTB/13
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Summary
Brief summary
Intravenous (IV) zoledronate is an effective and widely used treatment for osteoporosis. Zoledronate is the most potent bisphosphonate to enter clinical practice, and it also has the longest duration of anti-resorptive effect, with a single 5mg infusion still showing effects on bone turnover and bone mineral density (BMD) 5 years later. Duration of effect is, to some extent, dose-related. However, the need for an intravenous infusion is a disadvantage in some environments, such as general practices, where facilities for infusions are difficult to access or, in some countries, very expensive. A second problem with intravenous zoledronate is the occurrence of an acute phase response, a flu-like illness that occurs in 30-40% of those having first infusions. Oral zoledronate is potentially attractive for the prevention and treatment of osteoporosis, but has not been investigated to-date. It would be much more accessible, since infusion facilities would not be necessary for its administration. If the acute phase response is indeed much less common, then this would remove the other main limitation in the clinical use of zoledronate. The overall goal of this study is to establish a dosing regimen using zoledronate tablets that reproduces the bone turnover marker and bone density effects over 1 year of a zoledronate 5 mg infusion.
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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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Prof Ian Reid
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Address
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The University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+64 21855160
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ian Reid
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Address
114019
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The University of Auckland
Private Bag 92019
Auckland 1142
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Country
114019
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New Zealand
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Phone
114019
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+64 21855160
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Fax
114019
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Email
114019
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[email protected]
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Contact person for scientific queries
Name
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Ian Reid
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Address
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The University of Auckland
Private Bag 92019
Auckland 1142
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Country
114020
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New Zealand
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Phone
114020
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+64 21855160
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Fax
114020
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Email
114020
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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)?
No
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No/undecided IPD sharing reason/comment
Data sharing is not thought to be appropriate as this is a small, preliminary dose-find study which assesses only surrogate endpoints.
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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
No additional documents have been identified.
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