Post-Menopausal Osteopenia
Conditions
Brief summary
This 2 arm study will evaluate the efficacy and safety of oral Bonviva 150mg once monthly compared with placebo in post-menopausal women with osteopenia. Patients will be randomized to receive either Bonviva 150mg po monthly, or placebo monthly. The anticipated time on study treatment is 1-2 years, and the target sample size is 100-500 individuals.
Interventions
po monthly for 1 year
150mg po monthly for 1 year
Sponsors
Study design
Eligibility
Inclusion criteria
* women 45-60 years of age; * post-menopausal; * ambulatory.
Exclusion criteria
* vertebral fracture (except traumatic fracture such as in a motor vehicle accident); * low-trauma osteoporotic fracture in any other bone; * breast cancer diagnosed within last 20 years; * other malignancy diagnosed within last 10 years, except successfully resected basal cell cancer; * treatment with any bisphosphonate within last 2 years; * treatment with other drugs affecting bone metabolism within last 6 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Relative Change From Baseline in Mean Bone Mineral Density (BMD) of the Lumbar Spine (L2 to L4) at Month 12 | Baseline and Month 12 | BMD was measured by a single dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine at the time of screening and at Month 12. A BMD measurement was considered unsuitable in case of detection of a fracture, an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. The change in BMD was defined as the relative difference between the last individual measurement available at 12 months and Baseline, using the following formula: Relative change = 100 x (BMD at 1 year - BMD at baseline) / (BMD at baseline) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Absolute Change From Baseline in Mean Lumbar Spine BMD at Month 12 | Baseline and Month 12 | BMD was measured by a single dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine at the time of screening and at Month 12. A BMD measurement was considered unsuitable in case of detection of a fracture, an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. The absolute change from Baseline in mean BMD of the lumbar spine (L2-L4) was measured as g/cm\^2 and summarized using descriptive statistics. |
| Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Baseline and Month 12 | BMD was measured by a single DEXA scan of the proximal femur at the time of screening and at Month 12. The relative (%) change from Baseline in BMD of the proximal femur (total hip, trochanter, femoral neck) at Month 12 was summarized using descriptive statistics. BMD of fractured bones that could impact the scan area were not taken into account. |
| Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Baseline and Month 12 | BMD was measured by a single DEXA scan of the proximal femur at the time of screening and at Month 12. The absolute change from baseline in BMD of the proximal femur (total hip, trochanter, femoral neck) at Month 12 was summarized using descriptive statistics. BMD of fractured bones that could impact the scan area were not taken into account. |
| Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Baseline and 3, 6 and 12 months | Fasting blood samples were collected from participants for analysis of serum CTX (sCTX), which is a biochemical marker of bone resorption. Relative change from baseline of sCTX after 3, 6, and 12 months of treatment was summarized using descriptive statistics. |
| Absolute Change From Baseline in sCTX | Baseline and 3, 6, 12 months | Fasting blood samples were collected from participants for analysis of sCTX, which is a biochemical marker of bone resorption. Absolute change from baseline of sCTX after 3, 6, and 12 months of treatment was summarized using descriptive statistics. |
| Percentage of Responders | Up to 12 months | Percent responders were defined as follows: Participants with a) lumbar spine (LS) BMD, equal to or above Baseline at Month 12 b) proximal femur BMD, equal to or above Baseline at Month 12 c) Both lumbar spine and proximal femur BMD, equal or above Baseline at Month 12. BMD of the lumbar spine was defined as the BMD of at least two vertebrae (L2-L4) that were not fractured and not affected by an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. Proximal femur included total hip, trochanter and femoral neck sites. |
| Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs) | Up to 15 days after end of study treatment (Approximately 2 years) | An AE is any untoward medical occurrence in a participant who is administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A serious adverse event is any untoward medical occurrence that at any dose results in death, are life threatening, requires hospitalization or prolongation of hospitalization or results in disability/incapacity, and congenital anomaly/birth defect. |
| Number of Participants With Marked Laboratory Abnormalities | Screening up to 12 months | Blood for laboratory tests was taken at screening and immediately before participants received their monthly study medication at months 3, 6, and 12. The laboratory tests included: Hematology \[white blood cells (WBCs), platelets, hematocrit, and hemoglobin\] and Chemistry \[albumin, creatinine, blood urea nitrogen (BUN), alanine aminotransferase (ALT), total calcium, 25-hydroxy vitamin D, phosphate, magnesium, sodium, potassium, and chloride\]. |
Countries
United States
Participant flow
Recruitment details
This study was conducted at 10 centers in the United States.
