Postmenopausal Osteoporosis
Conditions
Brief summary
This 2 arm study will assess the impact of bone marker feedback (BMF), using serum carboxy-terminal collagen crosslinks (CTX) and communication of results at 3 months, on adherence to once monthly ibandronate (150 milligrams \[mg\] per oral \[po\]) in women with post-menopausal osteoporosis supported by patient-relationship program (PRP). Participants will be randomized either to receive BMF or no BMF; both groups will be supported by PRP. The anticipated time on study treatment is 3-12 months.
Interventions
Participants will receive ibandronate 150 mg QM orally for 6 months.
Sponsors
Study design
Eligibility
Inclusion criteria
* ambulatory, post-menopausal women with osteoporosis; * eligible for bisphosphonate treatment; * naïve to bisphosphonate therapy, or lapsed users (last bisphosphonate intake greater than or equal to \[\>=\] 6 months ago).
Exclusion criteria
* inability to stand or sit upright for at least 60 minutes; * inability to swallow a tablet whole; * hypersensitivity to bisphosphonates; * treatment with drugs, or presence of active disease, known to influence bone metabolism; * history of upper gastrointestinal disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Adherence to Treatment | Up to 6 months | Participants were considered adherent to treatment if they took at least 83 percent (%) of their assigned medications (5 of the 6 monthly ibandronate tablets) within the -1 to +21 days of their osteoporosis treatment date each month. Participant adherence was assessed by maintaining records of 'drug dispensed' and 'drug returned' on case report form (CRF) and participant's self-report on Visit 2 (Month 3) and final study visit (Month 6). A drug dispensing log was maintained by the investigator. Participants were instructed at the baseline visit and Visit 2 to save and return unused or partially used medication packages on Visit 2 and final study visit, respectively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q) Composite Satisfaction High Scores | At Month 6 | The OPSAT-Q is a validated questionnaire designed to capture satisfaction with bisphosphonate treatment. It comprises four domains: convenience (questions 1 - 6), quality of life (questions 7 and 8), overall satisfaction (questions 9 and 10), and side effects (questions 11 - 16). Satisfaction with treatment was assessed using the OPSAT-Q composite satisfaction score, which was the average of the scores from the four domains of the OPSAT-Q converted to a 0 - 100-point scale. Higher scores indicated greater treatment satisfaction. A score of 80 or more was considered as high score. |
| Percentage of Participants With Osteoporosis Patient Perception Survey (OPPS) and Osteoporosis Medical Care Satisfaction Questionnaire (OMSQ) Composite Satisfaction High Score | At Month 6 | OPPS: A standardized 6-item satisfaction questionnaire for osteoporosis medical care and treatment received during the study. Individual item score was transformed and converted to a 0 to 100 scale where higher score indicated greater satisfaction. The composite score was the average of individual item scores (transformed) and ranged from 0 to 100, where higher scores indicated greater satisfaction. OMSQ: A standardized 18-item satisfaction questionnaire for osteoporosis medical care, treatment received and blood test and their results during the study. Individual item score was transformed and converted to a 0 to 100 scale where higher score indicated greater satisfaction. The composite score was the average of individual item scores (transformed) and ranged from 0 to 100, where higher scores indicated greater satisfaction. |
| Percent Change From Baseline in CTX Based on Adherence to Ibandronate | Baseline, Month 6 | Serum CTX, a biochemical marker of bone resorption, was assessed for all participants at baseline and at final visit (Month 6). The sampling was done at the same time of the day each time to overcome the effect of circadian fluctuations. Participants were considered adherent to treatment if they took at least 83% of their assigned medications (5 of the 6 monthly ibandronate tablets) within the -1 to +21 days of their osteoporosis treatment date each month. Participant adherence was assessed by maintaining records of 'drug dispensed' and 'drug returned' on CRF and participant's self-report on Visit 2 (Month 3) and final study visit (Month 6). A drug dispensing log was maintained by the investigator. Participants were instructed at the baseline visit and Visit 2 to save and return unused or partially used medication packages on Visit 2 and final study visit, respectively. |
Countries
Hungary, Latvia, Poland, Romania, Russia, Slovakia, Slovenia
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| BMF Participants Postmenopausal women received ibandronate 150 mg QM orally for 6 months. Participants, in this arm, received BMF at Month 3. BMF was given in terms of providing serum CTX level at Month 3. A BMF-form was provided to the physicians to allow offering the bone marker result in an easy way. Participants were informed that their results were within or outside of the desired range. In addition, participants were also supported by PRP, carried out by supplying alarm devices, specifically designed to support the participant's regular drug intake. | 354 |
| No BMF Participants Postmenopausal women received ibandronate 150 mg QM orally for 6 months. Participants were supported by PRP, carried out by supplying alarm devices, specifically designed to support the participant's regular drug intake. | 357 |
| Total | 711 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 6 | 7 |
| Overall Study | Did not meet entry criteria | 1 | 1 |
| Overall Study | Lost to Follow-up | 2 | 0 |
| Overall Study | Non-compliance | 3 | 1 |
| Overall Study | Other | 1 | 1 |
| Overall Study | Withdrawal by Subject | 6 | 5 |
Baseline characteristics
| Characteristic | BMF Participants | No BMF Participants | Total |
|---|---|---|---|
| Age, Continuous | 66.7 years STANDARD_DEVIATION 7.12 | 65.6 years STANDARD_DEVIATION 6.64 | 66.2 years STANDARD_DEVIATION 6.9 |
| Sex: Female, Male Female | 354 Participants | 357 Participants | 711 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 | 196 / 354 | 224 / 357 |
| serious Total, serious adverse events | 8 / 354 | 5 / 357 |
Outcome results
Percentage of Participants With Adherence to Treatment
Participants were considered adherent to treatment if they took at least 83 percent (%) of their assigned medications (5 of the 6 monthly ibandronate tablets) within the -1 to +21 days of their osteoporosis treatment date each month. Participant adherence was assessed by maintaining records of 'drug dispensed' and 'drug returned' on case report form (CRF) and participant's self-report on Visit 2 (Month 3) and final study visit (Month 6). A drug dispensing log was maintained by the investigator. Participants were instructed at the baseline visit and Visit 2 to save and return unused or partially used medication packages on Visit 2 and final study visit, respectively.
