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CompletedNCT02304367Updated May 6, 2024Results posted

Study of Burosumab (KRN23) in Adults With Tumor-Induced Osteomalacia (TIO) or Epidermal Nevus Syndrome (ENS)

A Phase 2 interventional study of Burosumab in Tumor Induced Osteomalacia (TIO) and Epidermal Nevus Syndrome (ENS), sponsored by Kyowa Kirin, Inc.. Completed at 7 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-05-06.

Sponsored by Kyowa Kirin, Inc. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
17
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The primary objectives of this study are to evaluate the effect of burosumab treatment on:

  • Increasing serum phosphorus levels in adults with TIO or ENS-associated osteomalacia
  • Improvement in TIO/ENS-associated osteomalacia as determined by osteoid thickness (O.Th), osteoid surface/bone surface (OS/BS), osteoid volume/bone volume (OV/BV) and mineralization lag time (MLt).
02

Conditions studied

  • Tumor Induced Osteomalacia (TIO)
  • Epidermal Nevus Syndrome (ENS)

Keywords

  • TIO
  • ENS
  • FGF23
  • KRN23
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Have a clinical diagnosis of TIO/ENS-associated osteomalacia based on evidence of excessive fibroblast growth factor 23 (FGF23) that was not amenable to cure by surgical excision of the underlying tumor/lesion (documented by Investigator).
  2. Be ≥ 18 years of age
  3. Have a fasting serum phosphorus level \< 2.5 mg/dL
  4. Have an FGF23 level ≥ 100 pg/mL by Kainos assay
  5. Have a ratio of renal tubular maximum reabsorption rate of phosphate to glomerular filtration rate (TmP/GFR) \< 2.5 mg/dL
  6. Have an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min (using Cockcroft-Gault formula). Subjects with eGFR ≥ 30 but \< 60 mL/min will be considered eligible as long as in the opinion of the investigator the decline in renal function is not related to nephrocalcinosis.
  7. Have a corrected serum calcium level \< 10.8 mg/dL
  8. Females of child-bearing potential must have a negative urine pregnancy test at Screening and Baseline and be willing to have additional pregnancy tests during the study. Females considered not to be of childbearing potential include those who have not experienced menarche, are post-menopausal (defined as having no menses for at least 12 months without an alternative medical cause) or are permanently sterile due to total hysterectomy, bilateral salpingectomy, or bilateral oophorectomy.
  9. Be willing to use 2 forms of effective methods of contraception while participating in the study (sexually active subjects) and for 12 weeks after last dose of study drug.
  10. Be willing to provide access to prior medical records to determine eligibility including imaging, biochemical, and diagnostic, medical, and surgical history data
  11. Provide written informed consent after the nature of the study has been explained, and prior to any research-related procedures
  12. Be willing and able to complete all aspects of the study, adhere to the study visit schedule and comply with the assessments (in the opinion of the investigator)

Exclusion criteria

Exclusion Criteria:

  1. Have a prior diagnosis of human immunodeficiency virus (HIV), hepatitis B and/or hepatitis C
  2. Have a history of recurrent infection, a predisposition to infection, or a known immunodeficiency
  3. Are pregnant or breastfeeding at Screening or are planning to become pregnant (self or partner) at any time during the study
  4. Have participated in an investigational drug or device trial within 30 days prior to Screening or are currently enrolled in another study of an investigational product or device
  5. Have used a therapeutic monoclonal antibody (mAb), including KRN23, within 90 days prior to Screening or have a history of allergic or anaphylactic reactions to any mAb
  6. Have or a have a history of any hypersensitivity to KRN23 excipients that, in the judgment of the investigator, places the subject at increased risk for adverse effects
  7. Have used a pharmacologic vitamin D metabolite or its analog (e.g., calcitriol, doxercalciferol, and paricalcitol), phosphate, or aluminum hydroxide antacids (e.g., Maalox® and Mylanta®) within 2 weeks prior to Screening or during the study
  8. Have used medication to suppress parathyroid hormone (PTH) (e.g., Sensipar®, cinacalcet, calcimimetics) within 2 months prior to Screening
  9. Have a history of malignancy within 5 years of study entry with the exception of phosphaturic mesenchymal tumors (PMTs) of the mixed connective tissue type or non-melanoma skin cancers such as basal cell skin cancer
  10. Have donated blood or blood products within 60 days prior to Screening
  11. Have a history of allergic reaction to or have shown adverse reactions to a tetracycline (e.g., tetracycline hydrochloride [HCl] and demeclocycline), benzodiazepines, fentanyl or lidocaine
  12. Have any condition, which in the opinion of the investigator and sponsor, could present a concern for either subject safety or difficulty with data interpretation
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    Burosumab

    Participants received burosumab at a starting dose of 0.3 mg/kg administered subcutaneously (SC) every 4 weeks (Q4W). Doses may have been titrated up to a maximum of 2.0 mg/kg every 2 weeks (Q2W) in order to achieve fasting peak serum phosphorus levels within the target range of 2.5 to 4.0 mg/dL.

    Biological: Burosumab

Interventions

  • BiologicalBurosumab

    Solution for subcutaneous injection

    Also known as: KRN23, Crysvita®, UX023

05

What researchers measure

Primary outcomes

  1. Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the Mid-Point of the Dose Intervals Between Baseline and Week 24

    The percentage of participants achieving mean serum phosphorus levels above the lower limit of normal (LLN; 2.5 mg/dL \[0.81 mmol/L\]) at the mid-point of the dose interval (2 weeks after dosing), as averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

    Time frame: Mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22 [there was no study visit at Week 18])

  2. Change From Baseline to Week 48 in Osteoid Thickness

    Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid thickness is the mean thickness of osteoid seams.

    Time frame: Baseline, Week 48

  3. Change From Baseline to Week 48 in Osteoid Surface/Bone Surface (OS/BS)

    Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid surface/bone surface is expressed as the percentage of bone surface covered in osteoid.

    Time frame: Baseline, Week 48

  4. Change From Baseline to Week 48 in Osteoid Volume/Bone Volume (OV/BV)

    Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid volume/bone volume is expressed as the percentage of a given volume of bone tissue that consists of unmineralized bone (osteoid).

    Time frame: Baseline, Week 48

  5. Change From Baseline to Week 48 in Mineralization Lag Time (MLt)

    Mineralization lag time is a dynamic modeling parameter representing the mean time interval between the formation of osteoid and its subsequent mineralization which can be measured using histomorphometry with double tetracycline labeling. Mlt was calculated by dividing the osteoid width by the mineralizing apposition rate (MAR; the average rate at which new bone mineral is being added on any actively forming surface). If Mlt could not be calculated directly due to low tetracycline uptake, Mlt was imputed according to the following: Mlt = O.Th/(MAR\*MS/OS), where O.Th = osteoid thickness, MAR is imputed as 0.3 μm/day, MS/OS=mineralizing surface/osteoid surface, each measured at the same visit.

