A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety and Tolerability of Romosozumab Treatment in Postmenopausal Chinese Women With Osteoporosis
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 327
- 试验地点
- 31
- 主要终点
- Percent Change From Baseline in Bone Mineral Density (BMD) at the Lumbar Spine to the End of Double-Blind Period
研究概览
简要总结
The purpose of the study is to evaluate the effect of treatment with romosozumab for 6 months compared with placebo on the percent changes in bone mineral density (BMD) at the lumbar spine, at the total hip and femoral neck in postmenopausal Chinese women with osteoporosis.
研究设计
- 研究类型
- 干预性
- 分配方式
- 随机
- 干预模型
- 平行分组
- 主要目的
- 治疗
- 盲法
- 四盲 (受试者、医护人员、研究者、结局评估者)
入排标准
- 年龄范围
- 55 Years 至 90 Years(Adult, Older Adult)
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- Subject is considered reliable and capable of adhering to the protocol, visit schedule, and medication intake according to the judgment of the investigator
- Subject is an ambulatory postmenopausal Chinese women, 55 to 90 years of age (inclusive) at the time of Screening. Postmenopause is defined as no spontaneous vaginal bleeding or spotting for 12 or more consecutive months prior to Screening
- Subject has a bone mineral density (BMD) T-score ≤-2.50 at the lumbar spine, total hip, or femoral neck, as assessed by the central imaging vendor at the time of Screening based on DXA scans, and using data for Caucasian women from the National Health and Nutritional Examination Survey (NHANES, 1998)
- Subject must have at least 1 of following independent risk factors for fracture:
- History of fragility fracture (except hip fracture, a severe vertebral fracture or more than 2 moderate vertebral fractures)
- Parental history of hip fracture
- Low body weight (body mass index ≤19kg/m2)
- Elderly (age ≥ 65 years)
- Current smoker
- Subject has at least 2 vertebrae in the L1 to L4 region and at least 1 hip that are evaluable by dual-energy x-ray absorptiometry (DXA), as assessed by the central imaging vendor
排除标准
- Subject has a BMD T-score of ≤-3.50 at the total hip or femoral neck, as assessed by the central imaging vendor at the time of Screening based on DXA scans, and using data for Caucasian women from NHANES 1998
- Subject has a known history of hip fracture
- Subject has any severe (SQ3) or more than 2 moderate (SQ2) vertebral fractures, as assessed by the central imaging vendor based on the lateral spine x-ray at Screening
- Subject has a history of myocardial infarction (MI)
- Subject has a history of stroke
- Subject has a vitamin D insufficiency, defined as 25 (OH) vitamin D levels <20 ng/mL, as assessed by the central laboratory at Screening. Vitamin D repletion will be permitted and the subject may be retested once within the Screening Period
- Subject has used oral bisphosphonates:
- Any doses received within 3 months prior to randomization
- More than 1 month of cumulative use between 3 and 12 months prior to randomization
- More than 3 years of cumulative use, unless the last dose was received ≥5 years prior to randomization
- Subject has used intravenous (iv) bisphosphonates:
- zoledronic acid
- Any doses received within 3 years prior to randomization
- More than 1 dose received within 5 years prior to randomization
- iv ibandronate, iv pamidronate, or iv alendronate (ALN)
- Any doses received within 12 months prior to randomization
- More than 3 years of cumulative use, unless the last dose was received ≥5 years prior to randomization
- zoledronic acid
- Subject has used denosumab or any cathepsin K inhibitor:
- Any doses received within 18 months prior to randomization
- Subject has used tibolone, cinacalcet, or calcitonin:
- Any doses received within 3 months prior to randomization
- Subject has used teriparatide (TPTD) or any parathyroid hormone (PTH) derivative:
- Any doses received within 3 months prior to randomization
- More than 1 month of cumulative use between 3 and 12 months prior to randomization
- Subject has used systemic oral or transdermal estrogen or selective estrogen receptor modulators (SERMs):
- More than 1 month of cumulative use within 6 months prior to randomization
- Subject has used strontium ranelate or fluoride:
- More than 1 month of cumulative use within 5 years prior to randomization
- Subject has used hormonal ablation therapy:
- More than 1 month of cumulative use within 6 months prior to randomization
- Subject has used systemic glucocorticosteroids:
- ≥5mg prednisone equivalent per day for more than 14 days within 3 months prior to randomization
- Subject has a history of osteonecrosis of the jaw (ONJ) or atypical femoral fracture (AFF)
- Subject has evidence of any of the following:
- Current, uncontrolled hyper- or hypothyroidism. Uncontrolled hyperthyroidism is defined as thyroid-stimulating hormone (TSH) and thyroxine (T4) outside of the normal range. Uncontrolled hypothyroidism is defined as TSH >10
- Current, uncontrolled hyperparathyroidism or history of hypoparathyroidism. Uncontrolled hyperparathyroidism is defined as PTH outside the normal range in subjects with concurrent hypercalcemia or PTH values >20 % above upper limit of normal (ULN) in normocalcemic subjects
- Current hypercalcemia or hypocalcemia, defined as albumin-adjusted serum calcium outside the normal range, as assessed by the central laboratory at the time of Screening. Albumin-adjusted serum calcium levels may be retested once in case of an elevated albumin-adjusted serum calcium level within 1.1xULN of the laboratory's reference ranges
- Subject has ≥3xULN of any of the following: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), or >ULN total bilirubin (≥1.5xULN total bilirubin if known Gilbert's syndrome). If subject has elevations only in total bilirubin that are >ULN and <1.5xULN, fractionate bilirubin to identify possible undiagnosed Gilbert's syndrome (ie, direct bilirubin <35 %)
研究组 & 干预措施
Placebo
Subjects randomized to this arm will receive placebo during the Double-Blind-Placebo controlled Period and romosozumab during the Open-Label treatment Period
干预措施: Romosozumab (Drug)
Placebo
Subjects randomized to this arm will receive placebo during the Double-Blind-Placebo controlled Period and romosozumab during the Open-Label treatment Period
干预措施: Placebo (Drug)
Romosozumab
Subjects randomized to this arm will receive romosozumab during all treatment Periods.
干预措施: Romosozumab (Drug)
方案终点
主要结局
Percent Change From Baseline in Bone Mineral Density (BMD) at the Lumbar Spine to the End of Double-Blind Period
时间窗: From Baseline (Day 1) to the end of the Double-blind Period (Month 6)
Percent change from baseline in BMD at the lumbar spine was assessed by dual-energy x-ray absorptiometry (DXA) at 6 months. Missing postbaseline BMD other than due to COVID-19 were imputed using the last observation carried forward (LOCF) approach. Missing or out of window (exceed 70 days since previous IMP) post-baseline DXA BMD due to COVID-19 were set to missing and imputed by multiple imputation under missing at random approach. LSM = least square mean.
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Double-Blind Period
时间窗: From Baseline to the end of the Double-blind Period (Month 6)
An Adverse Event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a IMP, whether or not related to the IMP. TEAEs are defined as all AEs started on or worsened in severity on or after the date of receiving first dose of IMP and before or on the end of study (EOS) date.
Percentage of Participants With Treatment-emergent Adverse Events for Romosozumab During Overall Period
时间窗: From Month 7 up to Month 12 (Placebo/Romo) and From Day 1 up to Month 12 (Romo/Romo) + 3-month SFU (up to Month 15)
An AE is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with use of a IMP, whether or not related to IMP. TEAEs are defined as all AEs started on or worsened in severity on or after date of receiving first dose of IMP and before or on EOS date except lipid-type AEs starting on date of first dose of IMP and not worsening (and not deemed IMP related by the investigator). As pre-specified in Protocol and SAP, TEAEs were assessed and reported for 6 months for participants in placebo/romosozumab arm (Open-label Period) and for a total of 12 months for participants in romosozumab/romosozumab arm (Double-blind Period + Open-label Period combined) + 3 months of Safety follow-up for both arms (Up to Month 15) during overall period.
