Efficacy and Safety of Risedronate (Actonel), a Third Generation Bisphosphonate in Patients With Ankylosing Spondylitis: a Phase 2 Pilot Study
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Purpose
Randomized, controlled, double-blind, multicenter phase II study comparing risedronate 35mg (ActonelR 35mg weekly tablet) versus placebo in patients with active ankylosing spondylitis (AS) treated with standard first and second-line therapies.
Primary efficacy endpoint: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The time schedule for performing the BASDAI was at screening, upon inclusion (T0), then after 3, 6 and 12 months or at the time of premature withdrawal in case of drop-out.
secondary endpoints:
- Clinical endpoints: The secondary efficacy measures were the following: Bath Ankylosing Spondylitis Functional Index (BASFI) , Bath Ankylosing Spondylitis Metrology Index (BASMI), ASAS (Assessments in Ankylosing Spondylitis) Working Group core set of domains, Spinal pain VAS, ESR, CRP and the percentage of patients achieving 20% or greater decrease in each of these parameters. These parameters were determined at T0, T3, T6, T12 or at the time of premature withdrawal in case of drop-out. The spinal pain assessed by VAS was also done at screening.
- DEXA: Dual Energy X-Ray-Absorptiometry (DEXA) measurements were performed in all patients upon inclusion (T0) and at the end of the study (T12).
- Biochemical markers: selected biochemical markers of bone metabolism were measured at T0, T3, T6 and T12 or at the time of premature withdrawal in case of drop-out using commercially available kits. Bone formation was assessed by serum bone-specific alkaline phosphatase (BAP) and osteocalcin (OC) levels using commercially available kits. Bone resorption was assessed in serum by the C-terminal telopeptide of type I collagen degradation (Crosslaps R) and urinary N-terminal telopeptide of type I collagen degradation (Osteomark R).
- Trial with medicinal product
| Condition | Intervention | Phase |
|---|---|---|
|
Ankylosing Spondylitis |
Drug: drug treatment |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Treatment |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria: •Male or non-pregnant women (only women who are post menopausal, surgically sterile or practicing a reliable method of contraception may be included) aged 20 years or more
- Meeting the Modified New York diagnostic criteria for AS (Van der Linden S et al., 1984)
- Symptoms of active AS for more than 6 months prior to study entry
- Treated by first-line therapy (NSAIDs) for more than 6 months prior to study entry
- Bath AS Disease Activity Index (BASDAI) score of 4 or greater (Garrett S et al, 1994) and
- Spinal pain of 4 or greater on a 10-cm visual analogue scale despite maximum recommended or tolerated doses of NSAIDs given for a minimum of 1 month prior to study entry
Exclusion criteria: •End-stage AS with diffuse involvement of the spine (complete ankylosis)
- Intraarticular corticosteroid injections or IV infusion with methylprednisolone within the past 2 months prior to study entry. Patients with IA corticosteroid injections of the sacroiliac joints within the past 9 months prior to study entry.
- Severe renal insufficiency: serum creatinine > 25% above the upper limit of normal (>177 umol/l)
- Hypocalcemia
- Major surgery within the past 3 months prior to study entry or planned in the ensuing 12 months
- Orthopaedic surgery within the last 12 months
- Severe infections or comorbidities, or active peptic ulcer disease
- Patients who received bisphosphonates in the past 12 months prior to study entry or patients having known allergies to bisphosphonates.
- Patients treated with anti-osteoporotic drugs (except: Calcium and Vit. D) in the past 12 months prior to study entry.
- Patients unable to remain in an upright position (sitting or standing) during a minimum of 30 minutes
- No written informed consent obtained or inability to collaborate to the study design.
Contacts and Locations
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT01038011 History of Changes |
| Other Study ID Numbers: | Acto_2003 |
| Study First Received: | December 15, 2009 |
| Last Updated: | February 2, 2010 |
| Health Authority: | Switzerland: UZurich |
Additional relevant MeSH terms:
|
Spondylitis Spondylitis, Ankylosing Bone Diseases, Infectious Infection Bone Diseases Musculoskeletal Diseases |
Spinal Diseases Spondylarthropathies Spondylarthritis Ankylosis Joint Diseases Arthritis |
ClinicalTrials.gov processed this record on May 16, 2013