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Hip FracturesPhase 2HIP-SAPNCT03545347

Physiotherapy, Nutritional Supplement and Anabolic Steroids in Rehabilitation of Patients With Hip Fracture.

A Phase 2 study testing Nandrolone Decanoate, Protein-rich nutritional supplement and Physical therapy in people with Hip Fractures, run by Morten Tange Kristensen PT, PhD 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

This pilot trial investigates the preliminary effect and safety of a 12 week multi-modal intervention initiated during admission in the acute ward after hip fracture surgery. The intervention under investigation is a combination therapy consisting of physiotherapy, protein-rich nutritional supplement and nandrolone… Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Hip Fractures
What is being tested?
Nandrolone Decanoate, Protein-rich nutritional supplement and Physical therapy
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
29 participants
Where
1 siteDenmark
Study dates
3 Sep 2018to 3 Jun 2020
Phase
Phase 2
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 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients who have undergone surgery for a hip fracture at Amager-Hvidovre University Hospital and admitted at the Hip Fracture Unit at the hospital
  • Age >=60 years
  • Ability to speak and understand Danish and with a Danish Social Security Number
  • Able to give written informed consent
  • Residing at home and with an independent pre-fracture indoor walking ability (NMS≥2)

Who cannot join

  • Postoperative weight-bearing restrictions
  • Multiple fractures
  • Active cancer or suspected pathological fracture
  • Patients unable/unwilling to cooperate to testing and rehabilitation
  • Planned/elective hospitalization within the trial period.
  • Cognitive dysfunction determined by chart review, reported by nursing staff, or observed by trained research staff (disoriented, dementia, active delirium)
Show all 16Show fewer
  • Uncontrolled blood pressure (systolic > 150 mmHg, or diastolic > 100 mmHg)
  • Heart disease in the form of peri-, myo- or endocarditis.
  • History of stroke with motor disability.
  • Heart failure (NYHA class III and IV)
  • Evidence of kidney failure or renal impairment (estimated glomerular filtration rate < 30 mL/min/1.73 m2 or serum creatinine >200μmol/L)
  • Abnormal liver function tests (alanine aminotransferase, γ-glutamyltransferase, bilirubin, or alkaline phosphatase >2 times the upper limit of normal) or history of hepatic tumor.
  • Elevated hematocrit ≥ 50%
  • History of breast or prostate cancer
  • Abnormally elevated serum PSA assesed at the 3 week control corresponding to PSA < 4.0 µg/L (60-70 years), PSA < 5.0 µg/L (>70 years).
  • Allergic to any ingredient in the Deca-Durabolin solution (Nandrolone, benzyl alcohol, arachis oil (peanut-oil) and allergy to peanuts or soya) or milk protein allergy (related to the nutritional drink).

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Hvidovre Hospital

    Hvidovre, 2650

Other trials in Denmark

About this study

Official title: Preliminary Effect and Safety of Physiotherapy With Strength Training and Protein-rich Nutritional Supplement in Combination With Anabolic Steroids in Cross-continuum Rehabilitation of Patients With Hip Fracture - a Randomized Controlled Pilot Trial. (The HIP-SAP Trial)

This pilot trial investigates the preliminary effect and safety of a 12 week multi-modal intervention initiated during admission in the acute ward after hip fracture surgery. The intervention under investigation is a combination therapy consisting of physiotherapy, protein-rich nutritional supplement and nandrolone decanoate (Deca-Durabolin) supplement. The investigators expect the combination therapy to be a preliminary effective and safe treatment in elderly patients with hip fracture and that this combination therapy intervention program is more efficacious in improving muscle strength, and physical function 14 weeks after hip fracture surgery, compared to physiotherapy, protein-rich nutritional supplement plus placebo.

Conditions
Hip Fractures
Being tested
Nandrolone Decanoate, Protein-rich nutritional supplement, Physical therapy, Sodium Chloride 9mg/ml Injection
Keywords
Rehabilitation, Physiotherapy, Strength training, Anabolic steroids, Nutritional supplement
Medical subject headings
Hip Fractures

What participants receive

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

  • Nandrolone DecanoateDrug

    Also called Deca-durabolin, anabolic steroid

    Injections every 3 weeks, last injection at week 12. Women 50 mg, men with total testosterone ≥ 11 nmol/l will receive 100 mg, and men with total testosterone < 11 nmol/l will receive a dose of 200 mg.

  • Protein-rich nutritional supplementDietary supplement

    Also called Nestle Resource fiber 2.0

    The protein-rich nutritional supplement is a liquid containing 18 g milk-based protein pr bottle. Patients will receive a minimum of 1.35 g/kg bodyweight/day); which means that most patients will receive 2 bottles per day for 12 weeks.

