50 Participants Needed

Romosozumab + Teriparatide for Osteoporosis

(CAT Trial)

AP
Overseen ByAparna Patnaik, BA
Age: 18+
Sex: Female
Trial Phase: Phase 4
Sponsor: Massachusetts General Hospital
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how two medications, Romosozumab and Teriparatide (also known as Forteo), treat postmenopausal osteoporosis, a condition where bones weaken and become prone to fractures. The trial will test these medications separately and together to determine which is more effective. Women who have gone through menopause and have osteoporosis with a high risk of fractures may be suitable candidates for this trial. As a Phase 4 trial, this research focuses on understanding how these already FDA-approved and effective treatments can benefit more patients.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you have been using bone health treatments, you may not be eligible to participate.

What is the safety track record for these treatments?

Research has shown that romosozumab is generally safe for treating osteoporosis in postmenopausal women, though some concerns exist. Studies found that patients taking romosozumab experienced fewer fractures. However, a small increase in heart-related issues occurred, with about 2.5% of patients affected compared to 1.9% in a comparison group over a year.

For the combination of romosozumab and teriparatide, current evidence suggests both are safe for treating osteoporosis. Teriparatide has been used for a long time and is known to be effective and safe. When combined with romosozumab, both aim to strengthen bones.

Both medications have FDA approval, indicating they have passed strict safety checks for treating osteoporosis. However, discussing potential risks and benefits with a healthcare provider is always important before joining a clinical trial.12345

Why are researchers enthusiastic about this study treatment?

Researchers are excited about combining Romosozumab and Teriparatide for treating osteoporosis because these drugs work in a unique way compared to standard treatments like bisphosphonates. Romosozumab not only helps to increase bone formation but also decreases bone resorption, offering a dual action that is different from most current options that primarily slow bone loss. Teriparatide, on the other hand, stimulates new bone growth. By using them together, there's potential for a more robust approach to building stronger bones, addressing the condition from multiple angles. This innovative combination could lead to improved bone density and reduced fracture risk more effectively than existing treatments.

What evidence suggests that this trial's treatments could be effective for osteoporosis?

Research has shown that romosozumab, one of the treatments in this trial, effectively treats osteoporosis in postmenopausal women. Studies have found that it significantly improves bone mineral density (BMD), which is crucial for strong bones. One study revealed that romosozumab reduced the risk of new spine fractures by 73% compared to a placebo. Additionally, using romosozumab with teriparatide, another treatment option in this trial, has produced positive results. Specifically, patients who received both treatments experienced a significant increase in BMD in their lower back. These findings suggest that both romosozumab alone and in combination with teriparatide effectively improve bone health in osteoporosis.23567

Who Is on the Research Team?

BL

Benjamin Leder, MD

Principal Investigator

MGH

Are You a Good Fit for This Trial?

This trial is for postmenopausal women aged 45 and older who have osteoporosis with a high risk of fractures. Participants should not have used bone health treatments significantly before, nor should they have other bone diseases, serious kidney or liver issues, heart/lung problems, psychiatric disorders, abnormal calcium levels, severe vitamin D deficiency, anemia or a history of cancer (except skin cancer). They also shouldn't abuse alcohol or substances.

Inclusion Criteria

I am a woman aged 45 or older.
I have gone through menopause.
I have osteoporosis with a high risk of breaking bones.

Exclusion Criteria

I am allergic or react badly to romosozumab or teriparatide.
I have a bone condition that is not osteoporosis.
Anemia (hematocrit <32%)
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either romosozumab or a combination of romosozumab and teriparatide for the treatment of postmenopausal osteoporosis

12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Romosozumab
  • Teriparatide
Trial Overview The study is examining the effects of two FDA-approved medications for treating postmenopausal osteoporosis: Romosozumab and Teriparatide. It aims to understand how these drugs work in managing the condition and preventing fractures.
How Is the Trial Designed?
2Treatment groups
Active Control
Group I: RomosozumabActive Control1 Intervention
Group II: Romosozumab and TeriparatideActive Control2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials
3,066
Recruited
13,430,000+

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Collaborator

Trials
508
Recruited
1,090,000+

Published Research Related to This Trial

Romosozumab significantly reduces the incidence of new vertebral fractures in postmenopausal women with osteoporosis after just 12 months of treatment, showing strong efficacy compared to both placebo and active bisphosphonate controls.
However, there is a concerning numerical increase in cardiovascular events associated with romosozumab, suggesting it should be used cautiously, especially in patients with a history of cardiovascular issues or high cardiovascular risk.
Romosozumab: a Review of Efficacy, Safety, and Cardiovascular Risk.Fixen, C., Tunoa, J.[2021]
Romosozumab significantly improved bone mineral density (BMD) at the lumbar spine, total hip, and femoral neck compared to teriparatide, with notable improvements observed at both 6 and 12 months in a review of 4 studies involving 1304 patients.
Romosozumab had fewer injection-site reactions compared to teriparatide, and there were no significant differences in serious adverse events or mortality, indicating a favorable safety profile.
Romosozumab versus Teriparatide for the Treatment of Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis through a Grade Analysis of Evidence.Tian, A., Jia, H., Zhu, S., et al.[2023]
In a Phase II study involving 123 patients with relapsing forms of multiple sclerosis (MS), teriflunomide was found to be well tolerated as an add-on therapy to glatiramer acetate, with low rates of adverse events leading to treatment discontinuation.
Teriflunomide significantly reduced MRI markers of disease activity, showing a 64% relative reduction in T1-Gd lesions at the 7 mg dose compared to placebo, indicating its potential efficacy in managing MS.
A randomized trial of teriflunomide added to glatiramer acetate in relapsing multiple sclerosis.Freedman, MS., Wolinsky, JS., Truffinet, P., et al.[2020]

Citations

Real-World Evaluation of 12-Month Romosozumab ...Conclusions: This study demonstrated that 12 months of romosozumab treatment significantly improved BMD and bone turnover markers in ...
Romosozumab in osteoporosis: yesterday, today and tomorrowThe results demonstrated that romosozumab treatment increases LS BMD more effectively than denosumab treatment while not affecting RA disease ...
Global data show real-world effectiveness of romosozumab ...Romosozumab was associated with significant improvements in bone mineral density (BMD) at 12 months versus baseline in lumbar spine, total hip and femoral neck ...
Treatment effects, adverse outcomes and cardiovascular ...In conclusion, our study showed that romosozumab was an effective agent to treat osteoporosis with high quality evidence. There were no significant ...
Romosozumab Treatment in Postmenopausal Women with ...12-Month Fracture Efficacy. Romosozumab was associated with a risk of new vertebral fracture that was 73% lower than the risk with placebo at 12 ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39227560/
Cardiovascular Safety of Romosozumab Compared to ...Romosozumab might be a safe option for treating postmenopausal women with osteoporosis. The cardiovascular concerns associated with this treatment seem less ...
New warnings of romosozumab (Evenity) cardiovascular ...All-cause death occurred in 30 women (1.5%) in the romosozumab group and 22 women (1.1%) in the alendronate group. In the placebo-controlled ...
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