    Time frame: Baseline, Week 48

Secondary outcomes

  1. Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the End of the Dose Intervals Between Baseline and Week 24

    The percentage of participants achieving mean serum phosphorus levels above the lower limit of normal (2.5 mg/dL \[0.81 mmol/L\]) at the end of the dose interval (4 weeks post-dose, prior to the next dose), as averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

    Time frame: End of each dose interval from Baseline to Week 24 (Weeks 4, 8, 12, 16, 20, and 24)

  2. Mean Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24

    Mean change from Baseline to the mid-point of the dose interval (2 weeks after dosing) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

    Time frame: Baseline and the mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22)

  3. Percent Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24

    Mean percent change from Baseline to the mid-point of the dose interval (2 weeks after dosing) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

    Time frame: Baseline and the mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22)

  4. Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24

    Mean change from Baseline at the end of the dose interval (4 weeks post-dose, prior to the next dose) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, and 24

  5. Percent Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24

    Mean percent change from Baseline at the end of the dose interval (4 weeks post-dose, prior to the next dose) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, and 24

  6. Time-Adjusted Area Under the Curve (AUC) of Serum Phosphorus Levels Between Baseline and Week 24

    Serum phosphorus level versus time AUC was calculated using the trapezoidal rule. Time-adjusted AUC was calculated by dividing the AUC by duration of time included in AUC calculation.

    Time frame: Pre-dose on Day 1 and at Weeks 1, 2, 4, 6, 8, 10, 12, 14, 16, 20, 21, 22, and 24

  7. Change From Baseline Over Time in Serum 1,25-dihydroxyvitamin D (1,25(OH)2D) Concentration

    Least squares (LS) means and standard errors (SE) were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 1,25(OH)2D, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  8. Change From Baseline Over Time in Total Serum Fibroblast Growth Factor 23 (FGF23) Concentration

    Total FGF23 included free FGF23 and FGF23 bound to burosumab. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline total FGF23, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  9. Change From Baseline Over Time in Free Serum Fibroblast Growth Factor 23 (FGF23) Concentration

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline free FGF23, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  10. Change From Baseline Over Time in 24-hour Urinary Phosphorus

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  11. Change From Baseline Over Time in Tubular Reabsorption of Phosphate (TRP)

    Tubular reabsorption of phosphate (TRP) is the fraction of filtered phosphorus that is reabsorbed by renal tubules. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline TRP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  12. Change From Baseline Over Time in Ratio of Renal Tubular Maximum Phosphate Reabsorption Rate to Glomerular Filtration Rate (TmP/GFR)

    TmP/GFR measures renal phosphate reabsorption (the primary mechanism by which FGF23 regulates phosphate homeostasis) by comparing the fractional absorption of phosphate relative to the estimated rate of glomerular filtration. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline TmP/GFR, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  13. Change From Baseline Over Time in Fractional Excretion of Phosphorus (FEP)

    FEP is the percentage of phosphorus filtered by the kidney that is excreted into urine, calculated as 100% \* (2-hour urine phosphorus\*serum creatinine)/(2-hour urine creatinine \* serum phosphorus). Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline FEP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  14. Change From Baseline Over Time in Serum Alkaline Phosphatase (ALP)

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline ALP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  15. Change From Baseline Over Time in Bone-Specific Alkaline Phosphatase (BALP)

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BALP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  16. Percent Change From Baseline Over Time in BALP

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BALP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  17. Change From Baseline Over Time in Carboxy Terminal Cross-Linked Telopeptide of Type 1 Collagen (CTx)

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline CTx, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  18. Percent Change From Baseline Over Time in CTx

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline CTx, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  19. Change From Baseline Over Time in Procollagen Type 1 N-Propeptide (P1NP)

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline P1NP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  20. Percent Change From Baseline Over Time in P1NP

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline P1NP, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  21. Change From Baseline Over Time in Osteocalcin

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline osteocalcin, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  22. Percent Change From Baseline Over Time in Osteocalcin

    Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline osteocalcin, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  23. Change From Baseline Over Time in Hand-Held Dynamometry (HHD) Elbow Measurements

    To assess muscle strength, hand-held dynamometry was conducted using a standardized technique. Bilateral strength (defined as the average of the left and the right scores, measured in kilograms) of the elbow flexors and extensors was measured by the maximum voluntary isometric contraction against a dynamometer. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline strength measurements, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24 and 48

  24. Change From Baseline Over Time in Hand-Held Dynamometry (HHD) Knee Measurements

    To assess muscle strength, hand-held dynamometry was conducted using a standardized technique. Bilateral strength (defined as the average of the left and the right scores, measured in kilograms) of the knee flexors and extensors was measured by the maximum voluntary isometric contraction against a dynamometer. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline strength measurements, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24 and 48

  25. Change From Baseline Over Time in Sit-to-Stand (STS) Test

    The STS test measures lower extremity strength and mobility as a participant moves repeatedly from a seated position to standing. This study used a modified STS test that allowed participants to use the arms of the chair to help them stand and sit if necessary. The number of sit-to-stand repetitions performed in a 30-second period was recorded. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24 and 48

  26. Change From Baseline Over Time in Weighted Arm Lift (WAL) Test

    The Weighted arm lift (WAL) test assesses upper extremity strength, mobility and reaching ability. The test was administered bilaterally to determine the number of times the participant could raise a 1 kg weight above the head in a 30-second period. The number of repetitions completed with each arm was recorded. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline WAL measurements, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24 and 48

  27. Change From Baseline Over Time in Six-Minute Walk Test (6MWT)

    The 6MWT is a commonly used measure of mobility and was conducted in accordance with general principles set forth in the American Thoracic Society guidelines (ATS 2002). Participants were instructed to walk the length of a pre-measured course for 6 consecutive minutes (assistive devices could be used). The total distance walked at the end of 6 minutes was recorded in meters. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 6MWT measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24 and 48

  28. Change From Baseline Over Time in Brief Pain Inventory (BPI) Worst Pain Score

    The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Worst pain is defined as the answer to Question 3, in which participants rated their pain at its worst in the last 24 hours on a scale from 0 (no pain) to 10 (pain as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  29. Change From Baseline Over Time in Brief Pain Inventory (BPI) Pain Severity Score

    The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Pain severity is defined as the average of 4 questions (Questions 3 through 6) assessing worst pain, least pain, average pain, and pain right now, rated on a scale from 0 (no pain) to 10 (pain as bad as you can imagine). Mild pain is defined as a score of 1 to 4, moderate pain is defined as a score of 5 to 6, and severe pain is defined as a score of 7 to 10. A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  30. Change From Baseline Over Time in Brief Pain Inventory (BPI) Pain Interference Score

    The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Pain interference is defined as the average of 7 questions (9A through 9G) regarding the extent to which pain interfered with daily activities, including general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life in the last 24 hours, rated on a scale from 0 (does not interfere) to 10 (completely interferes). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  31. Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Worst Fatigue Score

    The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. Worst fatigue is defined as the answer to Question 3 in which participants rated their fatigue at its worst in the last 24 hours on a scale from 0 (no fatigue) to 10 (as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  32. Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Severity Score

    The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. Fatigue severity is defined as the average of 3 questions (Questions 1 through 3) assessing fatigue right now, usual level of fatigue, and worst fatigue, rated on a scale from 0 (no fatigue) to 10 (as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  33. Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Interference Score

    The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. The fatigue interference score is defined as the average of 6 questions (Questions 4A through 4F) regarding the extent to which fatigue interfered with daily activities, including general activity, mood, walking ability, work, relations with others, and enjoyment of life in the last 24 hours, rated on a scale from 0 (does not interfere) to 10 (completely interferes). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  34. Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Global Fatigue Score