次要结局
- Percent Change From Baseline in Bone Mineral Density at the Total Hip to the End of Double-Blind Period(From Baseline to the end of the Double-blind Period (Month 6))
- Percent Change From Baseline in Bone Mineral Density at the Femoral Neck to the End of the Double-Blind Period(From Baseline to the end of the Double-blind Period (Month 6))
- Percent Change From Baseline in Bone Mineral Density at the Lumbar Spine at Month 12(Baseline, Month 12)
- Percent Change From Baseline in Bone Mineral Density at the Total Hip at Month 12(Baseline, Month 12)
- Percent Change From Baseline in Bone Mineral Density at the Femoral Neck at Month 12(Baseline, Month 12)
试验结果
结果已于 2024-12-05 在 ClinicalTrials.gov 公示。 在 ClinicalTrials.gov 查看
受试者流程
入组 327 人 · 完成 292 人
主要终点
Percent Change From Baseline in Bone Mineral Density (BMD) at the Lumbar Spine to the End of Double-Blind Period
percent change · Standard Error · 时间窗: From Baseline (Day 1) to the end of the Double-blind Period (Month 6)
| Placebo (n=104) | Romosozumab (n=214) |
|---|---|
| 0.44 (0.442) | 9.81 (0.323) |
The Full Analysis Set (FAS) consisted of all randomized study participants who received at least 1 dose of investigational medicinal product (IMP) and provided at least 1 Baseline and post-Baseline BMD measurement.
Difference in LSM(Romosozumab - Placebo) 9.37 · 95% 置信区间 8.34–10.39 · p = <0.001 · ANCOVA
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Double-Blind Period
percentage of participants · 时间窗: From Baseline to the end of the Double-blind Period (Month 6)
| Placebo (n=109) | Romosozumab (n=218) |
|---|---|
| 70.6 | 72.9 |
The Safety Set (SS) consisted of all randomized study participants who received at least 1 dose of IMP.
Percentage of Participants With Treatment-emergent Adverse Events for Romosozumab During Overall Period
percentage of participants · 时间窗: From Month 7 up to Month 12 (Placebo/Romo) and From Day 1 up to Month 12 (Romo/Romo) + 3-month SFU (up to Month 15)
| Placebo/Romosozumab (n=98) | Romosozumab/Romosozumab Overall (n=218) |
|---|---|
| 80.6 | 88.1 |
The SS consisted of all randomized study participants who received at least 1 dose of IMP. The SS for open label period consisted of all randomized study participants who received at least 1 dose of IMP during open label period.
其他终点(5)
Percent Change From Baseline in Bone Mineral Density at the Total Hip to the End of Double-Blind Period
percent change · Standard Error · 时间窗: From Baseline to the end of the Double-blind Period (Month 6)
| Placebo (n=104) | Romosozumab (n=214) |
|---|---|
| 0.07 (0.285) | 2.93 (0.206) |
The FAS consisted of all randomized study participants who received at least 1 dose of IMP and provided at least 1 Baseline and post-Baseline BMD measurement.
Difference in LSM(Romosozumab - Placebo) 2.86 · 95% 置信区间 2.18–3.54 · p = <0.001 · ANCOVA
Percent Change From Baseline in Bone Mineral Density at the Femoral Neck to the End of the Double-Blind Period
percent change · Standard Error · 时间窗: From Baseline to the end of the Double-blind Period (Month 6)
| Placebo (n=104) | Romosozumab (n=214) |
|---|---|
| -0.15 (0.406) | 3.33 (0.347) |
The FAS consisted of all randomized study participants who received at least 1 dose of IMP and provided at least 1 Baseline and post-Baseline BMD measurement.
Difference in LSM(Romosozumab - Placebo) 3.48 · 95% 置信区间 2.58–4.38 · p = <0.001 · ANCOVA
Percent Change From Baseline in Bone Mineral Density at the Lumbar Spine at Month 12
percent change · Standard Error · 时间窗: Baseline, Month 12
| Placebo/Romosozumab Overall (n=104) | Romosozumab/Romosozumab Overall (n=214) |
|---|---|
| 8.80 (0.554) | 13.04 (0.389) |
The FAS consisted of all randomized study participants who received at least 1 dose of IMP and provided at least 1 Baseline and post-Baseline BMD measurement.
Percent Change From Baseline in Bone Mineral Density at the Total Hip at Month 12
percent change · Standard Error · 时间窗: Baseline, Month 12
| Placebo/Romosozumab Overall (n=104) | Romosozumab/Romosozumab Overall (n=214) |
|---|---|
| 1.83 (0.306) | 4.22 (0.216) |
The FAS consisted of all randomized study participants who received at least 1 dose of IMP and provided at least 1 Baseline and post-Baseline BMD measurement.
