Efficacy and Safety of Odanacatib in Postmenopausal Women Previously Treated With Oral Bisphosphonate (MK-0822-076)

A Phase III Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Effects of Odanacatib (MK-0822) on Bone Mineral Density (BMD) and Overall Safety in the Treatment of Osteoporosis in Postmenopausal Women Previously Treated With an Oral Bisphosphonate

Status

Terminated

Phases

Phase 3

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01803607

Enrollment

135

Registered

2013-03-04

Start date

2013-03-14

Completion date

2014-11-11

Last updated

2019-09-04

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Osteoporosis

Brief summary

The purpose of this study is to assess to what extent sequential treatment with odanacatib results in incremental gains in bone mineral density (BMD) over time in female participants who have received at least 3 years of bisphosphonate therapy. It was hypothesized that odanacatib treatment would increase femoral neck BMD relative to placebo after 24 months.

Interventions

DRUGodanacatib

odanacatib 50 mg oral tablet

OTHERplacebo to odanacatib

dose-matched placebo to odanacatib, oral tablet

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender

FEMALE

Age

60 Years to No maximum

Healthy volunteers

Inclusion criteria

* Postmenopausal for ≥5 years (defined as no menses for at least 5 years or at least 5 years post bilateral oophorectomy). * Prior or current treatment with oral bisphosphonate therapy (i.e., alendronate, risedronate, ibandronate) for postmenopausal osteoporosis for ≥3 years. * BMD T-score at any hip site (femoral neck, trochanter, or total hip) ≤-2.5 and \>-3.5 as assessed by dual-energy X-ray absorptiometry (DXA) without a history of a prior fragility fracture. For participants with a history of a prior fragility fracture (except hip fracture), BMD T-score can be ≤-1.5 and \>-3.5 at any hip site. * Serum 25-hydroxyvitamin D level of ≥20 and ≤60 ng/mL within 90 days of the time of randomization.

Exclusion criteria

* Evidence of a metabolic bone disorder other than osteopenia or osteoporosis * History or current evidence of hip fracture. * History of malignancy ≤5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer. * Active parathyroid disease. Participant with a documented history of parathyroid disease can be considered for inclusion if she has normal parathyroid hormone (PTH) at screening. * History of thyroid disease not adequately controlled by medication. * Current treatment with anti-seizure medication, with indices of calcium metabolism not within normal limits. * Prior treatment with strontium-containing products; intravenous bisphosphonates; cathepsin K inhibitors; RANK ligand inhibitors; fluoride treatment at a dose greater than 1 mg/day for more than 2 weeks. * Use of following medications within the 6 months prior to the screening visit: activated vitamin D; estrogen, with or without progestin, at a dose high enough to have systemic effects; raloxifene or other selective estrogen receptor modulator (SERM), tibolone or any aromatase inhibitor; sub-cutaneous calcitonin (Note: use of intranasal calcitonin is allowed at any time); anabolic steroid; PTH (1-34 or 1-84); growth hormone; systemic glucocorticoids (≥5 mg/day of prednisone or equivalent) for more than 2 weeks; cyclosporine for more than 2 weeks. * Concurrent use of cancer chemotherapy or heparin; protease inhibitors for human immunodeficiency virus (HIV) treatment; and vitamin A (excluding beta carotene) \>10,000 IU daily, unless willing to discontinue this dose during the study. * Current treatment with cytochrome P450 3A4 (CYP3A4) inducers or treatment with CYP3A4 inducer within 4 weeks of screening.

Design outcomes

Primary

Measure	Time frame	Description
Percent Change From Baseline to Month 12 in Femoral BMD	Baseline and Month 12	Dual-energy X-ray absorptiometry (DXA) was used to determine the change from baseline in femoral neck BMD at Month 12.

Secondary

Measure	Time frame	Description
Percent Change From Baseline to Month 12 in Trochanter, Total Hip, and Lumbar Spine BMD	Baseline and Month 12	DXA was used to determine the change from baseline in trochanter, total hip, and lumbar spine BMD at Month 12.
Change From Baseline in Serum C-telopeptides of Type 1 Collagen (s-CTx)	Baseline and Month 12	s-CTx is a biochemical marker of bone resorption. At baseline and Month 12, s-CTx was measured and expressed in ng/mL and results are expressed as percentage change from baseline.
Change From Baseline in Urine C-telopeptides of Type I Collagen (u-CTx)	Baseline and Month 12	u-CTx is a biochemical marker of bone resorption. At baseline and Month 12, u-CTx was measured and expressed in ug/mL and results are expressed as percentage change from baseline.
Percent Change From Baseline to Month 24 in Femoral Neck BMD: Within-Group Comparison of Odanacatib	Baseline and Month 24	DXA was used to determine the within-group change from baseline in femoral neck BMD at Month 24.
Change From Baseline in Serum Bone Specific Alkaline Phosphatase (s-BSAP)	Baseline and Month 12	s-BSAP is a biochemical marker of bone resorption. s-BSAP was measured and expressed in ng/mL at Baseline and Month 12, and results are shown as percentage change from baseline.
Change From Baseline in Serum N-terminal Propeptide of Type 1 Collagen (s-P1NP)	Baseline and Month 12	s-P1NP is a biochemical marker of bone resorption. s-P1NP was measured and expressed as ng/mL at Baseline and Month 12, and results are expressed as percentage change from baseline.
Change From Baseline in Urine N-telopeptides of Type 1 Collagen Corrected for Creatinine (u-NTx/Cr)	Baseline and Month 12	The u-NTx/Cr ratio is a biochemical marker of bone resorption. u-NTx/Cr was measured at baseline and Month 12 and expressed in nM:mM and results are expressed as percentage change from baseline.

Participant flow

Recruitment details

Postmenopausal female participants ≥60 years of age with low bone mineral density (BMD) and who had been treated with an oral bisphosphonate for at least 3 years were recruited at 81 sites in the United States.

Pre-assignment details

The Sponsor made a business decision to terminate the trial early due to poor enrollment; the decision was not related to any findings regarding the efficacy or safety profile of odanacatib.

Participants by arm

Arm	Count
Odanacatib 50 mg Participants received odanacatib 50 mg OW for 24 months. In addition, participants received Vitamin D 5600 IU as well as open-label daily calcium supplement of 500 mg (sourced locally as calcium carbonate or calcium citrate) to ensure a total daily intake (from both dietary and supplemental sources) of approximately 1200 mg of elemental calcium.	68
Placebo Participants received dose-matched placebo to odanacatib OW for 24 months. In addition, participants received Vitamin D 5600 IU as well as open-label daily calcium supplement of 500 mg (sourced locally as calcium carbonate or calcium citrate) to ensure a total daily intake (from both dietary and supplemental sources) of approximately 1200 mg of elemental calcium.	67
Total	135

Withdrawals & dropouts

Period	Reason	FG000	FG001
Overall Study	Adverse Event	5	3
Overall Study	Lack of Efficacy	0	1
Overall Study	Protocol Violation	3	2
Overall Study	Study terminated by sponsor	54	56
Overall Study	Withdrawal by Subject	6	5

Baseline characteristics

Characteristic	Odanacatib 50 mg	Placebo	Total
Age, Continuous	71.7 Years STANDARD_DEVIATION 7.9	70.7 Years STANDARD_DEVIATION 7.6	70.9 Years STANDARD_DEVIATION 7.7
Sex: Female, Male Female	68 Participants	67 Participants	135 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	15 / 67	9 / 68
serious Total, serious adverse events	6 / 67	4 / 68

Outcome results

Primary

Percent Change From Baseline to Month 12 in Femoral BMD

Dual-energy X-ray absorptiometry (DXA) was used to determine the change from baseline in femoral neck BMD at Month 12.