    The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. The first 3 questions measure fatigue severity and the next 6 questions assess the impact of fatigue on daily activities. The global fatigue score is defined as the average of all 9 questions on the BFI including severity and interference, and ranges from from 0 to 10, where higher scores correspond to greater levels of fatigue. A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  35. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Component Summary Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical component summary score (PCS) is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The PCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance struct

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  36. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Functioning Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical functioning (PF) domain includes 10 questions that assess limitations in physical activities because of health problems. The PF domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  37. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Physical Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The role-physical (RP) domain includes 4 questions that assess limitations in usual role activities because of physical health problems. The RP domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  38. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Bodily Pain Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The bodily pain (BP) domain includes 2 questions that assess pain level and impact of pain on normal work. The BP domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  39. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) General Health Perceptions Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The general health perceptions (GH) domain includes 5 questions that assess participants' perception of their own general health. The GH domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  40. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Component Summary Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The mental component summary score (MCS) is a weighted combination of the 8 subscales with positive weighting for vitality, social function, role limitations due to emotional problems, and mental health. The MCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  41. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Vitality Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The vitality (VT) domain includes 4 questions that assess energy levels and fatigue. The VT domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  42. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Social Functioning Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The social functioning (SF) domain includes 2 questions that assess limitations in social activities because of physical health or emotional problems. The SF domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  43. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Emotional Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The role-emotional (RE) domain includes 3 questions that assess limitations in usual role activities because of emotional problems. The RE domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

  44. Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Health Domain Score

    The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The mental health (MH) domain includes 5 questions that assess general mental health (psychological distress and well-being). The MH domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

    Time frame: Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240

Other outcomes

  1. Number of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious TEAEs, and TEAEs Leading to Discontinuation

    An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug, whether or not considered drug related. A serious AE was defined as an AE that at any dose, in the view of either the Investigator or Sponsor, results in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant incapacity or disability, a congenital anomaly/birth defect, or other important medical events (according to the investigator). An AE was considered a TEAE if it occurred on or after the first dose and was not present prior to the first dose, or it was present prior to the first dose but increased in severity during the study. Events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0: grade 1 (mild), grade 2 (moderate), grade 3 (severe), grade 4 (life-threatening), grade 5 (death).

    Time frame: From first dose of study drug up to database lock date (July 07, 2021); median duration of treatment in the TIO analysis set was 1594.0 (range: 168-2106) days.

  2. Number of Participants With Anti-burosumab Antibodies

    Time frame: From first dose of study drug up to database lock date (July 07, 2021); median duration of treatment in the TIO analysis set was 1594.0 (range: 168-2106) days.

06

Results

Posted Jul 30, 2020

Participant flow

This study was conducted at 8 centers in the United States, and enrolled adults with tumor-induced osteomalacia (TIO), epidermal nevus syndrome (ENS)-associated osteomalacia, or x-linked hypophosphatemia (XLH).

Participant flow — Overall Study
MilestoneBurosumab
Started17
Completed 48 weeks of study drug16
Completed 144 weeks of study drug12
Completed9
Not completed8
Withdrew: Lack of response to bruosumab1
Withdrew: Sponsor decision3
Withdrew: Death2
Withdrew: Physician decision1
Withdrew: Unable to return due to corona virus pandemic1

Outcome measures

PrimaryPercentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the Mid-Point of the Dose Intervals Between Baseline and Week 24

The percentage of participants achieving mean serum phosphorus levels above the lower limit of normal (LLN; 2.5 mg/dL \[0.81 mmol/L\]) at the mid-point of the dose interval (2 weeks after dosing), as averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

Time frame:
Mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22 [there was no study visit at Week 18])
Reported as:
Number · percentage of participants
Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the Mid-Point of the Dose Intervals Between Baseline and Week 24
percentage of participantsBurosumab
Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the Mid-Point of the Dose Intervals Between Baseline and Week 2450.0 (26.80 to 73.20)
PrimaryChange From Baseline to Week 48 in Osteoid Thickness

Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid thickness is the mean thickness of osteoid seams.

Time frame:
Baseline, Week 48
Reported as:
Mean · µm
Change From Baseline to Week 48 in Osteoid Thickness
µmBurosumab
Change From Baseline to Week 48 in Osteoid Thickness-5.12 (-10.04 to -0.20)
Statistical analysis
  • Burosumab · t-test · p = 0.0428
PrimaryChange From Baseline to Week 48 in Osteoid Surface/Bone Surface (OS/BS)

Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid surface/bone surface is expressed as the percentage of bone surface covered in osteoid.

Time frame:
Baseline, Week 48
Reported as:
Mean · percentage of bone surface
Change From Baseline to Week 48 in Osteoid Surface/Bone Surface (OS/BS)
percentage of bone surfaceBurosumab
Change From Baseline to Week 48 in Osteoid Surface/Bone Surface (OS/BS)-0.18 (-13.86 to 13.50)
Statistical analysis
  • Burosumab · t-test · p = 0.9770
PrimaryChange From Baseline to Week 48 in Osteoid Volume/Bone Volume (OV/BV)

Histomorphometry of trans-iliac crest bone biopsies was assessed by a blinded, central reader. Osteoid volume/bone volume is expressed as the percentage of a given volume of bone tissue that consists of unmineralized bone (osteoid).

Time frame:
Baseline, Week 48
Reported as:
Mean · percentage of bone volume
Change From Baseline to Week 48 in Osteoid Volume/Bone Volume (OV/BV)
percentage of bone volumeBurosumab
Change From Baseline to Week 48 in Osteoid Volume/Bone Volume (OV/BV)-5.47 (-11.87 to 0.93)
Statistical analysis
  • Burosumab · t-test · p = 0.0858
PrimaryChange From Baseline to Week 48 in Mineralization Lag Time (MLt)

Mineralization lag time is a dynamic modeling parameter representing the mean time interval between the formation of osteoid and its subsequent mineralization which can be measured using histomorphometry with double tetracycline labeling. Mlt was calculated by dividing the osteoid width by the mineralizing apposition rate (MAR; the average rate at which new bone mineral is being added on any actively forming surface). If Mlt could not be calculated directly due to low tetracycline uptake, Mlt was imputed according to the following: Mlt = O.Th/(MAR\*MS/OS), where O.Th = osteoid thickness, MAR is imputed as 0.3 μm/day, MS/OS=mineralizing surface/osteoid surface, each measured at the same visit.

Time frame:
Baseline, Week 48
Reported as:
Mean · days
Change From Baseline to Week 48 in Mineralization Lag Time (MLt)
daysBurosumab
Change From Baseline to Week 48 in Mineralization Lag Time (MLt)-565.20 (-2037.42 to 907.02)
Statistical analysis
  • Burosumab · t-test · p = 0.4077
SecondaryPercentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the End of the Dose Intervals Between Baseline and Week 24

The percentage of participants achieving mean serum phosphorus levels above the lower limit of normal (2.5 mg/dL \[0.81 mmol/L\]) at the end of the dose interval (4 weeks post-dose, prior to the next dose), as averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

Time frame:
End of each dose interval from Baseline to Week 24 (Weeks 4, 8, 12, 16, 20, and 24)
Reported as:
Number · percentage of participants
Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the End of the Dose Intervals Between Baseline and Week 24
percentage of participantsBurosumab
Percentage of Participants Achieving Mean Serum Phosphorus Levels Above 2.5 mg/dL at the End of the Dose Intervals Between Baseline and Week 2421.4 (7.57 to 47.59)
SecondaryMean Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24

Mean change from Baseline to the mid-point of the dose interval (2 weeks after dosing) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

Time frame:
Baseline and the mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22)
Reported as:
Mean · mg/dL
Mean Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24
mg/dLBurosumab
Mean Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 241.039 ± 0.5622
SecondaryPercent Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24

Mean percent change from Baseline to the mid-point of the dose interval (2 weeks after dosing) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 2, 6, 10, 14 and 22).

