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Fracture HealingPhase 2STARTT-HipNCT01081678

Study To Assess FRacTure Healing With SclerosTin Antibody - Hip

A Phase 2 study testing Romosozumab in people with Fracture Healing, run by Amgen at 99 sites in 24 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is an international, multi-center study to determine the efficacy, safety, and tolerability of romosozumab (AMG 785) in adults with a fresh unilateral hip fracture, status post surgical fixation. Read more about this study

Who is it for?
Ages 55 to 95 years
Conditions the study is for
Fracture Healing
What is being tested?
Romosozumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
332 participants
Where
99 sitesin 24 countries
Study dates
20 Jun 2010to 10 May 2013
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 to 95 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and females, age 55 to 95 years
  • fresh unilateral low energy intertrochanteric or femoral neck fracture as the primary injury, confirmed by X-ray and in the opinion of the treating surgeon amenable to repair by internal fixation
  • internal fixation of the fracture with devices approved by local regulatory agency, performed no later than 7 days after injury for intertrochanteric or undisplaced femoral neck fractures and no later than 2 days after injury for displaced femoral neck fractures
  • intertrochanteric fracture: sliding hip screw or IM nail
  • femoral neck fracture: sliding hip screw or at least 3 cancellous screws

Who cannot join

  • severe symptomatic osteoarthritis of the lower extremity
  • inability to independently rise from armchair or walk 200 meters before hip fracture
  • presence of concomitant injuries such as rib fractures, wrist fractures, or acute symptomatic vertebral fractures which severely impair the ability to rise from a chair
  • associated extremity injuries including ipsilateral or contralateral fractures of the foot, tibia or fibula, wrist, humerus, femoral shaft, femoral head or hip dislocation, that may delay weight-bearing beyond one week after surgery
  • head-injury, as defined by Glasgow Coma Scale < 13 prior to randomization
  • use of bone grafts or bone substitutes at the time of fracture fixation
Show all 15Show fewer
  • major polytrauma or significant axial trauma, with Injury Severity Score > 16
  • pathological fracture or history of metabolic or bone disease (except osteoporosis) that may interfere with the interpretation of the results, such as Paget's disease, rheumatoid arthritis, osteomalacia, osteopetrosis, ankylosing spondylitis, Cushing's disease, hyperprolactinemia
  • history of symptomatic spinal stenosis that has not been surgically corrected. If surgically corrected, the subject must be asymptomatic to be eligible for the study.
  • history of facial nerve paralysis
  • malignancy (except fully resected cutaneous basal cell or squamous cell carcinoma, cervical carcinoma in situ) within the last 5 years
  • history of solid organ or bone marrow transplants
  • evidence of elevated transaminases (≥ 2.0 x upper limits of normal) or significantly impaired renal function (creatinine clearance of ≤ 30 mL/min)
  • evidence of current hypercalcemia or hypocalcemia (outside of 1.1 x the normal range)
  • bone morphogenic proteins (BMP)-2 or BMP-7 at the time of definitive fracture fixation

Trial locations and contacts

99 sites in 24 countries.

