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Osteogenesis ImperfectaPhase 3OINCT02352753

Multicenter,Single-arm Study to Evaluate Efficacy, Safety, & Pharmacokinetics of Denosumab in Children w/ OI

A Phase 3 study testing Denosumab in people with Osteogenesis Imperfecta, run by Amgen at 49 sites in 13 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a prospective, multicenter, single-arm study in children 2 to 17 years of age with OI to evaluate efficacy and safety of denosumab. Read more about this study

Who is it for?
Ages 2 to 17 years
Conditions the study is for
Osteogenesis Imperfecta
What is being tested?
Denosumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
153 participants
Where
49 sitesin 13 countries
Study dates
24 Jun 2015to 26 Mar 2022
Phase
Phase 3
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 2 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Clinical diagnosis of OI defined as a clinical history consistent with type I-IV OI Clinical severity of OI as defined by 2 or more prevalent vertebral compression fractures; OR1 prevalent vertebral compression fracture and 1 or more nonvertebral fractures within the previous 2 years; OR 3 or more fractures within the previous 2 years.

Who cannot join

  • Inability or unwillingness to comply with the requirements for frequent calcium and phosphorus monitoring for 14 days after the first dose of denosumab (only applies to the first 5 subjects age 11 to17 enrolled in the study and the first 5 subjects of any age meeting the criteria for increased bone turnover
  • Currently unhealed fracture or osteotomy as defined by orthopedic opinion
  • Osteotomy within 5 months of screening
  • Evidence of untreated oral cavities or oral infections
  • Recent or planned invasive dental procedure
  • Surgical tooth extraction which has not healed by screening
Show all 36Show fewer
  • History of an electrophoresis pattern inconsistent with type I to IV OI
  • History of genetic testing results inconsistent with type I to IV OI
  • Abnormalities of the following per central laboratory reference ranges at screening: Serum albumin corrected calcium < lower limit of normal (LLN) Serum vitamin D < 20 ng/mL; re-screening for Vitamin D level < 20 ng/mL will be allowed, after adequate supplementation
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) > 1.5 x upper limit of normal (ULN)
  • Total bilirubin (TBL) > 1.5 x ULN (subjects with Gilbert syndrome are eligible)
  • Serum phosphorus < LLN
  • Serum alkaline phosphatase > 20% above the ULN or > 20% below the LLN
  • Estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (calculated bythe Schwartz equation at screening) Evidence of any of the following: Current hyperthyroidism (unless well-controlled on stable antithyroid therapy)
  • Current clinical hypothyroidism (unless well-controlled on stable thyroid replacement therapy)
  • History of hyperparathyroidism
  • Current hypoparathyroidism
  • Current, uncontrolled hypercalcemia (albumin-corrected serum Ca >10% ULN)
  • History of osteomalacia or rickets (chart review)
  • Other bone diseases that affect bone metabolism (eg, osteoporosis pseudoglioma syndrome, idiopathic juvenile osteoporosis, osteopetrosis, hypophosphatasia)
  • History of autoimmune disease
  • History of rare hereditary problems of fructose intolerance
  • Positive blood screen for human immunodeficiency virus -1 or -2 antibody
  • Positive blood screen for hepatitis B surface antigen or hepatitis C antibody
  • Received other osteoporosis treatment or bone active treatment with the following guidelines:
  • Prior treatment with
  • denosumab
  • fluoride or strontium for bone disease (fluoride taken for routine dental care is permitted)
  • parathyroid hormone (PTH) or PTH derivatives within 12 months prior to screening
  • zoledronic acid within 6 months prior to screening
  • oral bisphosphonates or intravenous bisphosphonates other than zoledronic acid if the first dose of denosumab would be before their next scheduled bisphosphonate dose would have been given
  • Administration of systemic glucocorticoids (≥ 5.0 mg prednisone equivalents/day for more than 10 days) within 3 months of screening.
  • Topical and inhaled glucocorticoids will be allowed
  • Administration of any of the following treatment within 3 months of screening:
  • Growth hormone (subjects on stable dose of growth hormone for at least 3 months prior to screening will be allowed)
  • Currently receiving treatment in another investigational drug study, or less than 30 days since ending treatment on another investigational drugstudy(s), or current or planned participation in a clinical trial that would preclude compliance with study requirements Other inclusion/exclusion criteria may apply.

