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Eldecalcitol for GLucocorticoid Induced OsteopoRosIs Versus Alfacalcidol

Not Applicable
Conditions
Osteoporosis
Interventions
Registration Number
NCT01974167
Lead Sponsor
e-GLORIA trial Protocol Review Committee
Brief Summary

The purpose of this study is to evaluate the efficacy and safety of eldecalcitol monotherapy compared with alfacalcidol monotherapy in patients with glucocorticoid-induced osteoporosis, using a randomized, open-label, parallel-group, comparative design.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
400
Inclusion Criteria
  • (1) Patients who are currently taking or plan to take oral glucocorticoid medication for 3 months or longer and thus require treatment as per the 'Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and mineral Research (2004),' and who meet at least one of the conditions below. No restriction is imposed on the underlying disease treated with the oral glucocorticoid medication.

    (i) Have any existing insufficiency fracture (ii) %YAM <80 (iii) Oral glucocorticoid daily dose >= 5 mg prednisolone equivalent

  • (2) Aged between 20 and 85 years (both inclusive) at consent

  • (3) Patients who are able to walk without assistance

  • (4) Provided consent to participate in the study

Exclusion Criteria
  • (1) BMD (L1-4 or T-Hip) T score < -3.5
  • (2) Have 3 or more vertebral fractures between L1 and L4.
  • (3) Have 1 or more SQ grade 3 vertebral fractures, or 3 or more SQ grade 2 vertebral fractures.
  • (4) Have received a bisphosphonate preparation for 2 weeks or longer within 6 months before the start of study treatment.
  • (5) Have received a bisphosphonate preparation for 2 years or longer within 3 years before the start of study treatment.
  • (6) Have received a parathyroid hormone preparation before the start of study treatment.
  • (7) Have received one or more doses of an anti-RANKL (receptor activator of nuclear factor-kappa B ligand) antibody.
  • (8) Have received one or more doses of an anti-sclerostin antibody or cathepsin K inhibitor.
  • (9) Have received any other investigational product (including placebo) within 16 weeks before the start of study treatment in the present study.
  • (10) Have received any of the following drugs that can affect bone metabolism within 8 weeks before the start of study treatment, with the exception of calcium preparations: (i) Bisphosphonates (ii) Active vitamin D preparations (including those for topical use) (iii) Selective estrogen receptor modulators (SERMs) (iv) Calcitonin preparations (v) Vitamin K2 preparations (vi) Ipriflavone preparations (vii) Reproductive hormone products (except those for vaginal use such as vaginal tablets and creams) (viii) Other drugs that can affect bone metabolism
  • (11) Pregnant woman or woman who desires to become pregnant
  • (12) Have corrected serum calcium >= 10.4 mg/dL or < 8.0 mg/dL at enrollment.
  • (13) Have corrected urinary calcium > 0.4 mg/dL GF at enrollment.
  • (14) Have a past or current history of urinary calculus.
  • (15) Have eGFR < 30 mL/min/1.73 m2 at enrollment.
  • (16) Have severe liver disease such as cirrhosis or severe heart disease such as severe cardiac failure.
  • (17) Have active malignancy or received treatment for malignancy, including adjuvant therapy, within the past 3 years.
  • (18) Have a history of hypersensitivity to eldecalcitol, alfacalcidol, or other vitamin D preparations.
  • (19) Other persons judged by the investigator (or subinvestigator) to be inappropriate to participate in this study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Alfacalcidol groupAlfacalcidolAlfacalcidol 1 microgram once daily orally
Eldecalcitol groupEldecalcitolEldecalcitol 0.75 microgram once daily orally
Primary Outcome Measures
NameTimeMethod
Percent change in lumbar spine (L1-4) bone mineral density12 months after the start of study drug administration
Incidence of vertebral fractures36 months

A vertebral fracture will be classified as a new fracture (i.e., change from grade 0 to grade 1, 2, or 3) or worsening of a prevalent fracture (i.e., change from grade 1 to grade 2 or 3, or change from grade 2 to grade 3) using a semi-quantitative \[SQ\] method according to the "Vertebral Fracture Assessment Criteria, 2012 revised version."

