drugset / Trial / NCT02563353
PTH and Vibration in OSteoporosis Study
Completed
35 enrolled
Odense University Hospital
Copenhagen University Hospital, Denmark · collabEsbjerg Hospital - University Hospital of Southern Denmark · collabOdense Patient Data Explorative Network · collabRegion of Southern Denmark · collabSygehus Lillebaelt · collabUniversity of Southern Denmark · collab
RandomizedParallel-groupOpen-labelTreatment
Summary
Objective: This is a randomized controlled trial (RCT) in osteoporosis patients randomized to standard parathyroid hormone (PTH) treatment alone or to standard PTH treatment and Whole-body vibration (WBV). PTH is an effective but expensive anabolic treatment for osteoporosis. WBV stimulates muscles and bones. A combined treatment might have synergistic or additive beneficial effects on bone, reducing fracture risk making treatment more effective and cost-effective. A beneficial effect on muscles and thereby falls risk of WBV may improve fracture risk even further. If the results of this pilot study are promising then a strong case can be made for a large multi-centre RCT using strong endpoints including fractures and falls.
Timeline
- Start
- 2015-11
- Primary completion
- 2018-11
- Completion
- 2019-11
Publications
- Background O'Neill TW, Cockerill W, Matthis C, Raspe HH, Lunt M, Cooper C, Banzer D, Cannata JB, Naves M, Felsch B, Felsenberg D, Janott J, Johnell O, Kanis JA, Kragl G, Lopes Vaz A, Lyritis G, Masaryk P, Poor G, Reid DM, Reisinger W, Scheidt-Nave C, Stepan JJ, Todd CJ, Woolf AD, Reeve J, Silman AJ. Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int. 2004 Sep;15(9):760-5. doi: 10.1007/s00198-004-1615-4. Epub 2004 May 12.
- Background Cockerill W, Lunt M, Silman AJ, Cooper C, Lips P, Bhalla AK, Cannata JB, Eastell R, Felsenberg D, Gennari C, Johnell O, Kanis JA, Kiss C, Masaryk P, Naves M, Poor G, Raspe H, Reid DM, Reeve J, Stepan J, Todd C, Woolf AD, O'Neill TW. Health-related quality of life and radiographic vertebral fracture. Osteoporos Int. 2004 Feb;15(2):113-9. doi: 10.1007/s00198-003-1547-4. Epub 2003 Nov 13.
- Background Tosteson AN, Gabriel SE, Grove MR, Moncur MM, Kneeland TS, Melton LJ 3rd. Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos Int. 2001 Dec;12(12):1042-9. doi: 10.1007/s001980170015.
- Background Borgstrom F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Lunsjo K, Thorngren KG, Sernbo I, Rehnberg C, Jonsson B. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006;17(5):637-50. doi: 10.1007/s00198-005-0015-8. Epub 2005 Nov 9.
- Background Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007 Mar;22(3):465-75. doi: 10.1359/jbmr.061113.
- Background Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001 May 10;344(19):1434-41. doi: 10.1056/NEJM200105103441904.
- Background Blick SK, Dhillon S, Keam SJ. Teriparatide: a review of its use in osteoporosis. Drugs. 2008;68(18):2709-37. doi: 10.2165/0003495-200868180-00012.
- Background Bergmann P, Body JJ, Boonen S, Boutsen Y, Devogelaer JP, Goemaere S, Kaufman J, Reginster JY, Rozenberg S. Loading and skeletal development and maintenance. J Osteoporos. 2010 Dec 20;2011:786752. doi: 10.4061/2011/786752.
- Background Lewis RD, Modlesky CM. Nutrition, physical activity, and bone health in women. Int J Sport Nutr. 1998 Sep;8(3):250-84. doi: 10.1123/ijsn.8.3.250.
- Background Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010 Feb;46(2):294-305. doi: 10.1016/j.bone.2009.10.005. Epub 2009 Oct 17.
- Background Chow JW, Fox S, Jagger CJ, Chambers TJ. Role for parathyroid hormone in mechanical responsiveness of rat bone. Am J Physiol. 1998 Jan;274(1):E146-54. doi: 10.1152/ajpendo.1998.274.1.E146.
- Background Li J, Duncan RL, Burr DB, Gattone VH, Turner CH. Parathyroid hormone enhances mechanically induced bone formation, possibly involving L-type voltage-sensitive calcium channels. Endocrinology. 2003 Apr;144(4):1226-33. doi: 10.1210/en.2002-220821.
- Background Roberts MD, Santner TJ, Hart RT. Local bone formation due to combined mechanical loading and intermittent hPTH-(1-34) treatment and its correlation to mechanical signal distributions. J Biomech. 2009 Nov 13;42(15):2431-8. doi: 10.1016/j.jbiomech.2009.08.030. Epub 2009 Sep 26.
