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NCT00907296: STARTT

Study of Romosozumab (AMG 785) in Tibial Diaphyseal Fractures Status Post Intramedullary Nailing

Completed Phase 2 Results posted Last updated 22 September 2022
What this trial tests

Phase 2 trial testing Romosozumab in Fracture Healing in 402 participants. Completed in 10 May 2013.

Timeline
2 September 2009
Primary endpoint
6 March 2012
10 May 2013

Quick facts

Lead sponsorAmgen
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment402
Start date2 September 2009
Primary completion6 March 2012
Estimated completion10 May 2013
Sites103 locations across Hong Kong, Italy, Poland, Denmark, New Zealand, Russia, Estonia, Mexico

Drugs / interventions tested

Conditions studied

Sponsor

Amgen — full company profile →

Who can join

Adults 18 to 85, any sex, with Fracture Healing. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Time to Radiographic Healing Primary · 52 weeks

Time to radiographic healing was defined as the time from intramedullary (IM) nailing to the first occurrence of bridging of 3 out of 4 cortices. Radiographic fracture healing was determined by a panel of independent reviewers (orthopedic/trauma surgeons and radiologists) blinded to treatment. The cumulative incidence function (CIF) method was used to estimate the median time to radiographic healing and the confidence intervals. Unplanned revision surgery to promote healing was considered a competing risk in CIF estimate.

GroupValue95% CI
Placebo16.414.6 – 18.0
Romosozumab 70 mg: 2 Doses18.614.0 – 24.4
Romosozumab 70 mg: 3 Doses18.313.0 – 21.0
Romosozumab 70 mg: 4 Doses18.213.7 – 20.7
Romosozumab 140 mg: 2 Doses17.812.6 – 22.9
Romosozumab 140 mg: 3 Doses18.113.1 – 20.7
Romosozumab 140 mg: 4 Doses17.012.7 – 21.4
Romosozumab 210 mg: 2 Doses14.412.6 – 17.0
Romosozumab 210 mg: 3 Doses15.413.3 – 17.4
Romosozumab 210 mg: 4 Doses16.414.4 – 18.6
Change From Week 8 in Short Form (36) Health Survey Physical Functioning Domain Secondary · Week 8 and weeks 12, 16, 20, 24, 36, and 52

The Medical Outcome Study Short Form 36-Item Health Survey (SF-36), Version 2, is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical functioning domain includes 10 questions that assess limitations in physical activities because of health problems. Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. The range of S