Time frame: Up to 6 months
Population: Intent to treat (ITT) population included all randomized participants. Number of participants analyzed=number of participants evaluable for this outcome.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BMF Participants | Percentage of Participants With Adherence to Treatment | 98.5 percentage of participants |
| No BMF Participants | Percentage of Participants With Adherence to Treatment | 98.6 percentage of participants |
Percentage of Participants With Osteoporosis Patient Perception Survey (OPPS) and Osteoporosis Medical Care Satisfaction Questionnaire (OMSQ) Composite Satisfaction High Score
OPPS: A standardized 6-item satisfaction questionnaire for osteoporosis medical care and treatment received during the study. Individual item score was transformed and converted to a 0 to 100 scale where higher score indicated greater satisfaction. The composite score was the average of individual item scores (transformed) and ranged from 0 to 100, where higher scores indicated greater satisfaction. OMSQ: A standardized 18-item satisfaction questionnaire for osteoporosis medical care, treatment received and blood test and their results during the study. Individual item score was transformed and converted to a 0 to 100 scale where higher score indicated greater satisfaction. The composite score was the average of individual item scores (transformed) and ranged from 0 to 100, where higher scores indicated greater satisfaction.
Time frame: At Month 6
Population: ITT population. Number of participants analyzed = participants evaluable for this outcome.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BMF Participants | Percentage of Participants With Osteoporosis Patient Perception Survey (OPPS) and Osteoporosis Medical Care Satisfaction Questionnaire (OMSQ) Composite Satisfaction High Score | 74.9 percentage of participants |
| No BMF Participants | Percentage of Participants With Osteoporosis Patient Perception Survey (OPPS) and Osteoporosis Medical Care Satisfaction Questionnaire (OMSQ) Composite Satisfaction High Score | 72.2 percentage of participants |
Percentage of Participants With Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q) Composite Satisfaction High Scores
The OPSAT-Q is a validated questionnaire designed to capture satisfaction with bisphosphonate treatment. It comprises four domains: convenience (questions 1 - 6), quality of life (questions 7 and 8), overall satisfaction (questions 9 and 10), and side effects (questions 11 - 16). Satisfaction with treatment was assessed using the OPSAT-Q composite satisfaction score, which was the average of the scores from the four domains of the OPSAT-Q converted to a 0 - 100-point scale. Higher scores indicated greater treatment satisfaction. A score of 80 or more was considered as high score.
Time frame: At Month 6
Population: ITT population. Number of participants analyzed = participants evaluable for this outcome.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BMF Participants | Percentage of Participants With Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q) Composite Satisfaction High Scores | 87.72 percentage of participants |
| No BMF Participants | Percentage of Participants With Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q) Composite Satisfaction High Scores | 87.62 percentage of participants |
Percent Change From Baseline in CTX Based on Adherence to Ibandronate
Serum CTX, a biochemical marker of bone resorption, was assessed for all participants at baseline and at final visit (Month 6). The sampling was done at the same time of the day each time to overcome the effect of circadian fluctuations. Participants were considered adherent to treatment if they took at least 83% of their assigned medications (5 of the 6 monthly ibandronate tablets) within the -1 to +21 days of their osteoporosis treatment date each month. Participant adherence was assessed by maintaining records of 'drug dispensed' and 'drug returned' on CRF and participant's self-report on Visit 2 (Month 3) and final study visit (Month 6). A drug dispensing log was maintained by the investigator. Participants were instructed at the baseline visit and Visit 2 to save and return unused or partially used medication packages on Visit 2 and final study visit, respectively.
Time frame: Baseline, Month 6
Population: ITT population. Number of participants analyzed = participants evaluable for this outcome and n represents number of participants analyzed for the specified category.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| BMF Participants | Percent Change From Baseline in CTX Based on Adherence to Ibandronate | Adherence-Yes (n=279, 281) | -47.5 percent change |
| BMF Participants | Percent Change From Baseline in CTX Based on Adherence to Ibandronate | Adherence-No (n=1, 6) | -71.74 percent change |
| No BMF Participants | Percent Change From Baseline in CTX Based on Adherence to Ibandronate | Adherence-Yes (n=279, 281) | -47.5 percent change |
| No BMF Participants | Percent Change From Baseline in CTX Based on Adherence to Ibandronate | Adherence-No (n=1, 6) | -25.8 percent change |