Effect of Parathyroid Hormone (PTH) and Weight-Bearing on Bone in Spinal Cord Injury (SCI)
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Purpose
Individuals with spinal cord injury sustain significant loss of bone mass in their lower extremities (20-40% or more). This study evaluates the ability of PTH and weight-bearing, two interventions that build bone, to increase bone mass in this population.
| Condition | Intervention | Phase |
|---|---|---|
|
Osteoporosis Bone Loss Spinal Cord Injury |
Drug: teriparatide Other: weight-bearing |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effect of PTH Combined With Weight-Bearing on Bone Density and Bone Architecture in People With Spinal Cord Injury |
- BMD at distal femur/proximal tibia [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Bone markers [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Adverse events [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
| Enrollment: | 12 |
| Study Start Date: | June 2009 |
| Study Completion Date: | December 2012 |
| Primary Completion Date: | March 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: PTH/Weight-Bearing |
Drug: teriparatide
teriparatide 20ug daily sc for 6 months
Other Name: Forteo
Other: weight-bearing
device assisted walking
Other Name: exercise
|
Detailed Description:
This pilot project aims to evaluate PTH with weight-bearing in a group of individuals with chronic SCI and loss of bone mass in their lower extremities. A convenience sample of 12 people with SCI will be enrolled into a 6 month study assessing the effects of a weight-bearing regime plus daily PTH (Forteo 20ug sc) on BMD and bone markers. Subjects will be evaluated at 3 and 6 months after initiating treatment with measurement of bone density as well as bone markers of formation and resorption. An optional extension to 12 months will be offered to all subjects.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 18-75 years
- Complete SCI - total loss of motor function below level of lesion
- Capable of positioning to have DEXA performed
- Capable of undertaking the weight-bearing exercise regime
- Capable of reading and understanding informed consent document
- Able to self-administer PTH or have someone in the family who can do so
- T score <-2.5 or Z score <-1.5 on evaluation of total hip BMD
- No known endocrinopathies
- Normal TSH levels
- Normal 25-OH vitamin D levels
- Normal calcium levels
- Normal renal function (creatinine <2.0mg/dl)
- Able to return for all follow-up visits
Exclusion Criteria:
- Surgical or other intervention resulting in metal or anatomy precluding obtaining DEXA and/or MRI measurements
- Other medical conditions that in the opinion of the investigator would preclude the subject from completing the study
- History of malignancy
- History of radiation therapy
- Unable to self-administer PTH or have it administered
- Elevated liver function tests >2x normal
- For males, significantly abnormal free testosterone levels
- Currently being prescribed anti-convulsants
- Currently being prescribed glucocorticoids, other than inhaled glucocorticoids
- Currently being prescribed any bone-active agents, including any bisphosphonate, raloxifene, hormone therapy (estrogen and estrogen/progestin), calcitonin or strontium-containing compounds.
- No previous history of bisphosphonate use
- No previous use of other bone-specific agents during past 2 years
Contacts and Locations| United States, Illinois | |
| Rehabilitation Institute of Chicago | |
| Chicago, Illinois, United States, 60611 | |
| Principal Investigator: | Thomas J Schnitzer, MD, PhD | Northwestern University |
More Information
No publications provided
| Responsible Party: | Thomas J. Schnitzer, professor, Northwestern University |
| ClinicalTrials.gov Identifier: | NCT00826228 History of Changes |
| Other Study ID Numbers: | STU00003009 |
| Study First Received: | January 20, 2009 |
| Last Updated: | April 3, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Osteoporosis Spinal Cord Injuries Bone Diseases, Metabolic Bone Diseases Musculoskeletal Diseases Spinal Cord Diseases Central Nervous System Diseases |
Nervous System Diseases Trauma, Nervous System Wounds and Injuries Teriparatide Bone Density Conservation Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013