Tests teriparatide for weak bones in people with chronic kidney disease

Trial details

Who runs it

Ditte Hansen

Trial code

NCT04522622

Record updated

23 April 2024

Original description

This study is a 1:1 randomized controlled trial with an intervention for 18 months and a follow up period of 12 months. The purpose of the study is to assess the safety and efficacy of recombinant human parathyroid hormone for treatment of adynamic bone disorder in patients with chronic kidney disease.Read full original descriptionShow less

Treatment of Adynamic Bone Disorder With Parathyroid Hormone in Patients With Chronic Kidney Disease

This study is a 1:1 randomized controlled trial with an intervention for 18 months and a follow up period of 12 months. The purpose of the study is to assess the safety and efficacy of recombinant human parathyroid hormone for treatment of adynamic bone disorder in patients with chronic kidney disease.

Inclusion: Age ≥18 years; CKD stage 4-5D (eGFR ≤29 ml/min) according to Kidney Disease Improving Global Outcomes(KDIGO) definition; DXA scan with a T-score at the total hip, femoral neck or lumbar spine (L1-4) ≤-2 (or Z-score ≤-2) in a minimum of 2 vertebraes (for patients with active oral prednisolone treatment ≥ 5 mg/day for minimum 3 months the T-score or Z-score limit i < -1) and/or former fragility fracture (vertebral, hip, for- or upper arm, ankle) assessed with VFA or x-ray of the columna; Patients with expected adynamic bone disorder, based on BSAP≤21 µg/l or biopsy-verified low bone turnover.

Exclusion: Previous fracture withon the last 6 months *Patients may be rescreened after the 6 months; Previous calciphylaxis; Treatment with digoxin; Antiresorptive or bone anabolic medication during the last 24 months (for bisphosphonates it is only during the last 12 months); Previous external beam or implant radiation therapy to the skeleton; Patients who have undergone a kidney transplantation within the last 12 months; Pregnancy, lactation or fertile women (post-menopausal females are not considered fertile) not using safe anticonception (the following contraceptive methods are considered appropriate: Intrauterine device (IUD) or hormonal anticontraceptive (oral contraceptives, implant, transdermal patches, vaginal ring or depot injection)); Drug or alcohol abuse; For those participating in the bone biopsy procedure: 1) Hypersensitivity to any of the tetracyclines or to any of the excipients or content, 2) Treatment with anticoagulants (vitamin K antagonists, Non-vitamin K Antagonist Oral Anticoagulants (NOAC), unfractionated or low-molecular heparin or antiplatelet agents that, due to clinical indication can't be paused, 3) Disturbances in thrombosis and/or haemostasis; Paget's disease or other metabolic bone disorders; Former or present malignant disease (except skin basal or planocellular carcinoma); Hypersensitivity to the active substance in teriparatide or to any of the excipients or content; Medical conditions or treatments that may interfere with assessments of the outcomes of the trial; Hypercalcemia defined as sustained ionized calcium >1.35 mmol/l; Reduced liver function *Alanine Aminotransferase (ALAT) >3x upper limit of normal or bilirubin > 2x upper limit of normal; Thyroid disturbances not adequately treated based on the opinion by the clinician *Patients may be rescreened after treatment optimization; 25 hydroxyvitamin D2 and D3 <50 nmol/l *Patients may be rescreened after correction; Inability to administer teriparatide; Inability to provide informed consent; Unable to participate in a clinical study based on the judgement by the local investigator; For those participating in pulse wave measurements: 1) Atrial fibrillation, 2) Aorta stenosis.

ClinicalTrials.gov NCT04522622