99 sites in 24 countries

United States12 sites
  • Research Site

    Altoona, Pennsylvania, 16602

  • Research Site

    Aurora, Colorado, 80012

  • Research Site

    Birmingham, Alabama, 35294

  • Research Site

    Brooklyn, New York, 11220

  • Research Site

    Denver, Colorado, 80204

  • Research Site

    Indianapolis, Indiana, 46202

  • Research Site

    Philadelphia, Pennsylvania, 19104

  • Research Site

    Pomona, California, 91767

  • Research Site

    Rochester, New York, 14642

  • Research Site

    St Louis, Missouri, 63110

  • Research Site

    State College, Pennsylvania, 16801

  • Research Site

    Woodbury, Minnesota, 55125

Other trials in United States

Canada9 sites
  • Research Site

    Cambridge, Ontario, N1R 3G2

  • Research Site

    Guelph, Ontario, N1E 4J4

  • Research Site

    Montreal, Quebec, H4J 1C5

  • Research Site

    Ottawa, Ontario, K1Y 4E9

  • Research Site

    Québec, Quebec, G1J 1Z4

  • Research Site

    Québec, Quebec, G1R 2J6

  • Research Site

    Red Deer, Alberta, T4N 6V7

  • Research Site

    Toronto, Ontario, M5C 1R6

  • Research Site

    Waterloo, Ontario, N2J 1C4

Other trials in Canada

India9 sites
  • Research Site

    Bangalore, Karnataka, 560 054

  • Research Site

    Hyderabad, Andhra Pradesh, 500 063

  • Research Site

    Jaipur, Rajasthan, 302 022

  • Research Site

    Mangalore, Karnataka, 575 002

  • Research Site

    Mangalore, 575 001

  • Research Site

    Nashik, Maharashtra, 422 002

  • Research Site

    Nashik, 422 009

  • Research Site

    Pune, Maharashtra, 411 005

  • Research Site

    Pune, Maharashtra, 411 044

Other trials in India

Belgium5 sites
  • Research Site

    Bruges, 8000

  • Research Site

    Genk, 3600

  • Research Site

    Leuven, 3000

  • Research Site

    Liège, 4020

  • Research Site

    Liège, 4000

Other trials in Belgium

Greece5 sites
  • Research Site

    Athens, 12462

  • Research Site

    Athens, 14561

  • Research Site

    Larissa, 41110

  • Research Site

    Pátrai, 26500

  • Research Site

    Thessaloniki, 56429

Other trials in Greece

Netherlands5 sites
  • Research Site

    Amsterdam, 1061 AE

  • Research Site

    Amsterdam, 1091 AC

  • Research Site

    Amsterdam, 1105 AZ

  • Research Site

    Haarlem, 2035 RC

  • Research Site

    Nieuwegein, 3435 CM

Other trials in Netherlands

United Kingdom5 sites
  • Research Site

    Barnet, EN5 3DJ

  • Research Site

    Leeds, LS1 3EX

  • Research Site

    London, E1 1BB

  • Research Site

    Newcastle, NE1 4LP

  • Research Site

    Norwich, NR4 7UY

Other trials in United Kingdom

Denmark4 sites
  • Research Site

    Ã…rhus C, 8000

  • Research Site

    Hvidovre, 2650

  • Research Site

    København NV, 2400

  • Research Site

    Viborg, 8800

Other trials in Denmark

Germany4 sites
  • Research Site

    Aachen, 52074

  • Research Site

    Berlin, 12200

  • Research Site

    München, 80336

  • Research Site

    Münster, 48149

Other trials in Germany

Hungary4 sites
  • Research Site

    Budapest, 1081

  • Research Site

    Miskolc, 3526

  • Research Site

    Nyíregyháza, 4400

  • Research Site

    Szeged, 6725

Other trials in Hungary

Italy4 sites
  • Research Site

    Florence, 50139

  • Research Site

    Milan, 20142

  • Research Site

    Roma (RM), 00133

  • Research Site

    Verona, 37126

Other trials in Italy

Poland4 sites
  • Research Site

    Kraków, 31-826

  • Research Site

    Lublin, 20-718

  • Research Site

    Warsaw, 00-739

  • Research Site

    Warsaw, 03-242

Other trials in Poland

Slovenia4 sites
  • Research Site

    Celje, 3000

  • Research Site

    Izola, 6310

  • Research Site

    Jesenice, 4270

  • Research Site

    Sempeter pri Gorici, 5290

Other trials in Slovenia

Switzerland4 sites
  • Research Site

    Basel, 4031

  • Research Site

    Lausanne, 1011

  • Research Site

    Lucerne, 6000

  • Research Site

    Zurich, 8063

Other trials in Switzerland

Bulgaria3 sites
  • Research Site

    Blagoevgrad, 2700

  • Research Site

    Pleven, 5800

  • Research Site