Time frame:
Baseline and the mid-point of each dose interval from Baseline to Week 24 (Weeks 2, 6, 10, 14 and 22)
Reported as:
Mean · percent change
Percent Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 24
percent changeBurosumab
Percent Change From Baseline in Serum Phosphorus Levels at the Mid-Point of the Dose Interval, as Averaged Across Dose Cycles Between Baseline and Week 2469.77 ± 43.743
SecondaryMean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24

Mean change from Baseline at the end of the dose interval (4 weeks post-dose, prior to the next dose) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

Time frame:
Baseline and Weeks 4, 8, 12, 16, 20, and 24
Reported as:
Mean · mg/dL
Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24
mg/dLBurosumab
Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 240.550 ± 0.4260
SecondaryPercent Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24

Mean percent change from Baseline at the end of the dose interval (4 weeks post-dose, prior to the next dose) averaged across dose cycles between Baseline and Week 24 (i.e. the average of serum phosphorus levels at Weeks 4, 8, 12, 16, 20, and 24).

Time frame:
Baseline and Weeks 4, 8, 12, 16, 20, and 24
Reported as:
Mean · percent change
Percent Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 24
percent changeBurosumab
Percent Mean Change From Baseline in Serum Phosphorus Levels at the End of the Dosing Cycle, as Averaged Across Dose Cycles Between Baseline and Week 2438.56 ± 33.027
SecondaryTime-Adjusted Area Under the Curve (AUC) of Serum Phosphorus Levels Between Baseline and Week 24

Serum phosphorus level versus time AUC was calculated using the trapezoidal rule. Time-adjusted AUC was calculated by dividing the AUC by duration of time included in AUC calculation.

Time frame:
Pre-dose on Day 1 and at Weeks 1, 2, 4, 6, 8, 10, 12, 14, 16, 20, 21, 22, and 24
Reported as:
Mean · mg/dL
Time-Adjusted Area Under the Curve (AUC) of Serum Phosphorus Levels Between Baseline and Week 24
mg/dLBurosumab
Time-Adjusted Area Under the Curve (AUC) of Serum Phosphorus Levels Between Baseline and Week 242.36 ± 0.632
SecondaryChange From Baseline Over Time in Serum 1,25-dihydroxyvitamin D (1,25(OH)2D) Concentration

Least squares (LS) means and standard errors (SE) were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 1,25(OH)2D, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · pg/mL
Change From Baseline Over Time in Serum 1,25-dihydroxyvitamin D (1,25(OH)2D) Concentration
pg/mLBurosumab
Week 249.90 ± 4.10
Week 4810.49 ± 4.82
Week 964.28 ± 3.80
Week 1443.15 ± 3.34
Week 1684.91 ± 3.94
Week 1920.67 ± 4.19
Week 2169.78 ± 3.04
Week 2406.56 ± 3.19
Statistical analysis
  • Burosumab · GEE model · p = 0.016Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.030Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.259Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.346Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.213Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.873Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
  • Burosumab · GEE model · p = 0.040Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 1,25(OH)2D.
SecondaryChange From Baseline Over Time in Total Serum Fibroblast Growth Factor 23 (FGF23) Concentration

Total FGF23 included free FGF23 and FGF23 bound to burosumab. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline total FGF23, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · pg/mL
Change From Baseline Over Time in Total Serum Fibroblast Growth Factor 23 (FGF23) Concentration
pg/mLBurosumab
Week 24246335.35 ± 61089.98
Week 48180511.74 ± 33529.14
Week 96331267.40 ± 103226.37
Week 144275758.40 ± 102349.79
Week 168185769.23 ± 65423.93
Week 192234826.20 ± 82198.24
Week 216254359.96 ± 81615.67
Week 240210119.10 ± 76610.50
Statistical analysis
  • Burosumab · GEE model · p = <0.0001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = <0.0001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.007Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.004Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
  • Burosumab · GEE model · p = 0.006Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline total FGF23.
SecondaryChange From Baseline Over Time in Free Serum Fibroblast Growth Factor 23 (FGF23) Concentration

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline free FGF23, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · pg/mL
Change From Baseline Over Time in Free Serum Fibroblast Growth Factor 23 (FGF23) Concentration
pg/mLBurosumab
Week 24624.91 ± 101.89
Week 48578.07 ± 95.37
Week 96736.59 ± 139.18
Week 144801.69 ± 103.41
Week 168787.16 ± 95.52
Week 192717.71 ± 115.99
Week 216704.87 ± 115.30
Week 240625.16 ± 125.93
Statistical analysis
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = <0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline free FGF23.
SecondaryChange From Baseline Over Time in 24-hour Urinary Phosphorus

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · mg/dL
Change From Baseline Over Time in 24-hour Urinary Phosphorus
mg/dLBurosumab
Week 24-3.66 ± 8.28
Week 483.59 ± 6.73
Week 963.22 ± 6.40
Week 1443.25 ± 6.971
Week 1684.98 ± 8.18
Week 1928.31 ± 4.54
Week 21613.93 ± 14.30
Week 24013.11 ± 9.35
Statistical analysis
  • Burosumab · GEE model · p = 0.659Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.752Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.594Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.614Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.542Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.067Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.330Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
  • Burosumab · GEE model · p = 0.161Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline 24-hour urinary phosphorus.
SecondaryChange From Baseline Over Time in Tubular Reabsorption of Phosphate (TRP)

Tubular reabsorption of phosphate (TRP) is the fraction of filtered phosphorus that is reabsorbed by renal tubules. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline TRP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · fraction of phosphorus reabsorbed
Change From Baseline Over Time in Tubular Reabsorption of Phosphate (TRP)
fraction of phosphorus reabsorbedBurosumab
Week 240.13 ± 0.02
Week 480.14 ± 0.02
Week 960.10 ± 0.03
Week 1440.13 ± 0.02
Week 1680.12 ± 0.02
Week 1920.14 ± 0.02
Week 2160.14 ± 0.01
Week 2400.12 ± 0.02
Statistical analysis
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TRP.
SecondaryChange From Baseline Over Time in Ratio of Renal Tubular Maximum Phosphate Reabsorption Rate to Glomerular Filtration Rate (TmP/GFR)

TmP/GFR measures renal phosphate reabsorption (the primary mechanism by which FGF23 regulates phosphate homeostasis) by comparing the fractional absorption of phosphate relative to the estimated rate of glomerular filtration. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline TmP/GFR, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · mg/dL
Change From Baseline Over Time in Ratio of Renal Tubular Maximum Phosphate Reabsorption Rate to Glomerular Filtration Rate (TmP/GFR)
mg/dLBurosumab
Week 240.81 ± 0.13
Week 480.88 ± 0.14
Week 960.73 ± 0.23
Week 1440.13 ± 0.02
Week 1681.07 ± 0.29
Week 1920.95 ± 0.16
Week 2160.88 ± 0.12
Week 2400.94 ± 0.15
Statistical analysis
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline TmP/GFR.
SecondaryChange From Baseline Over Time in Fractional Excretion of Phosphorus (FEP)