Secondary Outcome Measures
NameTimeMethod
Incidence of non-vertebral fractures (both traumatic and non-traumatic; 3 Major sites)36 months

The 3 Major sites are defined as the forearm, humerus, and femur.

Incidence of non-vertebral fractures (both traumatic and non-traumatic; 6 Major sites)36 months

The 6 Major sites are defined as the femur, lower leg, humerus, forearm, clavicle, and pelvis.

Incidence of non-vertebral fractures (traumatic; All sites)36 months
Incidence of non-vertebral fractures (traumatic; 3 Major sites)36 months
Incidence of non-vertebral fractures (non-traumatic; 3 Major sites)36 months
Incidence of non-vertebral fractures (non-traumatic; 6 Major sites)36 months
Incidence of non-vertebral fractures (both traumatic and non-traumatic; All sites)36 months
Incidence of vertebral fractures (clinical vertebral fractures)36 months
Incidence of non-vertebral fractures (3 Major sites) by number of prevalent fractures36 months
Incidence of new clinical vertebral fractures by severity36 months

SQ method is used for grading of vertebral fractures.

Incidence of FRAX-defined major osteoporotic fractures36 months

The 4 Major sites are defined as clinical fractures of the spine, forearm, hip, and shoulder.

Incidence of non-vertebral fractures (traumatic; 6 Major sites)36 months
Incidence of non-vertebral fractures (non-traumatic; All sites)36 months
Incidence of vertebral fractures (worsening of prevalent vertebral fractures)36 months
Incidence of vertebral fracture (new or worsening of prevalent fractures) by glucocorticoid dose36 months
Incidence of non-vertebral fractures (3 Major sites) by bone mineral density36 months
Incidence of non-vertebral fractures (6 Major sites) by number of prevalent fractures36 months
Incidence of new non-vertebral fractures (all sites) by severity36 months

SQ method is used for grading of vertebral fractures.

Incidence of non-vertebral fractures (all sites) by glucocorticoid dose36 months
Incidence of non-vertebral fractures (3 Major sites) by glucocorticoid dose36 months
Incidence of non-vertebral fractures (6 Major sites) by bone mineral density36 months
Incidence of vertebral fractures (new or worsening) by number of prevalent fractures36 months
Incidence of clinical vertebral fractures by number of prevalent fractures36 months
Incidence of non-vertebral fractures (all sites) by number of prevalent fractures36 months
Incidence of new non-vertebral fractures (6 Major sites) by severity36 months
Incidence of osteoporotic fractures36 months

An osteoporotic fracture is defined as a fracture of the following sites: vertebral body, ribs, pelvis, humerus, clavicle, scapula, sternum, proximal femur, other portions of the femur, tibia, fibula, and forearm.

Change in muscle strength (back muscle strength)36 months after the start of study drug administration (or at the time of withdrawal from the study)
Change in muscle strength (grip strength)36 months after the start of study drug administration (or at the time of withdrawal from the study)
Change in height36 months after the start of study drug administration (or at the time of withdrawal from the study)
Incidence of vertebral fractures (new vertebral fractures)36 months
Incidence of clinical vertebral fractures by glucocorticoid dose36 months
Incidence of non-vertebral fractures (6 Major sites) by glucocorticoid dose36 months
Incidence of clinical vertebral fractures by bone mineral density36 months
Incidence of non-vertebral fractures (all sites) by bone mineral density36 months
Incidence of new vertebral fractures by severity36 months

Semiquantitative (SQ) method is used for grading of vertebral fractures.

Incidence of new non-vertebral fractures (3 Major sites) by severity36 months

SQ method is used for grading of vertebral fractures.

Percent change in TRACP-5b bone metabolism marker12 months after the start of study drug administration
Incidence of vertebral fractures (new or worsening) by bone mineral density36 months
Frequency of falls36 months
Percent change in lumbar spine bone mineral density36 months after the start of study drug administration (or at the time of withdrawal from the study)
Change in proximal femur (total-hip) bone mineral density36 months after the start of study drug administration (or at the time of withdrawal from the study)
Percent change in PINP bone metabolism marker12 months after the start of study drug administration

Trial Locations

Locations (1)

Nara Hospital Kinki University Faculty of Medicine

🇯🇵

Ikoma, Nara, Japan

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