  • Physical therapyOther

    Also called Physiotherapy

    The physical therapy intervention will include progressive strength training initiated daily on weekdays during hospitalization and continued twice per week in the outpatient rehabilitation program in the municipality (treatment as usual but with strength training as an obligatory component) for a total intervention period of 12 weeks from time of inclusion.

  • Sodium Chloride 9mg/ml InjectionDrug

    Also called Saline

    Placebo injection of 1 ml Sodium Chloride

Study groups in NCT03545347
Study groupRoleWhat they receive
Nandrolone DecanoateExperimentalPhysical therapy with strength training, protein-rich nutritional supplement plus Nandrolone decanoate.
Receives: Drug: Nandrolone Decanoate; Dietary Supplement: Protein-rich nutritional supplement; Other: Physical therapy
Placebo (Sodium Chloride)Placebo comparatorPhysical therapy with strength training, protein-rich nutritional supplement plus placebo.
Receives: Dietary Supplement: Protein-rich nutritional supplement; Other: Physical therapy; Drug: Sodium Chloride 9mg/ml Injection

What is being measured

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

  1. Change in maximal isometric knee-extension strength (Nm/Kg) in the fractured limb.

    Measured using a belt fixed handheld dynamometer.

    Measured: Baseline and 14 weeks after inclusion

Secondary outcomes (44)
  1. Maximal isometric knee-extension strength (Nm/Kg) in the fractured limb in % of the non-fractured limb

    Measured using a belt fixed handheld dynamometer.

    Measured: Baseline and 14 weeks after inclusion

  2. Maximal isometric knee-extension strength (Nm/Kg) in the non-fractured limb.

    Measured using a belt fixed handheld dynamometer.

    Measured: Baseline and 14 weeks after inclusion.

  3. Hand-grip strength in the dominant hand.

    Measured using a handheld dynamometer, expressed in kg.

    Measured: Baseline and 14 weeks after inclusion.

  4. Bone mineral density (BMD)

    Registration of total body, total hip, femoral neck, lumbar spine. Assessed by Dual-energy X-ray absorptiometry (DEXA), expressed in g/cm2. Further the T-score is registered. The DEXA is conducted in accordance with the department's standard procedures.

    Measured: Baseline and 14 weeks after inclusion.

  5. Lean body mass (LBM)

    Registration of total body, legs bilaterally, arms bilaterally. Assessed by DEXA and expressed in kg.

    Measured: Baseline and 14 weeks after inclusion.

  6. Fat mass

    Total body. Assessed by DEXA and expressed in kg.

    Measured: Baseline and 14 weeks after inclusion.

  7. Nutrition screening using the Mini Nutritional Assessment Short Form (MNA-SF).

    Total score from 0-14 points, high scores indicating better nutritional status

    Measured: Baseline (prefracture) and 14 weeks after inclusion.

  8. Gait speed will be assessed using the 10 meter walk test (10mWT)

    The results reported in meters walked per second (m/s).

    Measured: Baseline and 14 weeks after inclusion.

  9. Timed up and go test (TUG)

    Performed using a 4 wheeled rollator and measured in seconds. The patient has to rise from a chair, walk 3 meters, turnaround, walk back and sit down.

    Measured: Baseline and 14 weeks after inclusion.

  10. The de Mortons Mobility Index (DEMMI)

    Measures mobility and consists of 15 mobility items ranging from mobility in bed to dynamic balance. The test results in a total score from 0 to 100 with 100 representing the highest level of mobility.

    Measured: Baseline and 14 weeks after inclusion.

  11. Upright time

    Assessed by using a body-worn accelerometer-based activity monitor (ActivePAL). The monitor will be attached to the thigh. The patient will wear the monitor for 7 days.

    Measured: Measured from the time of the control week 12 and one week ahead.

  12. Functional level is assessed by the New Mobility Score (NMS).

    The patients are interviewed about walking ability indoor, outdoor and when shopping. the week prior to hospital admission. The total score range from 0 to 9. A Higher score indicating higher independence.

    Measured: Baseline (prefracture) and 3/6/9/12/14 weeks after inclusion.

  13. The EQ-5D-3L is used for assessing health related quality of life.

    It is administered via interview.

    Measured: Baseline (prefracture) and 14 weeks after inclusion

  14. Hip fracture related pain at rest and during outcome assessment

    It is evaluated by Verbal Ranking Scale (VRS). The patient expresses pain levels on a verbal scale from 0-4, higher score indicating higher pain levels.

    Measured: Baseline and 3/6/9/12/14 weeks after inclusion.

  15. Global Rating of Change Scale

    Assessment of patient perceived change in walking ability during the trial period.

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  16. The Short Falls Efficacy Scale-International (Short FES-I)

    Measures the patient's fear of falling (Score 7-28, higher scores indicating a higher fear of falling). It is administered as an interview.

    Measured: Baseline and 14 weeks after inclusion.

