Study of Oral Recombinant Salmon Calcitonin (rsCT) to Prevent Postmenopausal Osteoporosis

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Tarsa Therapeutics, Inc.
ClinicalTrials.gov Identifier:
NCT01292187
First received: February 7, 2011
Last updated: July 12, 2012
Last verified: July 2012
  Purpose

The primary purpose of this study is to evaluate the efficacy of rsCT oral tablets in the prevention of bone loss in postmenopausal women with lower bone mineral density at increased risk of fracture. The secondary purpose of this study is to compare the safety and tolerability of rsCT oral tablets to placebo and to compare the safety and tolerability of rsCT oral tablets administered at dinner, compared to administration at bedtime.


Condition Intervention Phase
Osteoporosis, Postmenopausal
Drug: Recombinant Salmon Calcitonin
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Prevention
Official Title: A Randomized, Double-blind, Placebo-controlled Clinical Trial Evaluating the Safety and Efficacy of Oral Recombinant Salmon Calcitonin (rsCT) in the Prevention of Postmenopausal Osteoporosis in Women at Increased Risk of Fracture

Resource links provided by NLM:


Further study details as provided by Tarsa Therapeutics, Inc.:

Primary Outcome Measures:
  • Effect of rsCT compared to placebo on BMD of the lumbar spine, as assessed by DXA at Week 54. [ Time Frame: Week 54 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Effect of rsCT compared to placebo on various areas of the body. [ Time Frame: Weeks 28 and 54 ] [ Designated as safety issue: Yes ]
    • Effect of rsCT compared to placebo on BMD of the femoral neck, trochanter, and total hip, as assessed by DXA at Week 54.
    • Effect of rsCT compared to placebo on BMD of the lumbar spine, as assessed by DXA at Week 28.
    • Effect of rsCT compared to placebo on BMD of the femoral neck, trochanter, and total hip, as assessed by DXA at Week 28.
    • Effect of rsCT compared to placebo on CTx-1, a marker of bone resorption, at Weeks 28 and 54.


Enrollment: 129
Study Start Date: January 2011
Study Completion Date: July 2012
Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: rsCT tablets
Tablets containing 200 μg of recombinant salmon calcitonin, for oral administration.
Drug: Recombinant Salmon Calcitonin
Subjects randomized to the oral calcitonin treatment group will receive at each visit a sufficient supply of rsCT tablets (200 μg) to last until the next visit. Subjects randomized to the placebo group will receive at each visit a sufficient supply of placebo tablets to last until the next visit. Subjects will be instructed to refrigerate the treatment and placebo tablets. Subjects will take one study medication tablet daily, at bedtime or at dinner as instructed. They will be advised that these are coated, enteric-release tablets and cannot be chewed, broken, ground or mixed with applesauce or other food. The bedtime dose will be administered on an empty stomach, i.e., without food in the preceding 2 hours and until the following morning.
Other Name: rsCT
Placebo Comparator: Placebo tablets
Identical appearing placebo tablets, without active ingredient (rsCT)
Drug: Recombinant Salmon Calcitonin
Subjects randomized to the oral calcitonin treatment group will receive at each visit a sufficient supply of rsCT tablets (200 μg) to last until the next visit. Subjects randomized to the placebo group will receive at each visit a sufficient supply of placebo tablets to last until the next visit. Subjects will be instructed to refrigerate the treatment and placebo tablets. Subjects will take one study medication tablet daily, at bedtime or at dinner as instructed. They will be advised that these are coated, enteric-release tablets and cannot be chewed, broken, ground or mixed with applesauce or other food. The bedtime dose will be administered on an empty stomach, i.e., without food in the preceding 2 hours and until the following morning.
Other Name: rsCT

Detailed Description:

Calcitonin (CT) is a 32 amino-acid peptide hormone secreted by the parafollicular cells (C cells) of the thyroid gland in mammals. It inhibits bone resorption and is regulated by circulating concentrations of calcium. Salmon calcitonin (sCT) is more potent than the human form. Synthetic salmon calcitonin (ssCT) is currently available in the US for subcutaneous, intramuscular, intravenous, and nasal administration for treatment of Paget's disease, hypercalcemia, and osteoporosis. The identical r-DNA version of sCT is available in the US as a nasal spray for the treatment of postmenopausal osteoporosis. It is characterized as an anti-resorptive agent. Side-effects of sCT are minimal apart from nausea and vomiting, and those are usually resolved with continued dosing. The use of calcitonin is limited by the currently available routes of administration (injections and nasal spray). Tarsa Therapeutics, Inc. is developing oral recombinant salmon calcitonin for the treatment of postmenopausal osteoporosis.

