Effects of Anorexia Nervosa on Bone Mass in Adolescents
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| Study Type: | Interventional |
|---|---|
| Study Design: | Allocation: Randomized; Endpoint Classification: Efficacy Study; Intervention Model: Parallel Assignment; Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor); Primary Purpose: Treatment |
| Condition: |
Anorexia Nervosa |
| Interventions: |
Drug: Physiologic Estrogen/progesterone Other: Placebo |
Participant Flow
Recruitment Details
| Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations |
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|
Period of recruitment: 2003-2009. Location: Massachusetts General Hospital (Boston) and Hospital for Sick Children (Toronto). We screened 150 girls with anorexia nervosa (AN) (110 at MGH and 40 at SickKids) and 88 normal-weight controls 12-18 years. Following the screen, 110 AN and 40 controls were enrolled for the prospective study. |
Pre-Assignment Details
| Significant events and approaches for the overall study following participant enrollment, but prior to group assignment |
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| Reasons for enrolled participants being excluded from the trial before assignment to groups primarily included identification of exclusion criteria, loss of interest on the part of the participant, and loss to follow-up. |
Reporting Groups
| Description | |
|---|---|
| Physiologic Estrogen Replacement |
Mature girls with anorexia nervosa (bone age 15 or greater): Transdermal estradiol (100 mcg) with cyclic progesterone (days 1-10 of each month). Immature girls with anorexia nervosa (bone age less than 15 years): Ethinyl estradiol (3.75 mcg daily for the first 6 months, 7.5 mcg daily for the next 6 months, and 11.25 mcg daily for the final 6 months of the study |
| Placebo | Mature girls with anorexia nervosa with a bone age of 15 years of greater: Placebo patches; Immature girls with anorexia nervosa with a bone age of less than 15 years: Placebo pills |
Participant Flow: Overall Study
| Physiologic Estrogen Replacement | Placebo | |
|---|---|---|
| STARTED | 55 | 55 |
| COMPLETED | 31 | 30 |
| NOT COMPLETED | 24 | 25 |
| Physician Decision | 3 | 3 |
| Withdrawal by Subject | 10 | 10 |
| Lost to Follow-up | 11 | 12 |
Baseline Characteristics
Reporting Groups
| Description | |
|---|---|
| Physiologic Estrogen Replacement |
Mature girls with anorexia nervosa (bone age 15 or greater): Transdermal estradiol (100 mcg) with cyclic progesterone (days 1-10 of each month). Immature girls with anorexia nervosa (bone age less than 15 years): Ethinyl estradiol (3.75 mcg daily for the first 6 months, 7.5 mcg daily for the next 6 months, and 11.25 mcg daily for the final 6 months of the study |
| Placebo | Mature girls with anorexia nervosa with a bone age of 15 years of greater: Placebo patches; Immature girls with anorexia nervosa with a bone age of less than 15 years: Placebo pills |
| Total | Total of all reporting groups |
Baseline Measures
| Physiologic Estrogen Replacement | Placebo | Total | |
|---|---|---|---|
|
Number of Participants
[units: participants] |
55 | 55 | 110 |
|
Age
[units: participants] |
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| <=18 years | 55 | 55 | 110 |
| Between 18 and 65 years | 0 | 0 | 0 |
| >=65 years | 0 | 0 | 0 |
|
Age
[units: years] Mean ± Standard Deviation |
16.6 ± 1.6 | 16.3 ± 1.6 | 16.5 ± 0.2 |
|
Gender
[units: participants] |
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| Female | 55 | 55 | 110 |
| Male | 0 | 0 | 0 |
|
Region of Enrollment
[units: participants] |
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| United States | 55 | 55 | 110 |
Outcome Measures
| 1. Primary: | Percent Change in Spine Bone Density Over the Study Duration (18 Months) [ Time Frame: Baseline and 18 months ] |
| 2. Primary: | Change in Spine Bone Mineral Density Z-scores Over the Study Duration (18 Months) [ Time Frame: Baseline and 18 months ] |
| 3. Secondary: | Change in N-terminal Propeptide of Type 1 Procollagen (P1NP) Over the Study Duration (18 Months) [ Time Frame: Baseline and 18 months ] |
More Information
| Principal Investigators are NOT employed by the organization sponsoring the study. |
| There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. |
Limitations and Caveats
| Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data |
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| No text entered. |
Results Point of Contact:
Organization: Massachusetts General Hospital
phone: 617-726-3870
e-mail: aklibanski@partners.org
Publications of Results:
Publications automatically indexed to this study:
| Responsible Party: | Anne Klibanski, MD, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT00088153 History of Changes |
| Other Study ID Numbers: | DK062249, R01DK062249 |
| Study First Received: | July 20, 2004 |
| Results First Received: | July 6, 2011 |
| Last Updated: | October 6, 2011 |
| Health Authority: | United States: Food and Drug Administration |