Trial locations and contacts

49 sites in 13 countries.

49 sites in 13 countries

United States13 sites
  • Research Site

    Aurora, Colorado, 80045

  • Research Site

    Baltimore, Maryland, 21205

  • Research Site

    Boston, Massachusetts, 02115

  • Research Site

    Decatur, Georgia, 30033

  • Research Site

    Houston, Texas, 77030

  • Research Site

    Indianapolis, Indiana, 46202

  • Research Site

    Iowa City, Iowa, 52242

  • Research Site

    Los Angeles, California, 90027

  • Research Site

    Nashville, Tennessee, 37232

  • Research Site

    New Haven, Connecticut, 06510

  • Research Site

    Omaha, Nebraska, 68114

  • Research Site

    Torrance, California, 90502

  • Research Site

    Wilmington, Delaware, 19803

Other trials in United States

Czechia5 sites
  • Research Site

    Hradec Králové, 500 05

  • Research Site

    Pardubice, 532 03

  • Research Site

    Pilsen, 305 99

  • Research Site

    Prague, 140 59

  • Research Site

    Zlín, 762 75

Other trials in Czechia

France5 sites
  • Research Site

    Bordeaux, 33076

  • Research Site

    Paris, 75012

  • Research Site

    Paris, 75743

  • Research Site

    Saint-Priest-en-Jarez, 42270

  • Research Site

    Toulouse, 31059

Other trials in France

Poland4 sites
  • Research Site

    Bialystok, 15-274

  • Research Site

    Lodz, 91-738

  • Research Site

    Rzeszów, 35-301

  • Research Site

    Warsaw, 04-730

Other trials in Poland

United Kingdom4 sites
  • Research Site

    Birmingham, B4 6NH

  • Research Site

    Bristol, BS2 8AE

  • Research Site

    Glasgow, G51 4TF

  • Research Site

    Sheffield, S10 2TH

Other trials in United Kingdom

Belgium3 sites
  • Research Site

    Brussels, 1200

  • Research Site

    Ghent, 9000

  • Research Site

    Leuven, 3000

Other trials in Belgium

Bulgaria3 sites
  • Research Site

    Sofia, 1606

  • Research Site

    Sofia, 1784

  • Research Site

    Varna, 9010

Other trials in Bulgaria

Canada3 sites
  • Research Site

    Montreal, Quebec, H4A 0A9

  • Research Site

    Ottawa, Ontario, K1H 8L1

  • Research Site

    Toronto, Ontario, M5G 1X8

Other trials in Canada

Spain3 sites
  • Research Site

    Esplugues de Llobregat, Catalonia, 08950

  • Research Site

    Getafe, Madrid, 28905

  • Research Site

    Valencia, Valencia, 46026

Other trials in Spain

Australia2 sites
  • Research Site

    Subiaco, Western Australia, 6008

  • Research Site

    Westmead, New South Wales, 2145

Other trials in Australia

Italy2 sites
  • Research Site

    Roma, 00161

  • Research Site

    Verona, 37126

Other trials in Italy

Germany1 site
  • Research Site

    Cologne, 50931

Other trials in Germany

Hungary1 site
  • Research Site

    Budapest, 1094

Other trials in Hungary

About this study

Official title: To Evaluate the Effect of Denosumab in Lumbar Spine Bone Mineral Density (BMD) Z-score at 12 Months, as Assessed by Dual-energy X-ray Absorptiometry (DXA), in Children 2 to 17 Years of Age (at the Time of Screening) on a 3-Month Dosing Regimen With OI

This is a prospective, multicenter, single-arm study in children 2 to 17 years of age with OI to evaluate efficacy and safety of denosumab.

Read the detailed description

To evaluate the effect of denosumab in lumbar spine bone mineral density (BMD) Z-score at 12 months, as assessed by dual-energy X-ray absorptiometry (DXA), in children 2 to 17 years of age (at the time of screening) on a 3-Month Dosing Regimen with osteogenesis imperfecta (OI)

Being tested
Denosumab
Keywords
Amgen, OI, Bone
Medical subject headings
Osteogenesis Imperfecta

What participants receive

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

  • DenosumabDrug

    Subcutaneous (SC) injection.

