Efficacy of Pioglitazone on Bone Metabolism in Postmenopausal Women With Impaired Fasting Glucose.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00708175
Recruitment Status : Completed
First Posted : July 2, 2008
Results First Posted : February 3, 2012
Last Update Posted : February 3, 2012
Information provided by (Responsible Party):

Brief Summary:
The purpose of this study is to evaluate the effect of pioglitazone on bone metabolism in postmenopausal women with impaired fasting glucose.

Condition or disease Intervention/treatment Phase
Bone Metabolism Drug: Pioglitazone Drug: Placebo Phase 4

Detailed Description:

The World Health Organization has estimated that 30% of all women aged over 50 years (postmenopausal) have osteoporosis according to a definition of Bone Mineral Density at any site being more than 2.5 standard deviations below the mean for young healthy adult women.

A known risk factor for development of osteoporosis and fracture is diabetes mellitus, with correlations to duration of disease and poor glycemic control.

Pioglitazone is a thiazolidinedione developed by Takeda Pharmaceuticals for the treatment of type 2 diabetes. Preclinical studies to date on the bone effects of thiazolidinediones have not clearly identified a mechanism of bone loss. While there is evidence of increased bone fractures in postmenopausal diabetic females treated with a thiazolidinedione, the mechanism is not known. Initial studies with thiazolidinediones in humans have focused on short term exposure (12 to 14 weeks) and non-diabetic females. These studies have shown acute changes in circulating bone markers and bone density, but have been questioned because they may not represent bone metabolism in states of abnormal glucose metabolism. Impaired glucose tolerance has been identified not only as a risk factor for developing type 2 diabetes, but also at higher risk for known complications of diabetes. Examination of the effect of thiazolidinediones on bone metabolism in IGT patients will provide data in patients with abnormal glucose tolerance, but without the potential confounding effects of oral hypoglycemic medications to treat type 2 diabetes.

The primary objective of this study is to evaluate the effect of pioglitazone on bone mass and metabolism in postmenopausal women with impaired fasting glucose or impaired glucose tolerance. Total participation time in this study is approximately 1 year and six months.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 156 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 4, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Effect of Pioglitazone Compared to Placebo on Bone Metabolism in Impaired Fasting Glucose, Postmenopausal Women for One Year of Treatment
Study Start Date : May 2008
Actual Primary Completion Date : January 2011
Actual Study Completion Date : February 2011

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Experimental: Pioglitazone Drug: Pioglitazone
Pioglitazone 30 mg, tablets, orally, once daily for 4 weeks, then increased to Pioglitazone 45 mg, tablets, orally, once daily for up to 48 weeks.
Other Name: ACTOS®
Placebo Comparator: Placebo Drug: Placebo
Pioglitazone placebo-matching tablets, orally, once daily for up to 52 weeks.
Other Name: ACTOS®

Primary Outcome Measures :
  1. Percent Change From Baseline to Month 12 in Bone Mineral Density in the Total Proximal Femur by Dual-Energy-Ray Absorptiometry (DXA) [ Time Frame: Baseline and Month 12. ]
    The change in bone mineral density in the total proximal femur at month 12 relative to baseline. DXA is a means of measuring BMD through x-ray.

Secondary Outcome Measures :
  1. Percent Change From Month 12 to Month 18 in Bone Mineral Density in the Total Proximal Femur by DXA [ Time Frame: Month 12 and Month 18. ]
    The change in bone mineral density in the total proximal femur at month 18 relative to month 12. DXA is a means of measuring BMD through x-ray.

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Ages Eligible for Study:   up to 70 Years   (Child, Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Is female and has not experienced menses for at least 5 years.
  • Has a Fasting Plasma Glucose level greater than or equal to 100 and less than 126 mg/dL or a 2-hour post-oral glucose tolerance test greater than or equal to 140 and less than or equal to 199 mg/dL at Screening.
  • Has a body mass index greater than or equal to 16 and less than or equal to 40 kg/m2 and weighs less than 300 pounds (approximately 136 kilograms).
  • Agrees to take daily supplements of Vitamin D (a minimum of 800 IU daily) and calcium (a minimum of 1000 mg daily) during the treatment and wash-out periods.
  • Has clinical laboratory evaluations (including clinical chemistry, hematology, and complete urinalysis [fasted for at least 8 hours]) within the reference range for the testing laboratory unless the results are deemed not clinically significant by the investigator or sponsor.
  • Is in good health as determined by the physician (ie, via medical history and physical examination) at Screening.