Pre-assignment details
Of the 451 participants who were screened, 160 participants were randomly assigned to the two treatment arms (Placebo and Ibandronate). The major reason for screening failure was participants did not meet the Bone Mineral Density (BMD) entry criteria.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Participants with postmenopausal osteopenia were administered matching placebo tablet orally once monthly. All participants received OSCAL tablet (containing 500 mg calcium and 400 international units \[IU\] vitamin D) once a day as dietary supplements for the duration of the study. Participants received a total of 12 months of treatment and were followed for an additional period of 15 days. | 83 |
| Ibandronate (IBN) 150 mg Monthly Participants with postmenopausal osteopenia were administered 150 mg Ibandronate (IBN) tablet orally once monthly. All participants received OSCAL tablet (containing 500 mg/d calcium and 400 international units \[IU\]/d vitamin D) once a day as dietary supplements, for the duration of the study. Participants received a total of 12 months of treatment and were followed for an additional period of 15 days. | 77 |
| Total | 160 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 3 | 7 |
| Overall Study | Failure to Return | 1 | 1 |
| Overall Study | Refused Treatment | 5 | 3 |
| Overall Study | Relocated job out of state | 1 | 0 |
| Overall Study | Uncertainty to return | 0 | 1 |
Baseline characteristics
| Characteristic | Placebo | Ibandronate (IBN) 150 mg Monthly | Total |
|---|---|---|---|
| Age, Continuous | 53.4 years STANDARD_DEVIATION 3.83 | 53.7 years STANDARD_DEVIATION 3.64 | 53.5 years STANDARD_DEVIATION 3.73 |
| Sex: Female, Male Female | 83 Participants | 77 Participants | 160 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 41 / 82 | 40 / 76 |
| serious Total, serious adverse events | 1 / 83 | 3 / 77 |
Outcome results
Relative Change From Baseline in Mean Bone Mineral Density (BMD) of the Lumbar Spine (L2 to L4) at Month 12
BMD was measured by a single dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine at the time of screening and at Month 12. A BMD measurement was considered unsuitable in case of detection of a fracture, an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. The change in BMD was defined as the relative difference between the last individual measurement available at 12 months and Baseline, using the following formula: Relative change = 100 x (BMD at 1 year - BMD at baseline) / (BMD at baseline)
Time frame: Baseline and Month 12
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Relative Change From Baseline in Mean Bone Mineral Density (BMD) of the Lumbar Spine (L2 to L4) at Month 12 | -0.3941 Percentage | Standard Error 0.4148 |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Mean Bone Mineral Density (BMD) of the Lumbar Spine (L2 to L4) at Month 12 | 3.7285 Percentage | Standard Error 0.4229 |
Absolute Change From Baseline in BMD of the Proximal Femur at Month 12
BMD was measured by a single DEXA scan of the proximal femur at the time of screening and at Month 12. The absolute change from baseline in BMD of the proximal femur (total hip, trochanter, femoral neck) at Month 12 was summarized using descriptive statistics. BMD of fractured bones that could impact the scan area were not taken into account.
Time frame: Baseline and Month 12
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Total hip | -0.0083 g/cm^2 | Standard Deviation 0.0163 |
| Placebo | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Trochanter | -0.0061 g/cm^2 | Standard Deviation 0.0185 |
| Placebo | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Femoral neck | -0.0061 g/cm^2 | Standard Deviation 0.0284 |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Total hip | 0.0133 g/cm^2 | Standard Deviation 0.0194 |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Trochanter | 0.0182 g/cm^2 | Standard Deviation 0.0199 |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in BMD of the Proximal Femur at Month 12 | Femoral neck | 0.0078 g/cm^2 | Standard Deviation 0.0202 |
Absolute Change From Baseline in Mean Lumbar Spine BMD at Month 12
BMD was measured by a single dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine at the time of screening and at Month 12. A BMD measurement was considered unsuitable in case of detection of a fracture, an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. The absolute change from Baseline in mean BMD of the lumbar spine (L2-L4) was measured as g/cm\^2 and summarized using descriptive statistics.
Time frame: Baseline and Month 12
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Absolute Change From Baseline in Mean Lumbar Spine BMD at Month 12 | -0.0039 g/cm^2 | Standard Deviation 0.0319 |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in Mean Lumbar Spine BMD at Month 12 | 0.0322 g/cm^2 | Standard Deviation 0.0315 |
Absolute Change From Baseline in sCTX
Fasting blood samples were collected from participants for analysis of sCTX, which is a biochemical marker of bone resorption. Absolute change from baseline of sCTX after 3, 6, and 12 months of treatment was summarized using descriptive statistics.
Time frame: Baseline and 3, 6, 12 months
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point. n = the number of participants analyzed at a given time point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Placebo | Absolute Change From Baseline in sCTX | Month 3, n = 81, 72 | -0.0350 ng/ml |
| Placebo | Absolute Change From Baseline in sCTX | Month 6, n = 77, 72 | -0.0350 ng/ml |
| Placebo | Absolute Change From Baseline in sCTX | Month 12, n = 75, 68 | -0.0320 ng/ml |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in sCTX | Month 3, n = 81, 72 | -0.2570 ng/ml |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in sCTX | Month 6, n = 77, 72 | -0.2675 ng/ml |
| Ibandronate (IBN) 150 mg Monthly | Absolute Change From Baseline in sCTX | Month 12, n = 75, 68 | -0.2560 ng/ml |
Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs)
An AE is any untoward medical occurrence in a participant who is administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A serious adverse event is any untoward medical occurrence that at any dose results in death, are life threatening, requires hospitalization or prolongation of hospitalization or results in disability/incapacity, and congenital anomaly/birth defect.