Study groups in NCT02352753
Study groupRoleWhat they receive
DenosumabExperimentalParticipants received denosumab 1 mg/kg (up to a maximum of 60 mg) subcutaneously every 6 months (Q6M) for up to 36 months. Early efficacy and PK data from Q6M dosing supported adjustment of the dosing regimen from Q6M to every 3 months (Q3M). Participants enrolled and still receiving denosumab were transitioned from Q6M to Q3M dosing schedule. Participants could transition to Q3M dosing schedule up to and including the date they attended for their month 36 visit under the Q6M dosing regimen. Those participants received denosumab during the Q3M dosing regimen for 12 months. Participants who transition to Q3M at month 18 of the Q6M dosing regimen received denosumab Q3M for up to 18 months.
Receives: Drug: Denosumab

What is being measured

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

  1. Change From Baseline in Lumbar Spine Bone Mineral Density (BMD) Z-Score at 12 Months

    Lumbar spine BMD was measured by dual-energy X-ray absorptiometry (DXA) adjusted for age, sex, and race/ethnicity. The results were then converted to Z-scores. The Z-score indicated the number of standard deviations away from the reference population and a score of 0 is equal to the mean. Positive changes from Baseline indicated an improvement in lumbar spine BMD.

    Measured: Baseline and 12 months

Secondary outcomes (15)
  1. Change From Baseline in Lumbar Spine BMD Z-score at 6 Months

    Lumbar spine BMD was measured by DXA adjusted for age, sex, and race/ethnicity. The results were then converted to Z-scores. The Z-score indicated the number of standard deviations away from the reference population and a score of 0 is equal to the mean. Positive changes from Baseline indicated an improvement in lumbar spine BMD.

    Measured: Baseline and 6 months

  2. Change From Baseline in Proximal Femur BMD Z-score at 6 and 12 Months

    Proximal femur (total hip and femoral neck) BMD Z-score was measured by DXA adjusted for age, sex, and race/ethnicity. The results were then converted to Z-scores. The Z-score indicated the number of standard deviations away from the reference population and a score of 0 is equal to the mean. Positive changes from Baseline indicated an improvement in lumbar spine BMD.

    Measured: Baseline, 6 and 12 months

  3. Percentage of Participants With at Least 1 X-ray Confirmed Long Bone or New and Worsening Vertebral Fracture

    Measured: Q6M Dosing Regimen: Last 12 months of treatment (median treatment duration was 730.0 days); Q3M Dosing Regimen: Day 1 up to 12 months

  4. Percentage of Participants With at Least 1 X-ray Confirmed New and Worsening Vertebral Fracture

    Measured: Q6M Dosing Regimen: Last 12 months of treatment (median treatment duration was 730.0 days); Q3M Dosing Regimen: Day 1 up to 12 months

  5. Percentage of Participants With at Least 1 X-ray Confirmed New Vertebral Fracture

    Measured: Q6M Dosing Regimen: Last 12 months of treatment (median treatment duration was 730.0 days); Q3M Dosing Regimen: Day 1 up to 12 months

  6. Percentage of Participants Wth at Least 1 X-ray Confirmed Improving Vertebral Fracture

    Measured: Q3M Dosing Regimen: Baseline up to 12 months

  7. Percentage of Participants With at Least 1 Vertebral and Nonvertebral Fracture

    Measured: Q6M Dosing Regimen: Last 12 months of treatment (median treatment duration was 730.0 days); Q3M Dosing Regimen: Day 1 up to 12 months

  8. Change From Baseline in Child Health Questionnaire-Parent Form Physical Summary Score (CHQ-PF-50) at 12 Months

    The CHQ-PF-50 was a 50-item questionnaire completed by the parents or guardians of children between 5 and 18 years of age. The 50 questions measure 14 domains which were summarized as the physical and psychological summary scores. Each summary score was transformed and could range from 0 to 100, with higher score indicating better physical and psychosocial health. A negative change from Baseline indicates decreased well-being.

