Teriparatide (Forteo) in the Treatment of Patients With Postoperative Hypocalcemia - Full Text View

Sponsor:	M.D. Anderson Cancer Center
Collaborator:	Eli Lilly and Company
Information provided by:	M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:	NCT00623974

Purpose

Primary Objective:

-To identify the optimal dose of a seven-day course of twice-daily teriparatide as compared to standard therapy for hypocalcemia in patients after total thyroidectomy and/or extensive neck dissections (pharyngectomy, laryngectomy,unilateral, bilateral / central neck, mediastinal lymph node neck dissections), with which serum calcium will be raised to corrected serum calcium levels of 8-10.5mg/dL and maintained within this range until the end of the treatment course.

Condition	Intervention	Phase
Hypocalcemia	Drug: Teriparatide (Forteo) Drug: Calcium Drug: Calcitriol	Phase II

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	A Phase II Study of Short-Term Use of Teriparatide (Forteo) in the Treatment of Patients With Postoperative Hypocalcemia

Resource links provided by NLM:

MedlinePlus related topics: Calcium

Drug Information available for: Calcitriol Teriparatide Teriparatide acetate Calcium gluconate

U.S. FDA Resources

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:

Number of Patients With Success [ Time Frame: 2 - 7 days post-treatment ] [ Designated as safety issue: Yes ]
A patient "success" is defined as a normal calcium level (Ca>=8 and Ca<= 10.5) within 48 hours post-treatment initiation and a normal Ca level maintained through day 7 post-treatment initiation.

Enrollment:	7
Study Start Date:	May 2008
Study Completion Date:	June 2010
Primary Completion Date:	June 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Calcium + Calcitriol 1000 milligrams Calcium + 0.25 micrograms Calcitriol orally every 12 hours	Drug: Calcium 1000 milligrams by mouth (PO) Every 12 Hours Drug: Calcitriol 0.25 micrograms PO Every 12 Hours Other Name: Rocaltrol
Experimental: Teriparatide 20 mcg Teriparatide at 20 mcg; and 1000 milligrams Calcium + 0.25 micrograms Calcitriol orally every 12 hours	Drug: Teriparatide (Forteo) Subcutaneous Injection Every 12 Hours for 7 Days Other Names: Forteo PTH Parathyroid Hormone Drug: Calcium 1000 milligrams by mouth (PO) Every 12 Hours Drug: Calcitriol 0.25 micrograms PO Every 12 Hours Other Name: Rocaltrol
Experimental: Teriparatide 40 mcg Teriparatide at 40 mcg; and 1000 milligrams Calcium + 0.25 micrograms Calcitriol orally every 12 hours	Drug: Teriparatide (Forteo) Subcutaneous Injection Every 12 Hours for 7 Days Other Names: Forteo PTH Parathyroid Hormone Drug: Calcium 1000 milligrams by mouth (PO) Every 12 Hours Drug: Calcitriol 0.25 micrograms PO Every 12 Hours Other Name: Rocaltrol
Experimental: Teriparatide 60 mcg Teriparatide at 60 mcg; and 1000 milligrams Calcium + 0.25 micrograms Calcitriol orally every 12 hours	Drug: Teriparatide (Forteo) Subcutaneous Injection Every 12 Hours for 7 Days Other Names: Forteo PTH Parathyroid Hormone Drug: Calcium 1000 milligrams by mouth (PO) Every 12 Hours Drug: Calcitriol 0.25 micrograms PO Every 12 Hours Other Name: Rocaltrol

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Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patients who are scheduled for total thyroidectomy, and/or extensive neck dissections (pharyngectomy, laryngectomy, unilateral/bilateral/central neck, and/or mediastinal lymph node neck dissections).
Patients who develop, between 18-24 hours after surgery, hypocalcemia as defined by a corrected serum calcium <8.0mg/dL. [Corrected serum calcium (mg/dL) = Measured calcium + (4-albumin) x 0.8]

Exclusion Criteria:

Patients who have jejunal tubes
Patients <18 years old.
Treatment with teriparatide or calcitriol (Rocaltrol) within 1 month prior to surgery
Treatment with a bisphosphonate within 3 months prior to surgery
Hypercalcemia (corrected serum calcium >10.5mg/dL) or hypocalcemia (corrected serum calcium <8.4mg/dL) on preoperative labs (drawn within 21 days of surgery)
Paget's disease of bone
Elevated alkaline phosphatase > institutional upper limit of normal (ULN)
History of external beam irradiation to the skeleton
History of skeletal metastases
History of untreated gout
History of unstable angina pectoris
History of symptomatic orthostatic hypotension
Pregnancy (as screened by a serum/urine pregnancy test) or breast-feeding. Female subjects of childbearing potential must have a negative pregnancy test within 7 days of surgery. Postmenopausal women (absence of menses for 12 months) or women with history of hysterectomy or bilateral oophorectomy will not be required to have a pregnancy test. Male and female patients of reproductive potential must agree to utilize an effective form of contraception throughout the study period. The definition of effective contraception will be based on the judgment of the Investigator or designated associate.
Hepatic and renal dysfunction defined by the following parameters: (a) Serum AST (SGOT) and ALT (SGPT) > 3 times the institutional ULN, (b) Total serum bilirubin > 2 times the institutional ULN, (c) Serum creatinine > 1.5mg/dL or estimated creatinine clearance < 40mL/min
Psychiatric illness or social situation that would limit compliance with study requirements
Concomitant use of digoxin
Patients may not be receiving any other investigational agents or have participated in any investigational drug study within 28 days preceding the start of study treatment.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00623974

Locations

United States, Texas
UT MD Anderson Cancer Center
Houston, Texas, United States, 77030

Sponsors and Collaborators

M.D. Anderson Cancer Center

Eli Lilly and Company

Investigators

Principal Investigator:

Mimi Hu, MD

UT MD Anderson Cancer Center

More Information

Additional Information:

UT MD Anderson Cancer Center This link exits the ClinicalTrials.gov site

No publications provided

Responsible Party:	Mimi Hu, MD/Assistant Professor, U.T.M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:	NCT00623974 History of Changes
Other Study ID Numbers:	2006-0562
Study First Received:	February 14, 2008
Results First Received:	August 13, 2010
Last Updated:	June 27, 2011
Health Authority:	United States: Food and Drug Administration

Keywords provided by M.D. Anderson Cancer Center:

Hypocalcemia
Teriparatide
Forteo

Calcium
Calcitriol
Rocaltrol

Additional relevant MeSH terms:

Hypocalcemia
Calcium Metabolism Disorders
Metabolic Diseases
Water-Electrolyte Imbalance
Calcitriol
Calcium, Dietary
Teriparatide
Vitamins
Micronutrients
Growth Substances

Physiological Effects of Drugs
Pharmacologic Actions
Bone Density Conservation Agents
Calcium Channel Agonists
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Vasoconstrictor Agents
Cardiovascular Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on February 12, 2012