FEP is the percentage of phosphorus filtered by the kidney that is excreted into urine, calculated as 100% \* (2-hour urine phosphorus\*serum creatinine)/(2-hour urine creatinine \* serum phosphorus). Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline FEP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · percentage of phosphorus
Change From Baseline Over Time in Fractional Excretion of Phosphorus (FEP)
percentage of phosphorusBurosumab
Week 24-0.14 ± 0.02
Week 48-0.14 ± 0.02
Week 96-0.10 ± 0.03
Week 144-0.15 ± 0.02
Week 168-0.14 ± 0.02
Week 192-0.14 ± 0.02
Week 216-0.15 ± 0.01
Week 240-0.14 ± 0.02
Statistical analysis
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline FEP.
SecondaryChange From Baseline Over Time in Serum Alkaline Phosphatase (ALP)

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline ALP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · U/L
Change From Baseline Over Time in Serum Alkaline Phosphatase (ALP)
U/LBurosumab
Week 24-1.68 ± 10.91
Week 48-20.36 ± 11.68
Week 96-38.23 ± 11.90
Week 144-57.45 ± 10.97
Week 168-62.80 ± 12.35
Week 192-60.40 ± 12.41
Week 216-50.14 ± 26.09
Week 240-49.71 ± 24.35
Statistical analysis
  • Burosumab · GEE model · p = 0.878Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = 0.081Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = 0.055Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
  • Burosumab · GEE model · p = 0.041Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline ALP.
SecondaryChange From Baseline Over Time in Bone-Specific Alkaline Phosphatase (BALP)

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BALP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · μg/L
Change From Baseline Over Time in Bone-Specific Alkaline Phosphatase (BALP)
μg/LBurosumab
Week 24-1.13 ± 4.87
Week 48-9.65 ± 4.74
Week 96-15.89 ± 4.27
Week 144-19.81 ± 4.42
Week 168-22.05 ± 4.52
Week 192-21.54 ± 4.87
Week 216-15.50 ± 11.39
Week 240-21.58 ± 6.17
Statistical analysis
  • Burosumab · GEE model · p = 0.817Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = 0.042Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = 0.174Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
SecondaryPercent Change From Baseline Over Time in BALP

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BALP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · percent change
Percent Change From Baseline Over Time in BALP
percent changeBurosumab
Week 245.15 ± 13.06
Week 48-16.56 ± 8.35
Week 96-30.40 ± 8.57
Week 144-35.82 ± 9.47
Week 168-40.97 ± 9.60
Week 192-41.11 ± 9.93
Week 216-28.41 ± 20.71
Week 240-42.27 ± 11.65
Statistical analysis
  • Burosumab · GEE model · p = 0.694Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = 0.047Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = 0.170Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline BALP.
SecondaryChange From Baseline Over Time in Carboxy Terminal Cross-Linked Telopeptide of Type 1 Collagen (CTx)

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline CTx, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · pg/mL
Change From Baseline Over Time in Carboxy Terminal Cross-Linked Telopeptide of Type 1 Collagen (CTx)
pg/mLBurosumab
Week 24212.91 ± 125.76
Week 4897.02 ± 80.10
Week 966.55 ± 63.66
Week 144-19.28 ± 38.49
Week 168-100.84 ± 49.31
Week 192-200.40 ± 65.80
Week 216-140.71 ± 94.55
Week 240-92.14 ± 102.27
Statistical analysis
  • Burosumab · GEE model · p = 0.090Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.226Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.918Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.616Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.041Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.137Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.368Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
SecondaryPercent Change From Baseline Over Time in CTx

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline CTx, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · percent change
Percent Change From Baseline Over Time in CTx
percent changeBurosumab
Week 2433.77 ± 14.33
Week 4831.05 ± 20.220
Week 9611.96 ± 12.05
Week 14410.92 ± 8.86
Week 168-2.23 ± 8.29
Week 192-15.90 ± 11.21
Week 216-10.53 ± 7.40
Week 240-5.68 ± 10.26
Statistical analysis
  • Burosumab · GEE model · p = 0.018Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.133Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.321Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.218Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.788Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.156Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.155Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
  • Burosumab · GEE model · p = 0.580Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline CTx.
SecondaryChange From Baseline Over Time in Procollagen Type 1 N-Propeptide (P1NP)

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline P1NP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · ng/mL
Change From Baseline Over Time in Procollagen Type 1 N-Propeptide (P1NP)
ng/mLBurosumab
Week 2434.07 ± 10.90
Week 487.73 ± 7.05
Week 9611.28 ± 15.56
Week 1441.21 ± 5.55
Week 168-12.04 ± 3.36
Week 192-11.93 ± 8.11
Week 216-7.53 ± 14.58
Week 240-1.67 ± 14.39
Statistical analysis
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.273Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.469Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.828Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.141Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.606Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.907Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
SecondaryPercent Change From Baseline Over Time in P1NP

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline P1NP, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · percent change
Percent Change From Baseline Over Time in P1NP
percent changeBurosumab
Week 2453.71 ± 16.35
Week 4815.64 ± 10.84
Week 9618.09 ± 20.29
Week 14413.65 ± 8.68
Week 168-12.40 ± 4.98
Week 1920.93 ± 19.78
Week 216-7.58 ± 17.45
Week 2404.47 ± 16.82
Statistical analysis
  • Burosumab · GEE model · p = 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.149Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.372Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.116Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.013Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.962Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.664Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
  • Burosumab · GEE model · p = 0.790Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline P1NP.
SecondaryChange From Baseline Over Time in Osteocalcin

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline osteocalcin, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · ng/mL
Change From Baseline Over Time in Osteocalcin
ng/mLBurosumab
Week 249.51 ± 4.85
Week 482.20 ± 3.48
Week 96-0.54 ± 2.75
Week 144-0.52 ± 1.89
Week 168-3.14 ± 1.35
Week 192-6.91 ± 2.49
Week 216-7.97 ± 5.35
Week 240-8.55 ± 5.22
Statistical analysis
  • Burosumab · GEE model · p = 0.050Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.526Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.845Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.782Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.020Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.136Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.101Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
SecondaryPercent Change From Baseline Over Time in Osteocalcin

Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline osteocalcin, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · percent change
Percent Change From Baseline Over Time in Osteocalcin
percent changeBurosumab
Week 2441.49 ± 12.19
Week 4816.28 ± 13.79
Week 9615.04 ± 14.10
Week 14414.08 ± 8.38
Week 168-0.98 ± 7.11
Week 192-19.67 ± 10.42
Week 216-5.65 ± 11.48
Week 240-8.37 ± 10.17
Statistical analysis
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.238Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.286Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.093Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.890Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.059Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
  • Burosumab · GEE model · p = 0.623 (Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.)
  • Burosumab · GEE model · p = 0.411Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline osteocalcin.
SecondaryChange From Baseline Over Time in Hand-Held Dynamometry (HHD) Elbow Measurements

To assess muscle strength, hand-held dynamometry was conducted using a standardized technique. Bilateral strength (defined as the average of the left and the right scores, measured in kilograms) of the elbow flexors and extensors was measured by the maximum voluntary isometric contraction against a dynamometer. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline strength measurements, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24 and 48
Reported as:
Least squares mean · kg
Change From Baseline Over Time in Hand-Held Dynamometry (HHD) Elbow Measurements
kgElbow FlexionElbow Extension
Week 240.12 ± 0.5120.75 ± 0.704
Week 480.32 ± 0.7531.06 ± 0.760
Statistical analysis
  • Elbow Flexion · GEE model · p = 0.8209Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Elbow Extension · GEE model · p = 0.2851Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Elbow Flexion · GEE model · p = 0.6689Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Elbow Extension · GEE model · p = 0.1612Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Hand-Held Dynamometry (HHD) Knee Measurements