  17. Fatigue is assessed using the Short Form (36) Health Survey (SF36) vitality subscale.

    The scale consists of 4 items related to fatigue/energy. Score range from 0-100 points; high score defines a more favorable health state. Administered as an interview.

    Measured: Baseline (prefracture), and 3/6/9/12/14 weeks after inclusion.

  18. Depression is assessed using the Geriatric Depression Scale (GDS-15)

    Administered as an interview. Score range 0-15.

    Measured: Baseline (prefracture) and 14 weeks after inclusion.

  19. Re-admissions

    Assessed through the medical journal/interviews.

    Measured: 14 weeks after inclusion.

  20. Residential status (including home care)

    Change in residential status and home care (help provided in the patients home). Assessed through the medical journal/interviews.

    Measured: Baseline (prefracture) and 14 weeks after inclusion.

  21. Mortality

    Assessed through the medical journal/Danish civil register.

    Measured: 14 weeks after inclusion.

  22. Falls

    Number of falls. Assessed through interviews

    Measured: Assessed through weekly telephone interviews and hospital visits at 3/6/9/12/14 weeks after inclusion.

  23. Total testosterone (nmol/l)

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  24. Luteinizing hormone (LH), IU/l

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  25. Follicle-stimulating hormone (FSH) IU/l

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  26. Sex hormone binding globulin (SHBG), nmol/l

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  27. Lipid profile (Total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride) mmol/l.

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  28. C-reactive protein (CRP), mg/l.

    Blood test

    Measured: Baseline and 14 weeks after inclusion.

  29. Hematocrit (B-Erythrocyte, vol.fr.)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  30. Hemoglobin

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  31. Creatinine

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  32. Carbamide

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  33. Sodium (Na+)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  34. Potassium (K+)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  35. Calcium

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  36. Liver tests (Albumin, Alanine aminotransferase (ALAT), γ-glutamyltransferase, Bilirubin)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  37. International Normalized Ratio (INR)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  38. Prostate Specific Antigen (PSA)

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  39. Glucose

    Safety parameter, blood test

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  40. Blood pressure

    Safety parameter, assessed using a 'Blood pressure monitor' (mmHg).

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  41. Facial hirsutism

    Change in facial hair assessed using the 2 face-related items of Ferriman-Galway Hirsutism Score.

    Measured: Baseline, and 3/6/9/12/14 weeks after inclusion.

  42. Hoarseness

    Change in voice, reported by patient or observed by interviewer (no specific score available for this evaluation).

    Measured: Assessed at baseline and through weekly telephone interviews and hospital visits at 3/6/9/12/14 weeks after inclusion.

  43. Other adverse events

    Assessed through interview, observation

    Measured: Assessed through weekly interviews and hospital visits at 3/6/9/12/14 weeks after inclusion.

  44. Edema in non-fractured leg

    Change in edema assessed through interview

    Measured: Assessed at baseline and through weekly interviews and hospital visits at 3/6/9/12/14 weeks after inclusion.

Timeline

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

  1. First posted4 Jun 2018
  2. Study start3 Sep 2018
  3. Primary completion20 May 2020
  4. Study completion3 Jun 2020

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
29 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03545347
Sponsor's protocol ID
HvidovreUH-HIP-SAP-1
Other IDs
2017-001543-13, 2017
Acronym
HIP-SAP
Status last verified
Feb 2021
First submitted
18 May 2018
Last updated
12 Feb 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hulsbaek S, Bandholm T, Ban I, Foss NB, Jensen JB, Kehlet H, Kristensen MT. Feasibility and preliminary effect of anabolic steroids in addition to strength training and nutritional supplement in rehabilitation of patients with hip fracture: a randomized controlled pilot trial (HIP-SAP1 trial). BMC Geriatr. 2021 May 20;21(1):323. doi: 10.1186/s12877-021-02273-z.

    PubMed 34016037
  • Hulsbaek S, Ban I, Aasvang TK, Jensen JB, Kehlet H, Foss NB, Bandholm T, Kristensen MT. Preliminary effect and feasibility of physiotherapy with strength training and protein-rich nutritional supplement in combination with anabolic steroids in cross-continuum rehabilitation of patients with hip fracture: protocol for a blinded randomized controlled pilot trial (HIP-SAP1 trial). Trials. 2019 Dec 23;20(1):763. doi: 10.1186/s13063-019-3845-y.

    PubMed 31870451

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nandrolone Decanoate, Protein-rich nutritional supplement and Physical therapy in people with Hip Fractures, run by Morten Tange Kristensen PT, PhD 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 5 inclusion and 16 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 12 Feb 2021. 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. 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?

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?

Change in maximal isometric knee-extension strength (Nm/Kg) in the fractured limb. (time frame: Baseline and 14 weeks after inclusion). 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 NCT03545347, which also lists 2 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 12 Feb 2021.

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