  Eligibility

Ages Eligible for Study:   45 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Female and at least 45 years of age.
  • Must have undergone the onset of spontaneous or surgical menopause more than 5 years prior to entry. Spontaneous menopause is defined as 12 months of spontaneous amenorrhea. Surgical menopause is defined as ≥ 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy.
  • Serum follicle-stimulating hormone (FSH) levels must be ≥ 30 mIU/mL.
  • A body mass index (BMI) of not greater than 35 (BMI =weight [kg]/height[m]2).
  • Bone mineral density (BMD) T-score between -1.0 and -2.5 at the total hip, femoral neck, trochanter, or lumbar spine.
  • Additional risk factors such that the 10 year risk of a major osteoporotic fracture or hip fracture risk is at least as great as a 65-year-old woman of the same race and BMI of 25 kg/m2 as determined by the FRAX algorithm .
  • No clinically significant abnormal findings in the medical history or physical exam that would preclude participation in the investigator's opinion.
  • No clinically significant abnormal laboratory values at the screening assessment.
  • Subjects must give written informed consent after reading the Subject Information and Consent Form and having had the opportunity to discuss the study with the investigator.

Exclusion Criteria:

  • History of an osteoporotic fracture, defined as a fracture at the wrist, hip, or humerus occurring from a fall at standing height or less.
  • BMD T-Score at any site ≤ -2.5.
  • Current treatment (or within 3 months prior to randomization) with hormone replacement therapy.
  • History of metabolic and other bone diseases, including osteogenesis imperfecta, osteomalacia, and Paget's disease.
  • Vitamin D insufficiency defined as a 25 hydroxyvitamin D level < 20 ng/mL (50 nmol/L).
  • Prior use of calcitonin, ever.
  • Prior use of any bisphosphonate, ever.
  • Prior use of denosumab, fluoride, or strontium, ever.
  • Prior use of parathyroid hormone analogs, ever.
  • Any condition or disease that may interfere with the ability to have a dual energy x-ray absorptiometry (DXA) scan or to evaluate a DXA scan, for example, severe osteoarthritis of the spine, spinal fusion, pedicle screws, history of vertebroplasty, or degenerative disease that results in insufficient number of evaluable lumbar vertebrae, bilateral hip replacements.
  • Use of anabolic steroids or androgens within 6 months preceding randomization.
  • Use of vitamin D metabolites and analogs, (e.g., calcitriol) within 3 months preceding randomization). Note: Vitamin D supplementation is not exclusionary.
  • Use of estrogen or estrogen-related drugs (including selective estrogen receptor molecules), for example, tamoxifen, tibolone, or raloxifene within 3 months preceding randomization.
  • Chronic systemic treatment with glucocorticoids.
  • Clinically relevant abnormal history, physical findings, or laboratory values at the pre-study screening assessment that could interfere with the objectives of the study or the safety of the subject.
  • Presence of acute or chronic illness or history of chronic illness which, in the judgment of the investigator, makes participation in the study medically inappropriate.
  • Known acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) seropositivity.
  • Uncontrolled hypertension, significant gastrointestinal abnormalities, uncontrolled diabetes mellitus, significant coronary heart disease, any psychotic mental illness, chronic allergic rhinitis, asthma, uncorrected endocrine dysfunction, or significantly impaired hepatic, respiratory, or renal function.
  • Participation in any other clinical study within the previous month.
  • History of drug or alcohol abuse, or intake of more than 30 units of alcohol weekly.
  • Possibility that the subject will not cooperate with the requirements of the protocol.
  • Known sensitivity to sCT.
  • Shift workers-individuals who are at work during overnight hours.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01292187

Locations
United States, California
Diablo Clinical Research, Inc.
Walnut Creek, California, United States, 94598
United States, Florida
Innovative Research of West Florida, Inc.
Clearwater, Florida, United States, 33756
United States, Maryland
Bethesda Health Research
Bethesda, Maryland, United States, 20817
United States, Massachusetts
Clinical Pharmacology Study Group
Worcester, Massachusetts, United States, 01610
United States, Michigan
Michigan Bone and Mineral Clinic
Detroit, Michigan, United States, 48236
United States, Missouri
The Osteoporosis Center at St. Luke's Hospital
Chesterfield, Missouri, United States, 63107
United States, New Jersey
Comprehensive Clinical Research
Berlin, New Jersey, United States, 08009
United States, Pennsylvania
University of Pittsburgh - Department of Neurology
Pittsburgh, Pennsylvania, United States, 15213
United States, Washington
Puget Sound Osteoporosis Center
Seattle, Washington, United States, 98144
United States, Wisconsin
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, United States, 53705
Sponsors and Collaborators
Tarsa Therapeutics, Inc.
Investigators
Study Director: David S. Krause, MD Chief Medical Officer - Tarsa Therapeutics, Inc.
  More Information

Additional Information:
No publications provided

Responsible Party: Tarsa Therapeutics, Inc.
ClinicalTrials.gov Identifier: NCT01292187     History of Changes
Other Study ID Numbers: TAR-01-201
Study First Received: February 7, 2011
Last Updated: July 12, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by Tarsa Therapeutics, Inc.:
Osteoporosis
Osteopenia
Osteoporosis, Postmenopausal
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases
Salmon calcitonin
Calcitonin

Additional relevant MeSH terms:
Osteoporosis
Osteoporosis, Postmenopausal
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases
Salmon calcitonin
Calcitonin
Calcitonin Gene-Related Peptide
Bone Density Conservation Agents
Physiological Effects of Drugs
Pharmacologic Actions
Vasodilator Agents
Cardiovascular Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on August 21, 2014