To assess muscle strength, hand-held dynamometry was conducted using a standardized technique. Bilateral strength (defined as the average of the left and the right scores, measured in kilograms) of the knee flexors and extensors was measured by the maximum voluntary isometric contraction against a dynamometer. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline strength measurements, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24 and 48
Reported as:
Least squares mean · kg
Change From Baseline Over Time in Hand-Held Dynamometry (HHD) Knee Measurements
kgKnee FlexionKnee Extension
Week 240.94 ± 1.139-0.89 ± 1.573
Week 481.21 ± 1.2970.75 ± 1.158
Statistical analysis
  • Knee Flexion · GEE model · p = 0.4093Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Knee Extension · GEE model · p = 0.5720Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Knee Flexion · GEE model · p = 0.3501Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Knee Extension · GEE model · p = 0.5172Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Sit-to-Stand (STS) Test

The STS test measures lower extremity strength and mobility as a participant moves repeatedly from a seated position to standing. This study used a modified STS test that allowed participants to use the arms of the chair to help them stand and sit if necessary. The number of sit-to-stand repetitions performed in a 30-second period was recorded. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24 and 48
Reported as:
Least squares mean · sit-to-stand repetitions
Change From Baseline Over Time in Sit-to-Stand (STS) Test
sit-to-stand repetitionsBurosumab
Week 241.5 ± 0.54
Week 481.6 ± 0.50
Statistical analysis
  • Burosumab · GEE model · p = 0.0046Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline STS measurement.
  • Burosumab · GEE model · p = 0.0012Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline STS measurement.
SecondaryChange From Baseline Over Time in Weighted Arm Lift (WAL) Test

The Weighted arm lift (WAL) test assesses upper extremity strength, mobility and reaching ability. The test was administered bilaterally to determine the number of times the participant could raise a 1 kg weight above the head in a 30-second period. The number of repetitions completed with each arm was recorded. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline WAL measurements, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24 and 48
Reported as:
Least squares mean · arm lifts
Change From Baseline Over Time in Weighted Arm Lift (WAL) Test
arm liftsLeft Upper ExtremityRight Upper Extremity
Week 24-0.5 ± 1.090.6 ± 0.89
Week 480.1 ± 1.251.7 ± 1.17
Statistical analysis
  • Left Upper Extremity · GEE model · p = 0.6475Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Right Upper Extremity · GEE model · p = 0.5319Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Left Upper Extremity · GEE model · p = 0.9206Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Right Upper Extremity · GEE model · p = 0.1530Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Six-Minute Walk Test (6MWT)

The 6MWT is a commonly used measure of mobility and was conducted in accordance with general principles set forth in the American Thoracic Society guidelines (ATS 2002). Participants were instructed to walk the length of a pre-measured course for 6 consecutive minutes (assistive devices could be used). The total distance walked at the end of 6 minutes was recorded in meters. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline 6MWT measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24 and 48
Reported as:
Least squares mean · meters
Change From Baseline Over Time in Six-Minute Walk Test (6MWT)
metersBurosumab
Week 2419.5 ± 15.64
Week 4825.5 ± 16.58
Statistical analysis
  • Burosumab · GEE model · p = 0.2125Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.1241Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Pain Inventory (BPI) Worst Pain Score

The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Worst pain is defined as the answer to Question 3, in which participants rated their pain at its worst in the last 24 hours on a scale from 0 (no pain) to 10 (pain as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Pain Inventory (BPI) Worst Pain Score
score on a scaleBurosumab
Week 24-0.6 ± 0.7
Week 48-0.9 ± 0.7
Week 96-0.7 ± 0.4
Week 144-1.1 ± 0.6
Week 168-0.9 ± 0.7
Week 192-0.9 ± 0.6
Week 216-0.9 ± 0.8
Week 240-0.9 ± 0.9
Statistical analysis
  • Burosumab · GEE model · p = 0.410Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.210Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.060Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.076Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.171Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.141Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.263Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.320Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Pain Inventory (BPI) Pain Severity Score

The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Pain severity is defined as the average of 4 questions (Questions 3 through 6) assessing worst pain, least pain, average pain, and pain right now, rated on a scale from 0 (no pain) to 10 (pain as bad as you can imagine). Mild pain is defined as a score of 1 to 4, moderate pain is defined as a score of 5 to 6, and severe pain is defined as a score of 7 to 10. A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Pain Inventory (BPI) Pain Severity Score
score on a scaleBurosumab
Week 24-0.51 ± 0.62
Week 48-0.87 ± 0.66
Week 96-0.62 ± 0.38
Week 144-0.99 ± 0.42
Week 168-1.21 ± 0.40
Week 192-0.81 ± 0.66
Week 216-0.75 ± 0.63
Week 240-0.91 ± 0.76
Statistical analysis
  • Burosumab · GEE model · p = 0.407Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.192Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.106Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.020Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.220Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.230Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.232Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Pain Inventory (BPI) Pain Interference Score

The Brief Pain Inventory (BPI) is a self-reported, pain-specific questionnaire with a recall period of 24 hours. Pain interference is defined as the average of 7 questions (9A through 9G) regarding the extent to which pain interfered with daily activities, including general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life in the last 24 hours, rated on a scale from 0 (does not interfere) to 10 (completely interferes). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BPI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Pain Inventory (BPI) Pain Interference Score
score on a scaleBurosumab
Week 24-1.15 ± 0.66
Week 48-1.09 ± 0.80
Week 96-1.08 ± 0.55
Week 144-1.46 ± 0.61
Week 168-1.76 ± 0.37
Week 192-1.11 ± 0.58
Week 216-1.56 ± 0.87
Week 240-2.00 ± 1.10
Statistical analysis
  • Burosumab · GEE model · p = 0.082Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.176Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.047Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.017Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.000Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.057Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.071Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.070Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Fatigue Inventory (BFI) Worst Fatigue Score

The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. Worst fatigue is defined as the answer to Question 3 in which participants rated their fatigue at its worst in the last 24 hours on a scale from 0 (no fatigue) to 10 (as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Worst Fatigue Score
score on a scaleBurosumab
Week 24-1.3 ± 0.5
Week 48-0.9 ± 0.8
Week 96-1.0 ± 0.5
Week 144-0.9 ± 0.6
Week 168-1.6 ± 0.6
Week 192-1.0 ± 0.4
Week 216-2.1 ± 0.9
Week 240-2.6 ± 0.9
Statistical analysis
  • Burosumab · GEE model · p = 0.014Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.309Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.036Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.096Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.022Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.022Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.004Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Severity Score

The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. Fatigue severity is defined as the average of 3 questions (Questions 1 through 3) assessing fatigue right now, usual level of fatigue, and worst fatigue, rated on a scale from 0 (no fatigue) to 10 (as bad as you can imagine). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Severity Score
score on a scaleBurosumab
Week 24-1.47 ± 0.53
Week 48-1.31 ± 0.56
Week 96-1.58 ± 0.43
Week 144-1.44 ± 0.53
Week 168-2.34 ± 0.43
Week 192-1.62 ± 0.43
Week 216-2.62 ± 0.85
Week 240-2.57 ± 0.81
Statistical analysis
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.019Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.006Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Interference Score