Week 12
GroupValue95% CI
Placebo5.77± 9.90
Romosozumab 70 mg: 2 Doses6.31± 6.84
Romosozumab 70 mg: 3 Doses5.67± 8.60
Romosozumab 70 mg: 4 Doses5.04± 9.01
Romosozumab 140 mg: 2 Doses4.28± 8.22
Romosozumab 140 mg: 3 Doses7.08± 8.06
Romosozumab 140 mg: 4 Doses3.63± 9.30
Romosozumab 210 mg: 2 Doses3.65± 9.06
Romosozumab 210 mg: 3 Doses7.33± 7.99
Romosozumab 210 mg: 4 Doses5.64± 6.67
Week 16
GroupValue95% CI
Placebo9.64± 10.36
Romosozumab 70 mg: 2 Doses9.83± 7.24
Romosozumab 70 mg: 3 Doses9.19± 11.30
Romosozumab 70 mg: 4 Doses9.28± 11.14
Romosozumab 140 mg: 2 Doses8.89± 10.71
Romosozumab 140 mg: 3 Doses11.18± 9.23
Romosozumab 140 mg: 4 Doses8.78± 11.34
Romosozumab 210 mg: 2 Doses9.23± 9.59
Romosozumab 210 mg: 3 Doses9.50± 9.01
Romosozumab 210 mg: 4 Doses9.01± 10.41
Week 20
GroupValue95% CI
Placebo13.20± 12.25
Romosozumab 70 mg: 2 Doses14.53± 9.69
Romosozumab 70 mg: 3 Doses10.45± 11.66
Romosozumab 70 mg: 4 Doses13.50± 12.02
Romosozumab 140 mg: 2 Doses12.13± 10.88
Romosozumab 140 mg: 3 Doses14.77± 13.52
Romosozumab 140 mg: 4 Doses12.44± 11.97
Romosozumab 210 mg: 2 Doses12.61± 10.88
Romosozumab 210 mg: 3 Doses12.50± 10.76
Romosozumab 210 mg: 4 Doses11.05± 11.56
Week 24
GroupValue95% CI
Placebo15.87± 11.55
Romosozumab 70 mg: 2 Doses15.07± 9.31
Romosozumab 70 mg: 3 Doses10.34± 13.31
Romosozumab 70 mg: 4 Doses15.90± 11.26
Romosozumab 140 mg: 2 Doses14.57± 10.34
Romosozumab 140 mg: 3 Doses16.84± 12.70
Romosozumab 140 mg: 4 Doses11.79± 17.64
Romosozumab 210 mg: 2 Doses13.05± 10.99
Romosozumab 210 mg: 3 Doses13.05± 10.25
Romosozumab 210 mg: 4 Doses12.38± 14.04
Week 36
GroupValue95% CI
Placebo19.57± 11.60
Romosozumab 70 mg: 2 Doses20.96± 11.68
Romosozumab 70 mg: 3 Doses11.48± 17.84
Romosozumab 70 mg: 4 Doses17.23± 10.15
Romosozumab 140 mg: 2 Doses17.61± 11.03
Romosozumab 140 mg: 3 Doses19.43± 12.83
Romosozumab 140 mg: 4 Doses15.70± 19.03
Romosozumab 210 mg: 2 Doses15.01± 11.23
Romosozumab 210 mg: 3 Doses17.47± 14.34
Romosozumab 210 mg: 4 Doses15.22± 15.20
Week 52
GroupValue95% CI
Placebo20.74± 11.96
Romosozumab 70 mg: 2 Doses23.47± 11.55
Romosozumab 70 mg: 3 Doses13.63± 19.04
Romosozumab 70 mg: 4 Doses19.02± 10.80
Romosozumab 140 mg: 2 Doses19.63± 12.17
Romosozumab 140 mg: 3 Doses24.80± 11.24
Romosozumab 140 mg: 4 Doses17.19± 15.51
Romosozumab 210 mg: 2 Doses15.50± 13.17
Romosozumab 210 mg: 3 Doses18.29± 14.94
Romosozumab 210 mg: 4 Doses15.44± 17.15
Number of Participants With Unplanned Revision Surgeries Secondary · 52 weeks
GroupValue95% CI
Placebo8
Romosozumab 70 mg: 2 Doses1
Romosozumab 70 mg: 3 Doses3
Romosozumab 70 mg: 4 Doses3
Romosozumab 140 mg: 2 Doses1
Romosozumab 140 mg: 3 Doses0
Romosozumab 140 mg: 4 Doses0
Romosozumab 210 mg: 2 Doses0
Romosozumab 210 mg: 3 Doses1
Romosozumab 210 mg: 4 Doses1
Time to Clinical Healing Secondary · 52 weeks

Time to clinical healing was defined as the time from the IM nailing surgery date to the first date that both the score for ability to bear weight on the fractured limb and the score for absence of pain at the fracture site were equal to 6. The score for the ability to bear weight on the fractured limb was based on the ability to stand on affected leg without assistive device and the ability to walk without assistive device. The score ranges from 0 (unable to bear full body weight on the fractured limb) to 6 (able to bear full body weight on the fractured limb). Absence of pain at the fractur

GroupValue95% CI
Placebo18.416.6 – 20.4
Romosozumab 70 mg: 2 Doses21.415.7 – 28.6
Romosozumab 70 mg: 3 Doses18.314.4 – 22.4
Romosozumab 70 mg: 4 Doses17.114.4 – 21.0
Romosozumab 140 mg: 2 Doses20.812.6 – 28.0
Romosozumab 140 mg: 3 Doses22.315.0 – 24.3
Romosozumab 140 mg: 4 Doses15.012.6 – 17.0
Romosozumab 210 mg: 2 Doses16.312.4 – 21.0
Romosozumab 210 mg: 3 Doses14.612.9 – 18.6
Romosozumab 210 mg: 4 Doses17.614.9 – 19.7

Adverse events — posted to ClinicalTrials.gov

Time frame: 52 weeks. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo
Serious: 10/100 (10%)
Deaths:
Romosozumab 70 mg: 2 Doses
Serious: 4/34 (12%)
Deaths:
Romosozumab 70 mg: 3 Doses
Serious: 2/34 (6%)
Deaths:
Romosozumab 70 mg: 4 Doses
Serious: 3/32 (9%)
Deaths:
Romosozumab 140 mg: 2 Doses
Serious: 3/33 (9%)
Deaths:
Romosozumab 140 mg: 3 Doses
Serious: 4/32 (13%)
Deaths:
Romosozumab 140 mg: 4 Doses
Serious: 2/31 (6%)
Deaths:
Romosozumab 210 mg: 2 Doses
Serious: 3/32 (9%)
Deaths:
Romosozumab 210 mg: 3 Doses
Serious: 3/30 (10%)
Deaths:
Romosozumab 210 mg: 4 Doses
Serious: 0/35 (0%)
Deaths:

Serious adverse events (40 terms)