    Plovdiv, 4002

Other trials in Bulgaria

Finland3 sites
  • Research Site

    Kuopio, 70211

  • Research Site

    Oulu, 90220

  • Research Site

    Turku, 20520

Other trials in Finland

Argentina2 sites
  • Research Site

    Buenos Aires, C1012AAR

  • Research Site

    Buenos Aires, C1419AHN

Other trials in Argentina

Australia2 sites
  • Research Site

    Footscray, Victoria, 3011

  • Research Site

    Liverpool, New South Wales, 2170

Other trials in Australia

Estonia2 sites
  • Research Site

    Tallinn, 11312

  • Research Site

    Tartu, 50410

Other trials in Estonia

Hong Kong2 sites
  • Research Site

    Hong Kong

  • Research Site

    New Territories

Other trials in Hong Kong

Latvia2 sites
  • Research Site

    Riga, 1005

  • Research Site

    Valmiera, 4201

Other trials in Latvia

Lithuania2 sites
  • Research Site

    Kaunas, 44320

  • Research Site

    Vilnius, 04130

Other trials in Lithuania

Sweden2 sites
  • Research Site

    Linköping, 581 85

  • Research Site

    Lund, 221 85

Other trials in Sweden

New Zealand1 site
  • Research Site

    Christchurch, 8022

Other trials in New Zealand

About this study

Official title: A Multi-center, Randomized, Double-blind, Placebo-controlled Study to Determine the Efficacy, Safety, and Tolerability of AMG 785 in Adults With a Fresh Unilateral Hip Fracture, Status Post Surgical Fixation

This is an international, multi-center study to determine the efficacy, safety, and tolerability of romosozumab (AMG 785) in adults with a fresh unilateral hip fracture, status post surgical fixation.

Being tested
Placebo, Romosozumab
Keywords
AMG 785, Proximal Femur, Fracture Healing, Hip Fracture
Medical subject headings
Hip Fractures

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PlaceboDrug

    Administered by subcutaneous (under the skin) injection

  • RomosozumabDrug

    Also called AMG 785, Evenity

    Administered by subcutaneous injection

Study groups in NCT01081678
Study groupRoleWhat they receive
PlaceboPlacebo comparatorParticipants received placebo to romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12.
Receives: Drug: Placebo
Romosozumab 70 mgExperimentalParticipants received 70 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12.
Receives: Drug: Romosozumab
Romosozumab 140 mgExperimentalParticipants received 140 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12.
Receives: Drug: Romosozumab
Romosozumab 210 mgExperimentalParticipants received 210 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12.
Receives: Drug: Romosozumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Timed-Up-and-Go (TUG) Over Week 6 Through Week 20

    Functional healing was measured by the timed-up-and-go test (TUG) over Weeks 6 through 20. During this assessment, the clinician timed the participant while they stood up from a seated position in a chair, walked three meters, turned around, walked three meters back to the chair, and returned to the seated position. A TUG value of ten seconds or less was considered normal for a healthy elderly person. Higher TUG values after hip fracture have been shown to be a predictor of future falls.

    Least squares mean (LSM) estimates were based on a repeated measures model fitted with the log-transformed TUG values at weeks 2, 6, 12, 16, 20, 24, 36, 52 as the dependent variable and adjusted for treatment, randomized strata, gender, country category, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction and back-transformed using the exponential transformation.

    Measured: Weeks 6, 12, 16, and 20

Secondary outcomes (5)
  1. Timed-Up-and-Go (TUG) at Each Visit

    During the timed-up-and-go test the clinician timed the participant while they stood up from a seated position in a chair, walked 3 meters, turned around, walked 3 meters back to the chair, and returned to a seated position. A TUG value of ≤ 10 seconds is considered normal for a healthy elderly person.

    LSMs were based on a repeated measures model adjusting for treatment, randomized strata, gender, country category, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.