The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. The fatigue interference score is defined as the average of 6 questions (Questions 4A through 4F) regarding the extent to which fatigue interfered with daily activities, including general activity, mood, walking ability, work, relations with others, and enjoyment of life in the last 24 hours, rated on a scale from 0 (does not interfere) to 10 (completely interferes). A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Fatigue Interference Score
score on a scaleBurosumab
Week 24-1.57 ± 0.65
Week 48-1.88 ± 0.66
Week 96-1.98 ± 0.47
Week 144-1.67 ± 0.44
Week 168-2.20 ± 0.38
Week 192-1.24 ± 0.59
Week 216-2.72 ± 1.02
Week 240-3.00 ± 1.14
Statistical analysis
  • Burosumab · GEE model · p = 0.016Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.004Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.036Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.008Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.008Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in Brief Fatigue Inventory (BFI) Global Fatigue Score

The Brief Fatigue Inventory (BFI) is a self-reported questionnaire consisting of 9 items related to fatigue that are rated on a 0 to 10 numerical rating scale with a recall period of 24 hours. The first 3 questions measure fatigue severity and the next 6 questions assess the impact of fatigue on daily activities. The global fatigue score is defined as the average of all 9 questions on the BFI including severity and interference, and ranges from from 0 to 10, where higher scores correspond to greater levels of fatigue. A negative change from Baseline score indicates improvement. Least squares means and standard errors were estimated from a generalized estimation equation (GEE) model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline BFI measurement, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in Brief Fatigue Inventory (BFI) Global Fatigue Score
score on a scaleBurosumab
Week 24-1.54 ± 0.56
Week 48-1.66 ± 0.56
Week 96-1.83 ± 0.44
Week 144-1.58 ± 0.44
Week 168-2.23 ± 0.37
Week 192-1.34 ± 0.50
Week 216-2.66 ± 0.95
Week 240-2.83 ± 1.02
Statistical analysis
  • Burosumab · GEE model · p = 0.006Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.003Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = <0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.007Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.006Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Component Summary Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical component summary score (PCS) is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The PCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance struct

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Component Summary Score
score on a scaleBurosumab
Week 243.71 ± 1.42
Week 485.43 ± 2.33
Week 962.75 ± 1.37
Week 1447.98 ± 2.40
Week 1685.20 ± 2.14
Week 1923.82 ± 2.49
Week 2166.17 ± 2.17
Week 2405.82 ± 2.45
Statistical analysis
  • Burosumab · GEE model · p = 0.009Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.020Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.044Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.015Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.125Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.004Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.018Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Functioning Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical functioning (PF) domain includes 10 questions that assess limitations in physical activities because of health problems. The PF domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Physical Functioning Domain Score
score on a scaleBurosumab
Week 242.29 ± 1.58
Week 482.63 ± 2.51
Week 963.77 ± 1.58
Week 1447.89 ± 2.00
Week 1685.50 ± 2.24
Week 1923.02 ± 2.04
Week 2166.75 ± 1.96
Week 2404.56 ± 3.11
Statistical analysis
  • Burosumab · GEE model · p = 0.148Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.295Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.014Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.140Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.142Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Physical Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The role-physical (RP) domain includes 4 questions that assess limitations in usual role activities because of physical health problems. The RP domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Physical Domain Score
score on a scaleBurosumab
Week 244.85 ± 1.74
Week 485.00 ± 2.83
Week 963.25 ± 1.63
Week 1445.53 ± 2.81
Week 1685.70 ± 1.93
Week 1925.03 ± 2.80
Week 2164.82 ± 3.01
Week 2408.99 ± 3.28
Statistical analysis
  • Burosumab · GEE model · p = 0.005Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.077Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.046Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.049Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.003Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.073Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.109Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.006Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Bodily Pain Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The bodily pain (BP) domain includes 2 questions that assess pain level and impact of pain on normal work. The BP domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Bodily Pain Domain Score
score on a scaleBurosumab
Week 241.61 ± 1.65
Week 483.61 ± 1.48
Week 962.52 ± 1.08
Week 1445.40 ± 1.90
Week 1685.01 ± 2.16
Week 1924.92 ± 2.81
Week 2166.64 ± 1.88
Week 2406.59 ± 2.20
Statistical analysis
  • Burosumab · GEE model · p = 0.328Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.015Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.020Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.004Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.021Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.080Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.003Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) General Health Perceptions Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The general health perceptions (GH) domain includes 5 questions that assess participants' perception of their own general health. The GH domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) General Health Perceptions Domain Score
score on a scaleBurosumab
Week 242.38 ± 1.88
Week 486.09 ± 2.28
Week 961.03 ± 1.96
Week 1443.12 ± 2.64
Week 168-0.32 ± 2.51
Week 192-1.60 ± 2.94
Week 216-1.51 ± 2.05
Week 2401.81 ± 3.30
Statistical analysis
  • Burosumab · GEE model · p = 0.207Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.008Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.598Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.237Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.899Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.585Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.461Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.583Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Component Summary Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The mental component summary score (MCS) is a weighted combination of the 8 subscales with positive weighting for vitality, social function, role limitations due to emotional problems, and mental health. The MCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Component Summary Score
score on a scaleBurosumab
Week 241.07 ± 2.38
Week 481.37 ± 2.47
Week 963.91 ± 2.53
Week 144-0.85 ± 2.29
Week 1682.05 ± 1.81
Week 1920.55 ± 2.95
Week 2160.51 ± 2.67
Week 2405.13 ± 3.59
Statistical analysis
  • Burosumab · GEE model · p = 0.654Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.579Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.123Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.712Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.258Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.851Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.849Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.153Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Vitality Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The vitality (VT) domain includes 4 questions that assess energy levels and fatigue. The VT domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Vitality Domain Score
score on a scaleBurosumab
Week 245.98 ± 1.96
Week 485.27 ± 2.42
Week 966.71 ± 2.64
Week 1443.05 ± 2.30
Week 1686.04 ± 2.74
Week 1922.78 ± 2.85
Week 2166.79 ± 3.77
Week 2408.06 ± 4.03
Statistical analysis
  • Burosumab · GEE model · p = 0.002Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.030Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.011Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.186Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.027Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.330Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.072Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.045Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Social Functioning Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The social functioning (SF) domain includes 2 questions that assess limitations in social activities because of physical health or emotional problems. The SF domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Social Functioning Domain Score
score on a scaleBurosumab
Week 242.02 ± 2.24
Week 485.54 ± 2.48
Week 964.63 ± 1.34
Week 1443.22 ± 2.71
Week 1685.34 ± 2.06
Week 1922.84 ± 2.62
Week 2164.15 ± 2.08
Week 2406.30 ± 2.98
Statistical analysis
  • Burosumab · GEE model · p = 0.369Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.026Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = < 0.001Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.235Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.009Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.278Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.046Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.035Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Emotional Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The role-emotional (RE) domain includes 3 questions that assess limitations in usual role activities because of emotional problems. The RE domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Role Emotional Domain Score
score on a scaleBurosumab
Week 241.52 ± 1.98
Week 481.13 ± 2.72
Week 966.73 ± 3.03
Week 1442.10 ± 2.60
Week 1684.90 ± 2.22
Week 1923.51 ± 3.47
Week 2163.56 ± 3.08
Week 2406.04 ± 3.69
Statistical analysis
  • Burosumab · GEE model · p = 0.442Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.677Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.027Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.420Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.027Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.312Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.249Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.102Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
SecondaryChange From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Health Domain Score

The SF-36 v2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The mental health (MH) domain includes 5 questions that assess general mental health (psychological distress and well-being). The MH domain score was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement. LS means and SEs were estimated from a GEE model which includes the change from Baseline as the dependent variable, time as the categorical variable and adjusted for Baseline SF-36, with compound symmetry covariance structure.

