Zoledronic Acid Versus Alendronate for Prevention of Bone Loss After Organ Transplantation (CTX)
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Purpose
The purpose of this study is to compare the effectiveness and safety of zoledronic acid with alendronate in the prevention of bone loss after organ transplantation. Zoledronic acid is given as a single intravenous infusion. Alendronate is given as a weekly pill. Both are expected to be very effective, but it is not known which one will work best.
| Condition | Intervention | Phase |
|---|---|---|
|
Heart Transplantation Liver Transplantation Bone Resorption |
Drug: zoledronic acid Drug: alendronate |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Prevention |
| Official Title: | Zoledronic Acid Versus Alendronate for Prevention of Bone Loss After Organ Transplantation |
- total hip bone mineral density [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- lumbar spine bone mineral density [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- femoral neck bone mineral density [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- serum n-telopeptide (%) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
| Enrollment: | 84 |
| Study Start Date: | November 2005 |
| Estimated Study Completion Date: | January 2014 |
| Primary Completion Date: | April 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Group 1 will receive an infusion of active zoledronic acid 5 mg during the first 4 weeks after transplantation. Placebo alendronate 70 mg once weekly will be initiated at the same time as the first zoledronic acid infusion.
|
Drug: zoledronic acid
Drug is administered through 5 mg intravenous infusion over 20 minutes
Other Name: Zometa
|
|
Experimental: 2
Group 2 will receive an infusion of placebo during the first 5 weeks after transplantation. Active alendronate 70 mg once weekly will be initiated at the same time as the placebo infusion.
|
Drug: alendronate
Alendronate 70 mg will be taken once a week in the morning at least 30-60 minutes before first meal
Other Name: Fosamax
|
Detailed Description:
Patients who have undergone heart or liver transplantation are usually required to remain on medications, such as Prednisone and Cyclosporine A or Tacrolimus, that prevent the body from rejecting the transplanted organ. These medications may cause bone loss which leads to thinning of the bones (osteoporosis) and therefore greatly increase the risk of having broken bones (fractures) after transplantation. Several published studies have shown that 14% to 35% of heart transplant patients develop fractures (spine, ribs and hip) during the first year after transplantation. We have previously shown that alendronate (Fosamax), a drug approved by the FDA for prevention and treatment of postmenopausal osteoporosis and prednisone-induced osteoporosis, prevents bone loss after heart transplantation. We are conducting this study to determine whether a newer drug, zoledronic acid, is as effective as alendronate.
This study is a randomized, double-blind, placebo-controlled 2-year study. Participants will receive one dose of active zoledronic acid during the first month after heart or liver transplantation and weekly placebo alendronate pills or one dose of placebo zoledronic acid and weekly active alendronate pills for the first year after transplant. Over 2 years, participants will provide blood samples on nine occasions. Bone density will be performed 4-5 times and spine xrays will be performed twice.
Eligibility| Ages Eligible for Study: | 20 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- A man or woman, aged 20 to 70, of any race who has had a heart or liver transplant
Exclusion Criteria:
- hyperparathyroidism
- Paget's disease
- hyperthyroidism
- cancer
- severe kidney disease,
- intestinal disease
- active peptic ulcer disease
- current or past treatment for osteoporosis
- pregnancy or lactation
- severe oral/dental disease
Contacts and Locations| United States, New York | |
| Columbia University Medical Center | |
| New York, New York, United States, 10032 | |
| Principal Investigator: | Elizabeth Shane, M.D. | Columbia University |
More Information
Publications:
| Responsible Party: | Elizabeth Shane, Professor of Medicine, Endocrinology, Columbia University |
| ClinicalTrials.gov Identifier: | NCT00297830 History of Changes |
| Other Study ID Numbers: | AAAB2324, CZOL446H104 |
| Study First Received: | February 27, 2006 |
| Last Updated: | February 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Columbia University:
|
Heart Transplantation Liver Transplantation Immunosuppression Bone Density/drug effects |
Alendronate Zoledronic acid Comparative study Humans |
Additional relevant MeSH terms:
|
Bone Resorption Bone Diseases Musculoskeletal Diseases Zoledronic acid Alendronate |
Diphosphonates Bone Density Conservation Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013