    Missing TUG values for participants still on study were imputed using the last observation carried forward (LOCF) when possible. If no observation could be carried forward, the maximum TUG value observed among all participants at a given visit was used. TUG values obtained after unplanned revision surgery were replaced by carrying forward the last available observed or imputed value prior to unplanned revision surgery.

    Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52

  2. Time to Radiographic Healing

    Time to radiographic healing is the time interval from the surgery date for the eligible hip fracture to the date of radiographic healing, defined as effacement of the fracture lines by newly formed bone along the cortices and within the trabecular bone on anteroposterior and lateral (or oblique) radiographs. Radiographic fracture healing was determined by a panel of independent reviewers blinded to treatment.

    The cumulative incidence function (CIF) method was used to estimate the median time to radiographic healing and the confidence intervals. Unplanned revision surgery to promote healing was considered a competing risk in CIF estimate.

    Measured: 52 weeks

  3. Radiographic Union Scale for Hip (RUSH) Score At Each Visit

    The radiographic Union Scale for Hip (RUSH) is a semiquantitative scoring assessment to assess hip fracture healing after surgical repair. The RUSH has 4 key domains based on radiographic parameters used by orthopedic surgeons and radiologists in routine clinical practice including cortical bridging (4 to 12 points), cortical fracture line disappearance (4 to 12 points), trabecular consolidation (1 to 3 points), and trabecular index disappearance of fracture line (1 to 3 points). The score has a minimum of 10 points (definitely not healed) and a maximum of 30 points (definitely healed).

    Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52

  4. Harris Hip Score At Each Visit

    The Harris Hip Score is a clinician-based outcome that assesses pain, function, deformity, and range of motion. The pain domain measures pain severity and its effect on activities and need for pain medication. The function domain consists of daily activities and gait. Deformity takes into account hip flexion, adduction, internal rotation, and extremity length discrepancy. Range of motion measures hip flexion, abduction, external and internal rotation, and adduction. The score ranges form 0-100 (best possible outcome) covering pain (0-44 points), function (0-47 points), absence of deformity (4 points), and range of motion (5 points). LSMs were based on a repeated measures model fitted with the Harris hip score values at weeks 2, 6, 12, 16, 20, 24, 36, and 52 as the dependent variable and adjusted for treatment, randomized strata, gender, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.

    Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52

  5. Hip Pain Score at Each Visit

    Hip pain was assessed using a visual analog scale (VAS). Participants were asked to rate their pain as a result of the hip fracture on a 100 mm vertical scale with 0 indicating no pain at all and 100 indicating the worst pain they could imagine.

    LSMs were based on a repeated measures model fitted with hip pain score values at weeks 2, 6, 12, 16, 20, 24, 36, and 52 as the dependent variable and adjusted for treatment, randomized strata, gender, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.

    Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Mar 2010 (estimated)
  2. Study start20 Jun 2010
  3. Primary completion30 Jun 2012
  4. Study completion10 May 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
332 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01081678
Sponsor's protocol ID
20080394
Acronym
STARTT-Hip
Status last verified
Sep 2022
First submitted
4 Mar 2010
Last updated
21 Sep 2022

Publications

  • Schemitsch EH, Miclau T, Karachalios T, Nowak LL, Sancheti P, Poolman RW, Caminis J, Daizadeh N, Dent-Acosta RE, Egbuna O, Chines A, Maddox J, Grauer A, Bhandari M. A Randomized, Placebo-Controlled Study of Romosozumab for the Treatment of Hip Fractures. J Bone Joint Surg Am. 2020 Apr 15;102(8):693-702. doi: 10.2106/JBJS.19.00790.

    PubMed 31977817

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Romosozumab in people with Fracture Healing, run by Amgen at 99 sites in 24 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Sep 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 99 sites in United States, Canada, India, Belgium, Greece and 19 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Timed-Up-and-Go (TUG) Over Week 6 Through Week 20 (time frame: Weeks 6, 12, 16, and 20). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01081678, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2022.

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