Time frame:
Baseline and Weeks 24, 48, 96, 144, 168, 192, 216, and 240
Reported as:
Least squares mean · score on a scale
Change From Baseline Over Time in 36-Item Short Form Health Survey (SF-36) Mental Health Domain Score
score on a scaleBurosumab
Week 24-0.46 ± 2.54
Week 48-0.32 ± 2.48
Week 96-0.58 ± 2.12
Week 144-0.17 ± 1.97
Week 168-0.97 ± 1.61
Week 192-1.24 ± 2.23
Week 216-2.11 ± 2.87
Week 2403.50 ± 3.10
Statistical analysis
  • Burosumab · GEE model · p = 0.856Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.898Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.785Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.932Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.545Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.580Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.462Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
  • Burosumab · GEE model · p = 0.260Generalized estimation equation (GEE) model includes time as the categorical variable and adjusted for Baseline measurement.
Other pre-specifiedNumber of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious TEAEs, and TEAEs Leading to Discontinuation

An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug, whether or not considered drug related. A serious AE was defined as an AE that at any dose, in the view of either the Investigator or Sponsor, results in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant incapacity or disability, a congenital anomaly/birth defect, or other important medical events (according to the investigator). An AE was considered a TEAE if it occurred on or after the first dose and was not present prior to the first dose, or it was present prior to the first dose but increased in severity during the study. Events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0: grade 1 (mild), grade 2 (moderate), grade 3 (severe), grade 4 (life-threatening), grade 5 (death).

Time frame:
From first dose of study drug up to database lock date (July 07, 2021); median duration of treatment in the TIO analysis set was 1594.0 (range: 168-2106) days.
Reported as:
Count of participants · Participants
Number of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious TEAEs, and TEAEs Leading to Discontinuation
ParticipantsBurosumab
Any adverse event14
Serious adverse events (SAEs)8
Related adverse events9
Serious related adverse events0
Grade 3 or 4 adverse event8
TEAE leading to study discontinuation0
TEAE leading to treatment discontinuation1
TEAE leading to death2
Other pre-specifiedNumber of Participants With Anti-burosumab Antibodies
Time frame:
From first dose of study drug up to database lock date (July 07, 2021); median duration of treatment in the TIO analysis set was 1594.0 (range: 168-2106) days.
Reported as:
Count of participants · Participants
Number of Participants With Anti-burosumab Antibodies
ParticipantsBurosumab
Anti-burosumab binding antibodies2
Anti-burosumab neutralizing antibodies0

Adverse events

Collected over From first dose of study drug up to database lock date (July 07, 2021); median duration of treatment in the TIO analysis set was 1594.0 (range: 168-2106) days.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
KRN23 TIO2/14 (14.3%)8/14 (57.1%)14/14 (100%)
KRN23 XLH and ENS0/3 (0%)0/3 (0%)3/3 (100%)
Most frequent serious events
Showing 10 of 20
Most frequent serious events
EventKRN23 TIOKRN23 XLH and ENS
Neoplasm ProgressionNeoplasms benign, malignant and unspecified (incl cysts and polyps)4/140/3
Cardiac ArrestCardiac disorders2/140/3
Acute Respiratory FailureRespiratory, thoracic and mediastinal disorders2/140/3
Pulseless Electrical ActivityCardiac disorders1/140/3
AscitesGastrointestinal disorders1/140/3
PancreatitisGastrointestinal disorders1/140/3
Multi-Organ FailureGeneral disorders1/140/3
CholangitisHepatobiliary disorders1/140/3
Septic ShockInfections and infestations1/140/3
SialoadenitisInfections and infestations1/140/3
Most frequent other events
Showing 10 of 244
Most frequent other events
EventKRN23 TIOKRN23 XLH and ENS
Musculoskeletal PainMusculoskeletal and connective tissue disorders4/142/3
Pain In ExtremityMusculoskeletal and connective tissue disorders9/142/3
ArthralgiaMusculoskeletal and connective tissue disorders9/141/3
Upper Respiratory Tract InfectionInfections and infestations7/141/3
CoughRespiratory, thoracic and mediastinal disorders7/141/3
DiarrhoeaGastrointestinal disorders6/140/3
NauseaGastrointestinal disorders5/141/3
VomitingGastrointestinal disorders5/141/3
NasopharyngitisInfections and infestations5/141/3
Back PainMusculoskeletal and connective tissue disorders5/140/3

Baseline characteristics

All enrolled participants

Age, Continuous
Age, Continuous(years)Burosumab
Mean53.1 ± 13.86
Sex: Female, Male
Sex: Female, Male(Participants)Burosumab
Female8
Male9
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Burosumab
Hispanic or Latino0
Not Hispanic or Latino17
Unknown or Not Reported0
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Burosumab
American Indian or Alaska Native0
Asian0
Black or African American2
Native Hawaiian or Other Pacific Islander0
White15
Other0
Diagnosis
Diagnosis(Participants)Burosumab
Tumor-Induced osteomalacia (TIO)14
Epidermal nevus syndrome-associated osteomalacia1
X-linked hypophosphatemia (XLH)2
Serum Total Fibroblast Growth Factor 23 (FGF23)
Serum Total Fibroblast Growth Factor 23 (FGF23)(pg/mL)Burosumab
Mean770.06 ± 797.654
Serum Phosphorus
Serum Phosphorus(mg/dL)Burosumab
Mean1.60 ± 0.474
Osteoid Volume/Bone Volume (OB/BV)
Osteoid Volume/Bone Volume (OB/BV)(percentage of bone volume)Burosumab
Mean17.61 ± 19.485

3 further baseline measures are reported on the registry.

07

Study locations

7 sites
  • Colorado Center for Bone Research at Panorama Orthopedics and Spine Center
    Golden, Colorado 80401, United States
  • Yale University School of Medicine
    New Haven, Connecticut 06510, United States
  • Indiana University Hospital
    Indianapolis, Indiana 46202, United States
  • Johns Hopkins University
    Baltimore, Maryland 21224, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Duke University
    Durham, North Carolina 27710, United States
  • Houston Methodist Research Institute
    Houston, Texas 77030, United States
08

References and documents

Publications

  • Khadora M, Mughal MZ. Burosumab treatment in a child with cutaneous skeletal hypophosphatemia syndrome: A case report. Bone Rep. 2021 Oct 1;15:101138. doi: 10.1016/j.bonr.2021.101138. eCollection 2021 Dec. PubMed 34660853 ↗

Study documents

  • Study protocol · Sep 26, 2019
  • Statistical analysis plan · May 4, 2016

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT02304367
Lead sponsor
Kyowa Kirin, Inc.
Responsible party
Sponsor
First posted
Dec 1, 2014
Start date
Mar 24, 2015
Primary completion
Jul 27, 2017
Completion
Jan 21, 2021
Results posted
Jul 30, 2020
Last update
May 6, 2024

Study contacts

Medical Director
study director · Ultragenyx Pharmaceutical Inc

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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