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OsteoporosisPaVOSNCT02563353

PTH and Vibration in OSteoporosis Study

A study testing whole-body vibration and teriparatide in people with Osteoporosis, run by Odense University Hospital at 1 site in Denmark.

Completed

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

Official record
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Trial summary

Objective: This is a randomized controlled trial (RCT) in osteoporosis patients randomized to standard parathyroid hormone (PTH) treatment alone or to standard PTH treatment and Whole-body vibration (WBV). PTH is an effective but expensive anabolic treatment for osteoporosis. WBV stimulates muscles and bones. Read more about this study

Who is it for?
Ages 50 years and older, women only
Conditions the study is for
Osteoporosis
What is being tested?
whole-body vibration and teriparatide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
1 siteDenmark
Study dates
Nov 2015to Nov 2019
Phase
Interventional
Are there results?
None posted in the registry

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 50 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Women starting PTH treatment for osteoporosis according to Danish Osteoporosis guidelines

Who cannot join

  • Women currently taking oral glucocorticoids
  • Women unable to give informed consent
  • Women unable to stand for 2 minutes at a time on the vibration platform
  • Women who have contraindications to WBV (e.g. joint prosthesis, pacemakers)

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Odense University Hospital

    Odense, 5000

Other trials in Denmark

About this study

Official title: PTH and Vibration in OSteoporosis (PaVOS) Study

Objective:

This is a randomized controlled trial (RCT) in osteoporosis patients randomized to standard parathyroid hormone (PTH) treatment alone or to standard PTH treatment and Whole-body vibration (WBV). PTH is an effective but expensive anabolic treatment for osteoporosis. WBV stimulates muscles and bones. A combined treatment might have synergistic or additive beneficial effects on bone, reducing fracture risk making treatment more effective and cost-effective. A beneficial effect on muscles and thereby falls risk of WBV may improve fracture risk even further.

If the results of this pilot study are promising then a strong case can be made for a large multi-centre RCT using strong endpoints including fractures and falls.

Read the detailed description

Study Objectives

  1. To determine if WBV in addition to standard PTH treatment has a greater effect on bone mass in osteoporosis patients compared to standard PTH treatment alone.
  2. To determine if WBV in addition to standard PTH treatment has a greater effect on bone microarchitecture in osteoporosis patients compared to standard PTH treatment alone, as assessed by high resolution peripheral quantitative computed tomography (HR-pQCT).
  3. To determine if WBV in addition to standard PTH treatment has a greater effect on markers of bone formation and resorption in osteoporosis patients compared to standard PTH treatment alone.
  4. To study the effects of WBV on muscle function and balance in osteoporosis
  5. To assess the safety and adherence to WBV in osteoporotic patients

Study Design:

General Design This will be a multi-center randomized controlled trial (RCT) in osteoporosis patients being started on standard PTH treatment according to Danish Osteoporosis guidelines. Participants will be randomized to standard PTH treatment alone or to standard PTH treatment and WBV.

Statistical Plan:

Sample Size Determination The inclusion of 32 participants (16 in both groups) would give the study 80% power to detect a clinically significant additional increase of 22% with WBV (assuming a 9% increase of BMD in the PTH alone group and 11% increase in the combined PTH+WBV group, and assuming a SD of the BMD increase of 2%. Allowing for a 20% dropout rate, the plan is to include 40 participants (20 in each group). From previous research on WBV by one of the investigators (TM), statistically significant differences were found in bone formation markers and in muscle strength at 3 months between the WBV and control groups with a sample size of 35. The number of participants in the latter pilot work is reassuringly consistent with the sample size calculations. The number needed to be included is far less (34%) than the actual number of patients treated with PTH in the recruiting departments in a similar time period last year.

Statistical Methods:

STATA/SPSS will be used for data analysis. For the primary endpoint (BMD at 12 months) the mean percentage changes in BMD between the two groups will be compared using Analysis of Variance (ANOVA) provided the distribution is normal. For the other endpoints parametric tests will be used to assess differences in the two groups for normally distributed data and non-parametric tests for data not normally distributed.

The randomization will be done online in the data capture program Red Cap. There will be created a Data dictionary that contains detailed descriptions of each variable used by the registry, including the source of the variable, and normal ranges if relevant.

Information:

Participants will be recruited during their attendance at the outpatient clinics. At that time the subjects will be given a full explanation of the study as well as the patient information sheet and invited to participate in the study. At an interval of not less than 24 hours, patients will be invited to consent prior to starting their PTH treatment.