- Background Wysocki A, Butler M, Shamliyan T, Kane RL. Whole-body vibration therapy for osteoporosis: state of the science. Ann Intern Med. 2011 Nov 15;155(10):680-6, W206-13. doi: 10.7326/0003-4819-155-10-201111150-00006.
- Background Gusi N, Raimundo A, Leal A. Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial. BMC Musculoskelet Disord. 2006 Nov 30;7:92. doi: 10.1186/1471-2474-7-92.
- Background Cardinale M, Pope MH. The effects of whole body vibration on humans: dangerous or advantageous? Acta Physiol Hung. 2003;90(3):195-206. doi: 10.1556/APhysiol.90.2003.3.2.
- Background Cardinale M, Rittweger J. Vibration exercise makes your muscles and bones stronger: fact or fiction? J Br Menopause Soc. 2006 Mar;12(1):12-8. doi: 10.1258/136218006775997261.
- Background Cardinale M, Wakeling J. Whole body vibration exercise: are vibrations good for you? Br J Sports Med. 2005 Sep;39(9):585-9; discussion 589. doi: 10.1136/bjsm.2005.016857.
- Background Eisman JA. Good, good, good... good vibrations: the best option for better bones? Lancet. 2001 Dec 8;358(9297):1924-5. doi: 10.1016/S0140-6736(01)06975-6. No abstract available.
- Background Rubin C, Xu G, Judex S; New Collective Author. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli. FASEB J. 2001 Oct;15(12):2225-9. doi: 10.1096/fj.01-0166com.
- Background Xie L, Jacobson JM, Choi ES, Busa B, Donahue LR, Miller LM, Rubin CT, Judex S. Low-level mechanical vibrations can influence bone resorption and bone formation in the growing skeleton. Bone. 2006 Nov;39(5):1059-1066. doi: 10.1016/j.bone.2006.05.012. Epub 2006 Jul 7.
- Background Judex S, Lei X, Han D, Rubin C. Low-magnitude mechanical signals that stimulate bone formation in the ovariectomized rat are dependent on the applied frequency but not on the strain magnitude. J Biomech. 2007;40(6):1333-9. doi: 10.1016/j.jbiomech.2006.05.014. Epub 2006 Jun 30.
- Background Xie L, Rubin C, Judex S. Enhancement of the adolescent murine musculoskeletal system using low-level mechanical vibrations. J Appl Physiol (1985). 2008 Apr;104(4):1056-62. doi: 10.1152/japplphysiol.00764.2007. Epub 2008 Feb 7.
- Background Rubin C, Pope M, Fritton JC, Magnusson M, Hansson T, McLeod K. Transmissibility of 15-hertz to 35-hertz vibrations to the human hip and lumbar spine: determining the physiologic feasibility of delivering low-level anabolic mechanical stimuli to skeletal regions at greatest risk of fracture because of osteoporosis. Spine (Phila Pa 1976). 2003 Dec 1;28(23):2621-7. doi: 10.1097/01.BRS.0000102682.61791.C9.
- Background Bosco C, Iacovelli M, Tsarpela O, Cardinale M, Bonifazi M, Tihanyi J, Viru M, De Lorenzo A, Viru A. Hormonal responses to whole-body vibration in men. Eur J Appl Physiol. 2000 Apr;81(6):449-54. doi: 10.1007/s004210050067.
- Background Erskine J, Smillie I, Leiper J, Ball D, Cardinale M. Neuromuscular and hormonal responses to a single session of whole body vibration exercise in healthy young men. Clin Physiol Funct Imaging. 2007 Jul;27(4):242-8. doi: 10.1111/j.1475-097X.2007.00745.x.
- Background Fritton JC, Rubin CT, Qin YX, McLeod KJ. Whole-body vibration in the skeleton: development of a resonance-based testing device. Ann Biomed Eng. 1997 Sep-Oct;25(5):831-9. doi: 10.1007/BF02684167.
- Background Gilsanz V, Wren TA, Sanchez M, Dorey F, Judex S, Rubin C. Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res. 2006 Sep;21(9):1464-74. doi: 10.1359/jbmr.060612.
- Background Cardinale M, Lim J. Electromyography activity of vastus lateralis muscle during whole-body vibrations of different frequencies. J Strength Cond Res. 2003 Aug;17(3):621-4. doi: 10.1519/1533-4287(2003)0172.0.co;2.
- Background Hazell TJ, Kenno KA, Jakobi JM. Evaluation of muscle activity for loaded and unloaded dynamic squats during vertical whole-body vibration. J Strength Cond Res. 2010 Jul;24(7):1860-5. doi: 10.1519/JSC.0b013e3181ddf6c8.
