Intravenous Bisphosphonate in Stress Fracture Treatment -A Randomised Controlled Double Blinded Multicenter Trial
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|ClinicalTrials.gov Identifier: NCT03576599|
Recruitment Status : Terminated (difficult to include patients)
First Posted : July 3, 2018
Last Update Posted : September 13, 2019
|Condition or disease||Intervention/treatment||Phase|
|Stress Fracture Foot Stress Fracture Ankle||Drug: Zoledronic Acid Injectable Product Drug: Placebo||Phase 4|
Randomised controlled multicenter trial. Prospective study. The trial will be performed in accordance with the CONSORT-statement. The inclusion period will be two years. The patients will be randomised to standard treatment (casting, partial weight-bearing, orthotic insoles) in addition to either zoledronic acid or placebo (saline) infusions. The randomization process will be carried out through a web based randomization service (Norwegian University of Science and Technology, Unit for applied clinical research). Patient data will be kept and organized by a study coordinator (nurse) and will not be revealed for the clincal investigators, except in medical emergency situations. In such cases, the patient will be excluded from the study. A number of bottles containing zoledronic acid or placebo will be available in each of the participating hospitals. The bottles containing zoledronic acid and placebo are visually identical, numbered from 1 through 80 (two bottles with similar number, the second bottle will be kept for the second infusion). The patients will be randomised in blocks, creating evenly sized groups given zoledronic acid or placebo. When a patient is included and thereafter randomised, the study coordinator decides which bottle number to be given and provides this information to the physician. The study coordinator is the only person in the study group which is not blinded.
On the first visit, the included patients will undergo clinical examination and baseline parameters will be registered. If MRI is not previously obtained, this will be performed as quickly as possible. The clinical controls will be scheduled 4 and 12 and 26 weeks thereafter, the latter including MRI. If healing has still not occured, the patients will be given the second infusion and meet for clinical examination every 4 weeks until healing. Clinical healing is defined as painless or near painless (VAS pain 0-2) weight bearing. If healing has not occured 12 months after inclusion, surgery will be considered.
MRI will be obtained at (or before) baseline, 6 months and one year. MRIs will be examined by a blinded radiologist. Bone marrow lesions (BMLs) will be measured (area and volume) and fracture lines registered.
All patients (both groups) will be prescribed calcium and vitamin D (Calcigran Forte 500mg/400IE) taken orally once daily in the whole study period. This is recommended as an adjunct to bisphosphonate treatment on a general basis/standard treatment and is not to be investigated separately.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||5 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Official Title:||Intravenous Bisphosphonate in Stress Fracture Treatment|
|Actual Study Start Date :||June 29, 2017|
|Actual Primary Completion Date :||June 26, 2019|
|Actual Study Completion Date :||June 26, 2019|
Active Comparator: Zoledronic Acid Injectable Product
Patients randomized to treatment with Zoledronic Acid 5mg infusion, repeated after 3 months
Drug: Zoledronic Acid Injectable Product
One Group are randomiced to Zoledronic Acid Injectable Product and one Group to Placebo
Other Name: Aclasta
Placebo Comparator: Placebo
Patients randomized to Placebo infusion (saline), repeated after 3 months
- The American Orthopedic Foot and Ankle Score (AOFAS) mid foot scale [ Time Frame: 1 year ]a scale evaluating pain, function and alignment of the foot. 0-100, With 100 as maximum score
- Visual analoge scale (VAS) for pain [ Time Frame: 3, 6, 8, 10 and 12 months ]Patient Reported Outcome Measure (PROM) for evaluating local pain
- Change in bone marrow lesions evaluated by magnetic resonance imaging (MRI) [ Time Frame: 1 year ]the intensity and the amount of bone marrow oedema is evaluated
- The American Orthopedic Foot and Ankle Score (AOFAS) mid foot scale [ Time Frame: 3, 6, 8, 10, 12 months ]a scale evaluating pain, function and alignment of the foot
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03576599
|Oslo University Hospital|
|Oslo, Norway, 0450|
|Study Chair:||Elisabeth E Husebye, PhD||Oslo University Hospital|