The information will be sufficient for subjects to make an informed decision about their participation in this study. The subject will complete and sign a consent form to indicate they are giving valid consent to participate in the trial.

Withdrawal of Subjects:

Patients who withdraw consent from participation in the trial will be withdrawn from the trial. This will not affect their standard medical management and not cause any adverse effect on the subject.

Conditions
Osteoporosis
Being tested
whole-body vibration, teriparatide
Keywords
whole body vibration, PTH
Medical subject headings
Osteoporosis

What participants receive

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

  • whole-body vibrationOther

    Also called vibration therapy

    Whole-body vibration on vibration platforms. 30-40 Hertz, from 2 mm (low) to 4 mm (high) amplitude,

    1 minutes x 6 with 1 minute break between. 3 times a week.

  • teriparatideDrug

    Also called PTH

    Teriparatide, 20 microgram/day. 24 months of treatment.

Study groups in NCT02563353
Study groupRoleWhat they receive
controlgroupActive comparatorTeriparatide, 20 microgram/day. 24 months of treatment
Receives: Drug: teriparatide
studygroup 1ExperimentalTeriparatide, 20 microgram/day. 24 months of treatment. 12 months of Whole-body vibration on vibration platforms.
Receives: Other: whole-body vibration; Drug: teriparatide
studygroup 2ExperimentalTeriparatide, 20 microgram/day. 24 months of treatment. 24 months of Whole-body vibration on vibration platforms
Receives: Other: whole-body vibration; Drug: teriparatide

What is being measured

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

  1. Changes in the BMD, Bone Mineral Density of hip and spine region (Hologic DXA machine)

    DXA scan of hip and spine regions, BMD (g/cm^2)

    Measured: at the time the participants start treatment and in an interval as close as possible to after 6, 12, 18, 24 months from baseline

Secondary outcomes (13)
  1. Changes in the Bone microarchitecture at the tibia

    HRpQCT assesses parameters of bone microarchitecture at the tibia.

    Measured: at the time the participants start treatment and in an interval as close as possible to after 6, 12, 18 and 24 months from baseline

  2. Changes in the Bone microarchitecture at the radius

    HRpQCT assesses parameters of bone microarchitecture at the radius.

    Measured: at the time the participants start treatment and in an interval as close as possible to after 6, 12, 18 and 24 months from baseline

  3. changes in muscle mass

    Full body DXA

    Measured: at the time the participants start treatment and in an interval as close as possible to after 12 and 24 months from baseline

  4. Changes from baseline in the markers of bone resorption

    CTX, sclerostin

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3, 6, 12, 18, 24 months from baseline

  5. Changes from baseline in the markers of bone formation

    P1NP

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3, 6, 12, 18, 24 months from baseline

  6. Changes in Muscle strength

    Measurements of muscle strength (leg extensor power)

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3,6,12,18 and 24 months from baseline

  7. Changes in handgrip strength

    Measurements of muscle strength (handgrip strength)

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3,6,12,18 and 24 months from baseline

  8. Changes in Balance

    Short Physical Performance Battery (SPPB)

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3, 6 ,12, 18 and 24 months from baseline

  9. Adherence to WBV

    Self Reporting training log

    Measured: During 2 years from the start of the treatment

  10. Changes in physical activity

    IPAQ short version

    Measured: at the time the participants start treatment and in an interval as close as possible to after 12, and 24 months from baseline

  11. Changes in quality of life

    EQ5D questionaire.

    Measured: at the time the participants start treatment and in an interval as close as possible to after 12, and 24 months from baseline

  12. Changes in basic mobility

    Time up and go test

    Measured: at the time the participants start treatment and in an interval as close as possible to after 3,6,12,18 and 24 months from baseline

  13. Changes in The Falls Efficacy Scale International

    FES-I

    Measured: at the time the participants start treatment and in an interval as close as possible to after 12, and 24 months from baseline

Timeline

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

  1. First posted30 Sep 2015 (estimated)
  2. Study startNov 2015
  3. Primary completionNov 2018
  4. Study completionNov 2019

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02563353
Sponsor's protocol ID
S-20150121
Acronym
PaVOS
Status last verified
Sep 2020
First submitted
15 Sep 2015
Last updated
18 Sep 2020
Results posted
No
Data monitoring committee
Yes

Publications

  • O'Neill TW, Cockerill W, Matthis C, Raspe HH, Lunt M, Cooper C, Banzer D, Cannata JB, Naves M, Felsch B, Felsenberg D, Janott J, Johnell O, Kanis JA, Kragl G, Lopes Vaz A, Lyritis G, Masaryk P, Poor G, Reid DM, Reisinger W, Scheidt-Nave C, Stepan JJ, Todd CJ, Woolf AD, Reeve J, Silman AJ. Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int. 2004 Sep;15(9):760-5. doi: 10.1007/s00198-004-1615-4. Epub 2004 May 12.