Exclusion Criteria:

  • Has a fasting triglyceride level greater than 500 mg/dL.
  • Has a hemoglobinopathy causing anemia or interfering with glycosylated hemoglobin assays.
  • Has an alanine transaminase level greater than or equal to 2.5 times the upper limit of normal, active liver disease or jaundice.
  • Has Vitamin D (25-OH-D) less than 20 ng/mL.
  • Has Baseline Bone Mineral Density defined as a T-score less than -2.0 at the total hip, spine, or femoral neck based on Caucasian reference values.
  • Has unexplained microscopic or macroscopic hematuria confirmed by repeat testing.
  • Has any of the following disorders:

    • Rheumatoid Arthritis
    • Thyroid (uncontrolled on thyroid replacement therapy), parathyroid, pituitary, nutritional, inflammatory, gastrointestinal, autoimmune, or renal or other disease known to affect bone metabolism.
    • A personal history of kidney stones.
  • Has a clinical history after age 45 of wrist, hip, or leg fractures.
  • Has a history of more than 1 asymptomatic vertebral deformity or any vertebral deformity attributed to osteoporosis.
  • Has a known history of drug abuse (defined as illicit drug use) or a known history of alcohol abuse within 2 years of Screening.
  • Has signs and/or symptoms of heart failure.
  • Is currently participating in another investigational study or has participated in an investigational study within the past 30 days or 5 half lives of the investigational product, whichever is longer.
  • Has any other serious disease or condition at screening or at randomization that might make it difficult to successfully manage and follow up with the subject according to the protocol.
  • Has a history of cancer, other than basal cell carcinoma or Stage 1 squamous cell carcinoma of the skin that has not been in remission for at least 5 years prior to the first dose of study drug.
  • Has a history of breast cancer.
  • Is taking or has ever taken pioglitazone or other Thiazolidinediones.
  • Has received or donated blood or blood products within 30 days preceding the Screening visit or plans to donate blood during the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00708175

  Hide Study Locations
United States, California
Greenbrae, California, United States
Los Banos, California, United States
San Diego, California, United States
Walnut Creek, California, United States
West Hills, California, United States
United States, Colorado
Lakewood, Colorado, United States
Longmont, Colorado, United States
United States, Florida
Boynton Beach, Florida, United States
Hialeah, Florida, United States
Jupiter, Florida, United States
United States, Georgia
Dunwoody,, Georgia, United States
Gainesville, Georgia, United States
United States, Hawaii
Honolulu, Hawaii, United States
United States, Idaho
Idaho Falls, Idaho, United States
United States, Illinois
Chicago, Illinois, United States
United States, Iowa
Des Moines, Iowa, United States
Iowa City, Iowa, United States
United States, Kentucky
Louisville, Kentucky, United States
United States, Louisiana
Metarie, Louisiana, United States
United States, Maine
Scarborough, Maine, United States
United States, Maryland
Bethesda, Maryland, United States
United States, Michigan
Detroit, Michigan, United States
United States, Nebraska
Omaha, Nebraska, United States
United States, New Mexico
Albuquerque, New Mexico, United States
United States, New York
Mineola, New York, United States
West Haverstraw, New York, United States
United States, North Carolina
Pinehurst, North Carolina, United States
United States, Ohio
Cincinnati, Ohio, United States
United States, Oregon
Portland, Oregon, United States
United States, South Carolina
Aiken, South Carolina, United States
Greenville, South Carolina, United States
United States, Tennessee
Brentwood, Tennessee, United States
United States, Texas
Denton, Texas, United States
Houston, Texas, United States
Sponsors and Collaborators
Study Director: VP Clinical Science Strategy Takeda

Additional Information:
Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Takeda Identifier: NCT00708175     History of Changes
Other Study ID Numbers: AD-4833_402
U1111-1115-0660 ( Registry Identifier: WHO )
First Posted: July 2, 2008    Key Record Dates
Results First Posted: February 3, 2012
Last Update Posted: February 3, 2012
Last Verified: January 2012

Keywords provided by Takeda:
Glucose Metabolism Disorder
Dysmetabolic Syndrome
Type II Diabetes
Diabetes Mellitus

Additional relevant MeSH terms:
Hypoglycemic Agents
Physiological Effects of Drugs