Time frame: Up to 15 days after end of study treatment (Approximately 2 years)
Population: The safety population included participants who had at least one dose of the trial medication documented in the CRF whether withdrawn prematurely or not.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs) | Any AE | 64 participants |
| Placebo | Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAE | 1 participants |
| Ibandronate (IBN) 150 mg Monthly | Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs) | Any AE | 60 participants |
| Ibandronate (IBN) 150 mg Monthly | Number of Participants With Any Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAE | 3 participants |
Number of Participants With Marked Laboratory Abnormalities
Blood for laboratory tests was taken at screening and immediately before participants received their monthly study medication at months 3, 6, and 12. The laboratory tests included: Hematology \[white blood cells (WBCs), platelets, hematocrit, and hemoglobin\] and Chemistry \[albumin, creatinine, blood urea nitrogen (BUN), alanine aminotransferase (ALT), total calcium, 25-hydroxy vitamin D, phosphate, magnesium, sodium, potassium, and chloride\].
Time frame: Screening up to 12 months
Population: The safety population included participants who had at least one dose of the trial medication documented in the CRF whether withdrawn prematurely or not.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Number of Participants With Marked Laboratory Abnormalities | WBC, low | 1 participants |
| Placebo | Number of Participants With Marked Laboratory Abnormalities | ALT, high | 2 participants |
| Placebo | Number of Participants With Marked Laboratory Abnormalities | Phosphate, high | 1 participants |
| Ibandronate (IBN) 150 mg Monthly | Number of Participants With Marked Laboratory Abnormalities | WBC, low | 0 participants |
| Ibandronate (IBN) 150 mg Monthly | Number of Participants With Marked Laboratory Abnormalities | ALT, high | 0 participants |
| Ibandronate (IBN) 150 mg Monthly | Number of Participants With Marked Laboratory Abnormalities | Phosphate, high | 0 participants |
Percentage of Responders
Percent responders were defined as follows: Participants with a) lumbar spine (LS) BMD, equal to or above Baseline at Month 12 b) proximal femur BMD, equal to or above Baseline at Month 12 c) Both lumbar spine and proximal femur BMD, equal or above Baseline at Month 12. BMD of the lumbar spine was defined as the BMD of at least two vertebrae (L2-L4) that were not fractured and not affected by an osteoarthritic process, or a scanning artifact that could not be removed to such a degree that accurate measurement of BMD would be considered jeopardized by the central reading center. Proximal femur included total hip, trochanter and femoral neck sites.
Time frame: Up to 12 months
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Percentage of Responders | Lumbar spine equal to or above baseline | 38.6 Percentage |
| Placebo | Percentage of Responders | Proximal femur equal to or above baseline | 15.5 Percentage |
| Placebo | Percentage of Responders | LS and proximal femur equal to or above baseline | 8.5 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Percentage of Responders | Lumbar spine equal to or above baseline | 88.2 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Percentage of Responders | Proximal femur equal to or above baseline | 60.3 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Percentage of Responders | LS and proximal femur equal to or above baseline | 54.4 Percentage |
Relative Change From Baseline in Mean Proximal Femur BMD at Month 12
BMD was measured by a single DEXA scan of the proximal femur at the time of screening and at Month 12. The relative (%) change from Baseline in BMD of the proximal femur (total hip, trochanter, femoral neck) at Month 12 was summarized using descriptive statistics. BMD of fractured bones that could impact the scan area were not taken into account.
Time frame: Baseline and Month 12
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Total hip | -0.9265 Percentage | Standard Deviation 1.879 |
| Placebo | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Trochanter | -0.9120 Percentage | Standard Deviation 3.0025 |
| Placebo | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Femoral Neck | -0.7537 Percentage | Standard Deviation 3.7743 |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Total hip | 1.4855 Percentage | Standard Deviation 2.1862 |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Trochanter | 2.8688 Percentage | Standard Deviation 3.0906 |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Mean Proximal Femur BMD at Month 12 | Femoral Neck | 1.0930 Percentage | Standard Deviation 2.6466 |
Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX)
Fasting blood samples were collected from participants for analysis of serum CTX (sCTX), which is a biochemical marker of bone resorption. Relative change from baseline of sCTX after 3, 6, and 12 months of treatment was summarized using descriptive statistics.
Time frame: Baseline and 3, 6 and 12 months
Population: The ITT population included participants who were randomized, received at least one dose of the trial medication and had baseline and at least one follow-up evaluation data point. n = the number of participants analyzed at a given time point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Placebo | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 3, n = 81, 72 | -4.2230 Percentage |
| Placebo | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 6, n = 77, 72 | -6.5934 Percentage |
| Placebo | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 12, n = 75, 68 | -6.7416 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 3, n = 81, 72 | -55.7688 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 6, n = 77, 72 | -61.6459 Percentage |
| Ibandronate (IBN) 150 mg Monthly | Relative Change From Baseline in Serum C-telopeptide Crosslinks of Type 1 Collagen (CTX) | Month 12, n = 75, 68 | -56.5432 Percentage |