    Measured: Baseline and 12 months

  9. Change From Baseline in CHQ-PF-50 Psychological Summary Score at 12 Months

    The CHQ-PF-50 was a 50-item questionnaire completed by the parents or guardians of children between 5 and 18 years of age. The 50 questions measure 14 domains which were summarized as the physical and psychological summary scores. Each summary score was transformed and could range from 0 to 100, with higher score indicating better physical and psychosocial health. A positive change from Baseline indicates improved well-being.

    Measured: Baseline and 12 months

  10. Change From Baseline in Childhood Health Assessment Questionnaire (CHAQ) Disability Index Score at 12 Months

    The disability domain (questions 1-54) of the CHAQ was used to measure the participant's assessment of physical functioning or the parent's assessment of the child's physical functioning. The disability index comprised of 8 categories (dressing and grooming, arising, eating, walking, hygiene, reaching, gripping, and activities). Scoring ranged from 1 to 5; 1 was "without any difficulty," 2 was "with some difficulty," 3 was "with much difficulty," and 4 was "unable to do." An answer of "not applicable" was scored as a 5, but was not counted. If a child required assistance from another person or used an aid or other device for any of the 8 categories, the minimum score for that category was recorded as a 3. The CHAQ questions were scored and converted to a total index score ranging from 0 to 3. Negative change from Baseline indicates an improvement.

    Measured: Baseline and 12 months

  11. Change From Baseline in Wong-Baker Faces Pain Rating Scale (WBFPRS) at 12 Months

    Participants were asked to report their level of pain by choosing a face that best described their own pain (the corresponding number: 0, 2, 4, 6, 8, 10) were then recorded. The WBFPRS ranged from 0, "no hurt," to 10, "hurts worst". A negative change from baseline indicates an improvement.

    Measured: Baseline and 12 months

  12. Serum Concentration of Denosumab

    Measured: Days 1 (predose), 10, 30, and 60, & weeks 12, 24, 36, 48, 60, 72 (end of study visit), early termination visit, & follow-up visit 12 weeks after last dose (average duration of treatment: 231 days)

  13. Serum Bone Turnover Marker (BTM) - Serum Type I Collagen C Telopeptide

    Measured: Baseline and Days 10 and 30, and Months 3, 6, 9, 12, 15 and 18

  14. BTM - Bone-specific Alkaline Phosphatase (BSAP)

    Measured: Baseline and Days 10 and 30, and Months 3, 6, 9, 12, and 15

  15. Change From Baseline in Growth Velocity at 12 Months

    Change from baseline in growth velocity was determined by calculating age-adjusted Z-scores for height, weight and body mass index (BMI).

    Height-for-age Z-score was defined as the difference between the participant's height and the median height for the population with the same age and gender, divided by the population standard deviation.

    The definitions of growth velocity based on weight and BMI were analogously calculated. To programmatically calculate the Z-scores, the National Center for Health Statistics percentiles growth charts, based on the 2000 Center for Disease Control and Prevention (CDC) (http://www.cdc.gov/growthcharts/c c_charts.htm), and the CDC Anthropometric Software Package 3.0 Z-scores were used.

    During normal growth, the change in z-score for each of the three should equal 0. A positive change in any of the three indicates growth acceleration, whereas a negative change indicates deceleration.

    Measured: Baseline and 12 months

Timeline

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

  1. First posted2 Feb 2015 (estimated)
  2. Study start24 Jun 2015
  3. Primary completion26 Mar 2022
  4. Study completion26 Mar 2022

Why it stopped: The study was stopped earlier than planned due to safety concerns about high levels of calcium in the blood of the participants

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 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential
Masking
None (open label)
Enrolment
153 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02352753
Sponsor's protocol ID
20130173
Other IDs
2014-000184-40, 2014
Acronym
OI
Status last verified
Nov 2022
First submitted
28 Jan 2015
Last updated
28 Dec 2022
Data monitoring committee
Yes
Individual data sharing
Yes: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Denosumab in people with Osteogenesis Imperfecta, run by Amgen at 49 sites in 13 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 1 inclusion and 36 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: stopped early, as of the sponsor's last update on 28 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 49 sites in United States, Czechia, France, Poland, United Kingdom and 8 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. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 28 Dec 2022). 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?

Change From Baseline in Lumbar Spine Bone Mineral Density (BMD) Z-Score at 12 Months (time frame: Baseline and 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 Dec 2022.

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