- Background Roelants M, Verschueren SM, Delecluse C, Levin O, Stijnen V. Whole-body-vibration-induced increase in leg muscle activity during different squat exercises. J Strength Cond Res. 2006 Feb;20(1):124-9. doi: 10.1519/R-16674.1.
- Background Pollock RD, Woledge RC, Mills KR, Martin FC, Newham DJ. Muscle activity and acceleration during whole body vibration: effect of frequency and amplitude. Clin Biomech (Bristol). 2010 Oct;25(8):840-6. doi: 10.1016/j.clinbiomech.2010.05.004. Epub 2010 Jun 11.
- Background Russo CR, Lauretani F, Bandinelli S, Bartali B, Cavazzini C, Guralnik JM, Ferrucci L. High-frequency vibration training increases muscle power in postmenopausal women. Arch Phys Med Rehabil. 2003 Dec;84(12):1854-7. doi: 10.1016/s0003-9993(03)00357-5.
- Background Torvinen S, Kannu P, Sievanen H, Jarvinen TA, Pasanen M, Kontulainen S, Jarvinen TL, Jarvinen M, Oja P, Vuori I. Effect of a vibration exposure on muscular performance and body balance. Randomized cross-over study. Clin Physiol Funct Imaging. 2002 Mar;22(2):145-52. doi: 10.1046/j.1365-2281.2002.00410.x.
- Background Ward K, Alsop C, Caulton J, Rubin C, Adams J, Mughal Z. Low magnitude mechanical loading is osteogenic in children with disabling conditions. J Bone Miner Res. 2004 Mar;19(3):360-9. doi: 10.1359/JBMR.040129. Epub 2004 Jan 27.
- Background Tanaka SM, Alam IM, Turner CH. Stochastic resonance in osteogenic response to mechanical loading. FASEB J. 2003 Feb;17(2):313-4. doi: 10.1096/fj.02-0561fje. Epub 2002 Dec 3.
- Background Kerschan-Schindl K, Grampp S, Henk C, Resch H, Preisinger E, Fialka-Moser V, Imhof H. Whole-body vibration exercise leads to alterations in muscle blood volume. Clin Physiol. 2001 May;21(3):377-82. doi: 10.1046/j.1365-2281.2001.00335.x.
- Background Corrie H, Brooke-Wavell K, Mansfield NJ, Cowley A, Morris R, Masud T. Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls. Age Ageing. 2015 Jan;44(1):115-22. doi: 10.1093/ageing/afu136. Epub 2014 Oct 7.
- Background Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S. Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study. J Bone Miner Res. 2004 Mar;19(3):352-9. doi: 10.1359/JBMR.0301245. Epub 2003 Dec 22.
- Background Gomez-Cabello A, Ara I, Gonzalez-Aguero A, Casajus JA, Vicente-Rodriguez G. Effects of training on bone mass in older adults: a systematic review. Sports Med. 2012 Apr 1;42(4):301-25. doi: 10.2165/11597670-000000000-00000.
- Background Sitja Rabert M, Rigau Comas D, Fort Vanmeerhaeghe A, Santoyo Medina C, Roque i Figuls M, Romero-Rodriguez D, Bonfill Cosp X. Whole-body vibration training for patients with neurodegenerative disease. Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD009097. doi: 10.1002/14651858.CD009097.pub2.
- Jepsen DB, Masud T, Holsgaard-Larsen A, Hansen S, Jorgensen NR, Ryg J. The combined effect of parathyroid hormone (1-34) and whole-body vibration exercise on physical performance in OSteoporotic women (PaVOS study): a secondary analysis from a randomised controlled trial. BMC Sports Sci Med Rehabil. 2020 Sep 5;12:54. doi: 10.1186/s13102-020-00204-w. eCollection 2020.
- Jepsen DB, Ryg J, Hansen S, Jorgensen NR, Gram J, Masud T. The combined effect of Parathyroid hormone (1-34) and whole-body Vibration exercise in the treatment of postmenopausal OSteoporosis (PaVOS study): a randomized controlled trial. Osteoporos Int. 2019 Sep;30(9):1827-1836. doi: 10.1007/s00198-019-05029-z. Epub 2019 Jul 15.
- Jepsen DB, Ryg J, Jorgensen NR, Hansen S, Masud T. The combined effect of Parathyroid hormone (1-34) and whole-body Vibration exercise in the treatment of OSteoporosis (PaVOS)- study protocol for a randomized controlled trial. Trials. 2018 Mar 16;19(1):186. doi: 10.1186/s13063-018-2551-5.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Teriparatide | Protein / enzyme biologic | 20 ug | Subcutaneous |