Percent Change From Baseline in Bone Mineral Density at the Femoral Neck at Month 12
percent change · Standard Error · 时间窗: Baseline, Month 12
| Placebo/Romosozumab Overall (n=104) | Romosozumab/Romosozumab Overall (n=214) |
|---|---|
| 1.87 (0.441) | 4.66 (0.371) |
The FAS consisted of all randomized study participants who received at least 1 dose of IMP and provided at least 1 Baseline and post-Baseline BMD measurement.
安全性
| 组别 | 严重不良事件 | 死亡 |
|---|---|---|
| Placebo | 5 / 109 | 0 / 109 |
| Romosozumab | 8 / 218 | 0 / 218 |
| Placebo/Romosozumab | 9 / 98 | 0 / 98 |
| Romosozumab/Romosozumab Overall | 25 / 218 | 1 / 218 |
最常见的严重不良事件(人数)
| 事件 | Placebo | Romosozumab | Placebo/Romosozumab | Romosozumab/Romosozumab Overall |
|---|---|---|---|---|
| Cataract | 0 / 109 | 2 / 218 | 0 / 98 | 2 / 218 |
| Cerebrovascular insufficiency | 0 / 109 | 0 / 218 | 1 / 98 | 2 / 218 |
| Acute myocardial infarction | 0 / 109 | 1 / 218 | 0 / 98 | 1 / 218 |
| Coronary artery disease | 0 / 109 | 1 / 218 | 0 / 98 | 1 / 218 |
| Atrial fibrillation | 1 / 109 | 0 / 218 | 0 / 98 | 0 / 218 |
| Bile duct stone | 0 / 109 | 1 / 218 | 0 / 98 | 1 / 218 |
| Cholangitis acute | 0 / 109 | 1 / 218 | 0 / 98 | 1 / 218 |
| Herpes zoster | 1 / 109 | 0 / 218 | 0 / 98 | 0 / 218 |
| Spinal compression fracture | 0 / 109 | 1 / 218 | 0 / 98 | 1 / 218 |
| Ankle fracture | 1 / 109 | 0 / 218 | 0 / 98 | 0 / 218 |
数值为申办方在 ClinicalTrials.gov 公示的原始数据,未经重新计算;括号内为公示的离散度(如 95% 置信区间)。
相关文献
- 结果论文Zhenlin Z, Qingyun X, Decai C, Aijun C, Yanan H, Mei Z, Xu C, Hua L, Youjia X, Qun C, Huilin Y, Xiaoyan X, Yujie L, Xuan D, Jun J, LingLing G, Theresa RJ, Lars B, Weibo X. Romosozumab increases bone mineral density in postmenopausal Chinese women with osteoporosis: A randomised phase three study. J Orthop Translat. 2026 Jun 3;59:101135. doi: 10.1016/j.jot.2026.101135. eCollection 2026 Jul. PubMed 42282279
研究者
研究点 (31)
标识符
- NCT 编号
- NCT05067335
- 其他研究编号
- OP0002
日期
- 首次提交
- (5年前)
- 首次发布
- (4年前)
- 主要完成日期
- (2年前)
- 研究完成日期
- (2年前)
- 最近核实
- (2个月前)
- 最近更新
- (前天)
监管与共享
- FDA 监管药物
- 是
- FDA 监管器械
- 否
- 个体参与者数据共享计划
- 是
- 是否有结果
- 是
Data from this trial may be requested by qualified researchers six months after product approval in the US and/or Europe, or global development is discontinued, and 18 months after trial completion. Investigators may request access to anonymized individual patient-level data and redacted trial documents which may include: analysis-ready datasets, study protocol, annotated case report form, statistical analysis plan, dataset specifications, and clinical study report. Prior to use of the data, proposals need to be approved by an independent review panel at www.Vivli.org and a signed data sharing agreement will need to be executed. All documents are available in English only, for a prespecified time, typically 12 months, on a password protected portal. This plan may change if the risk of re-identifying trial participants is determined to be too high after the trial is completed; in this case and to protect participants, individual patient-level data would not be made available.