    PubMed 15138664
  • Cockerill W, Lunt M, Silman AJ, Cooper C, Lips P, Bhalla AK, Cannata JB, Eastell R, Felsenberg D, Gennari C, Johnell O, Kanis JA, Kiss C, Masaryk P, Naves M, Poor G, Raspe H, Reid DM, Reeve J, Stepan J, Todd C, Woolf AD, O'Neill TW. Health-related quality of life and radiographic vertebral fracture. Osteoporos Int. 2004 Feb;15(2):113-9. doi: 10.1007/s00198-003-1547-4. Epub 2003 Nov 13.

    PubMed 14618303
  • Tosteson AN, Gabriel SE, Grove MR, Moncur MM, Kneeland TS, Melton LJ 3rd. Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos Int. 2001 Dec;12(12):1042-9. doi: 10.1007/s001980170015.

    PubMed 11846331
  • Borgstrom F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Lunsjo K, Thorngren KG, Sernbo I, Rehnberg C, Jonsson B. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006;17(5):637-50. doi: 10.1007/s00198-005-0015-8. Epub 2005 Nov 9.

    PubMed 16283064
  • Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007 Mar;22(3):465-75. doi: 10.1359/jbmr.061113.

    PubMed 17144789
  • Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001 May 10;344(19):1434-41. doi: 10.1056/NEJM200105103441904.

    PubMed 11346808
  • Blick SK, Dhillon S, Keam SJ. Teriparatide: a review of its use in osteoporosis. Drugs. 2008;68(18):2709-37. doi: 10.2165/0003495-200868180-00012.

    PubMed 19093708
  • Bergmann P, Body JJ, Boonen S, Boutsen Y, Devogelaer JP, Goemaere S, Kaufman J, Reginster JY, Rozenberg S. Loading and skeletal development and maintenance. J Osteoporos. 2010 Dec 20;2011:786752. doi: 10.4061/2011/786752.

    PubMed 21209784
  • Lewis RD, Modlesky CM. Nutrition, physical activity, and bone health in women. Int J Sport Nutr. 1998 Sep;8(3):250-84. doi: 10.1123/ijsn.8.3.250.

    PubMed 9738135
  • Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010 Feb;46(2):294-305. doi: 10.1016/j.bone.2009.10.005. Epub 2009 Oct 17.

    PubMed 19840876
  • Chow JW, Fox S, Jagger CJ, Chambers TJ. Role for parathyroid hormone in mechanical responsiveness of rat bone. Am J Physiol. 1998 Jan;274(1):E146-54. doi: 10.1152/ajpendo.1998.274.1.E146.

    PubMed 9458760
  • Li J, Duncan RL, Burr DB, Gattone VH, Turner CH. Parathyroid hormone enhances mechanically induced bone formation, possibly involving L-type voltage-sensitive calcium channels. Endocrinology. 2003 Apr;144(4):1226-33. doi: 10.1210/en.2002-220821.

    PubMed 12639904
  • Roberts MD, Santner TJ, Hart RT. Local bone formation due to combined mechanical loading and intermittent hPTH-(1-34) treatment and its correlation to mechanical signal distributions. J Biomech. 2009 Nov 13;42(15):2431-8. doi: 10.1016/j.jbiomech.2009.08.030. Epub 2009 Sep 26.

    PubMed 19782988
  • Wysocki A, Butler M, Shamliyan T, Kane RL. Whole-body vibration therapy for osteoporosis: state of the science. Ann Intern Med. 2011 Nov 15;155(10):680-6, W206-13. doi: 10.7326/0003-4819-155-10-201111150-00006.

    PubMed 22084334
  • Gusi N, Raimundo A, Leal A. Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial. BMC Musculoskelet Disord. 2006 Nov 30;7:92. doi: 10.1186/1471-2474-7-92.

    PubMed 17137514

Questions about this trial

What is this clinical trial studying?

A study testing whole-body vibration and teriparatide in people with Osteoporosis, run by Odense University Hospital at 1 site in Denmark.

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 4 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 18 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. 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.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Changes in the BMD, Bone Mineral Density of hip and spine region (Hologic DXA machine) (time frame: at the time the participants start treatment and in an interval as close as possible to after 6, 12, 18, 24 months from baseline). 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 NCT02563353, which also lists 44 linked publications.

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 18 Sep 2020.

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