ReactionSystemPlaceboRomosozumab 70 mg: 2 DosesRomosozumab 70 mg: 3 DosesRomosozumab 70 mg: 4 DosesRomosozumab 140 mg: 2 DosesRomosozumab 140 mg: 3 DosesRomosozumab 140 mg: 4 DosesRomosozumab 210 mg: 2 DosesRomosozumab 210 mg: 3 DosesRomosozumab 210 mg: 4 Doses
WoundInjury, poisoning and procedural complications
Abdominal pain upperGastrointestinal disorders
Chest painGeneral disorders
ChillsGeneral disorders
Device breakageGeneral disorders
InflammationGeneral disorders
MalaiseGeneral disorders
Oedema peripheralGeneral disorders
CellulitisInfections and infestations
Device related infectionInfections and infestations
InfectionInfections and infestations
Localised infectionInfections and infestations
MalariaInfections and infestations
PneumoniaInfections and infestations
Post procedural infectionInfections and infestations
Wound infectionInfections and infestations
Bone fissureInjury, poisoning and procedural complications
Femur fractureInjury, poisoning and procedural complications
Fracture displacementInjury, poisoning and procedural complications
Loss of anatomical alignment after fracture reductionInjury, poisoning and procedural complications
Lower limb fractureInjury, poisoning and procedural complications
Ulna fractureInjury, poisoning and procedural complications
Blood creatine phosphokinase increasedInvestigations
Oxygen saturation decreasedInvestigations
ArthralgiaMusculoskeletal and connective tissue disorders
Other adverse events (26 terms — click to expand)

ReactionSystemPlaceboRomosozumab 70 mg: 2 DosesRomosozumab 70 mg: 3 DosesRomosozumab 70 mg: 4 DosesRomosozumab 140 mg: 2 DosesRomosozumab 140 mg: 3 DosesRomosozumab 140 mg: 4 DosesRomosozumab 210 mg: 2 DosesRomosozumab 210 mg: 3 DosesRomosozumab 210 mg: 4 Doses
PainGeneral disorders
Oedema peripheralGeneral disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
PyrexiaGeneral disorders
InsomniaPsychiatric disorders
VomitingGastrointestinal disorders
NasopharyngitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
DiarrhoeaGastrointestinal disorders
Medical device discomfortGeneral disorders
FallInjury, poisoning and procedural complications
Bone painMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
ParaesthesiaNervous system disorders
AstheniaGeneral disorders
InfluenzaInfections and infestations
RhinitisInfections and infestations
Limb injuryInjury, poisoning and procedural complications
Procedural painInjury, poisoning and procedural complications
Alanine aminotransferase increasedInvestigations
Diabetes mellitusMetabolism and nutrition disorders
Depressed moodPsychiatric disorders
CoughRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
BlisterSkin and subcutaneous tissue disorders

Most-reported serious reactions: Wound, Abdominal pain upper, Chest pain, Chills, Device breakage, Inflammation, Malaise, Oedema peripheral.

Data from ClinicalTrials.gov NCT00907296 adverse events section.

Sponsor's own description

The primary objective of this study is to investigate the effect of romosozumab compared with placebo on time to radiographic healing of fresh tibial diaphyseal fractures (fractures in the midsection of the shinbone).

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Bone regeneration strategies: Engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives.
    Ho-Shui-Ling A, Bolander J, Rustom LE, Johnson AW, et al · · 2018 · cited 606× · PMID 30036727 · DOI 10.1016/j.biomaterials.2018.07.017
  2. Role of sclerostin in bone and cartilage and its potential as a therapeutic target in bone diseases.
    Lewiecki EM. · · 2014 · cited 112× · PMID 24688605 · DOI 10.1177/1759720x13510479
  3. Advances in regenerative orthopedics.
    Evans CH. · · 2013 · cited 56× · PMID 24182709 · DOI 10.1016/j.mayocp.2013.04.027
  4. Sclerostin Antibody Therapy for the Treatment of Osteoporosis: Clinical Prospects and Challenges.
    MacNabb C, Patton D, Hayes JS. · · 2016 · cited 44× · PMID 27313945 · DOI 10.1155/2016/6217286
  5. Sclerostin inhibition: a novel therapeutic approach in the treatment of osteoporosis.
    Shah AD, Shoback D, Lewiecki EM. · · 2015 · cited 40× · PMID 26082665 · DOI 10.2147/ijwh.s73244
  6. Treatment effects, adverse outcomes and cardiovascular safety of romosozumab - Existing worldwide data: A systematic review and meta-analysis.
    Wong RMY, Wong PY, Liu C, Wong HY, et al · · 2024 · cited 8× · PMID 39189010 · DOI 10.1016/j.jot.2024.07.011
  7. Anti‐sclerostin antibodies for the treatment of osteoporosis
    Pundole X, Lopez‐Olivo M, Suarez‐Almazor M, Lu H. · · 2017

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing