ClinicalTrials.gg
RecruitingNCT04522622Updated Apr 23, 2024

Treatment of Adynamic Bone Disorder With Parathyroid Hormone in Chronic Kidney Disease

A Phase 4 interventional study of Teriparatide and DXA,VFA, X-ray, HR-pQCT, 18-F NAF PET/CT in Adynamic Bone Disease, Chronic Kidney Diseases and Cardiac Disease, sponsored by Ditte Hansen. Recruiting at 4 sites in Denmark. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2024-04-23.

Sponsored by Ditte Hansen · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Started Dec 2021; still recruiting 4 years 10 months later.

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Phase
Phase 4
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 120 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 116 studies in Renal Insufficiency, Chronic with a site in Denmark — 27 open to participants now, 35 under way, 9 of them phase 3. Renal Insufficiency, Chronic · Denmark.

Planned enrollment
67th of 90
48 · median 136
Started
2021
with 11 others
Phase 4
8 of 116
4 open now
Primary completion
2026-09
later than 10 of 34 live
Registered
62nd of 116
by date

Among the 116 studies in Renal Insufficiency, Chronic with a site in Denmark, this one is the 67th largest by planned enrollment of the 90 interventional ones that give a count, is one of 12 that started in 2021, is one of 8 in phase 4, reaches primary completion later than 10 of the 34 other live ones, and was the 62nd registered.

Renal Insufficiency, Chronic

3,095 studies on the registry are indexed under Renal Insufficiency, Chronic; 701 are open to participants now.

Browse Renal Insufficiency, Chronic studies →

Open to participants now

27 of the 116 studies in Renal Insufficiency, Chronic with a site in Denmark are open now. Recruiting first, the newest first:

21 more — sign in →

All 27 open studies →

A study can be open while its sites in Denmark have not opened yet or have stopped. Only those recruiting at a site in Denmark →

Who these studies take

Of the 435 Renal Insufficiency, Chronic studies recruiting now, 244 (56%) set no upper age limit and 111 (26%) stop at 75 or younger; 45 take children under 18; 80 take healthy volunteers.

This study: 18 Years to 120 Years · all sexes · no healthy volunteers.

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02

Study summary

This study is a 1:1 randomized controlled trial with an intervention for 18 months and a follow up period of 12 months. The purpose of the study is to assess the safety and efficacy of recombinant human parathyroid hormone for treatment of adynamic bone disorder in patients with chronic kidney disease.

Read the detailed description

This study is a 1:1 randomized controlled trial with an intervention for 18 months and a follow up period of 12 months.

The study will explore if treatment with recombinant human parathyroid hormone (PTH) improves bone turnover and bone mineral density (BMD), and thereby prevents the high risk of fracture in patients with chronic kidney disease (CKD).

Disturbed bone metabolism is related to increased risk of cardiovascular disease in patients with CKD. This study also wishes to examine of treatment with recombinant PTH improves cardiovascular parameters.

03

Conditions studied

  • Adynamic Bone Disease
  • Chronic Kidney Diseases
  • Cardiac Disease
  • Chronic Kidney Disease-Mineral and Bone Disorder

Keywords

  • Fracture risk
  • Teriparatide
04

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥18 years
  • CKD stage 4-5D ( ≤29 ml/min) according to Kidney Disease Improving Global Outcomes(KDIGO) definition
  • DXA scan with a T-score at the total hip, femoral neck or lumbar spine (L1-4) ≤-2 (or Z-score ≤-2) in a minimum of 2 vertebraes (for patients with active oral prednisolone treatment ≥ 5 mg/day for minimum 3 months the T-score or Z-score limit i \< -1) and/or former fragility fracture (vertebral, hip, for- or upper arm, ankle) assessed with VFA or x-ray of the columna
  • Patients with expected adynamic bone disorder, based on BSAP≤21 µg/l or -verified low bone turnover

Exclusion criteria

Exclusion Criteria:

  • Hypercalcemia defined as sustained ionized calcium >1.35 mmol/l
  • Previous fracture withon the last 6 months *Patients may be rescreened after the 6 months
  • Previous calciphylaxis
  • Thyroid disturbances not adequately treated based on the opinion by the clinician *Patients may be rescreened after treatment optimization
  • Treatment with digoxin
  • Paget's disease or other metabolic bone disorders
  • Antiresorptive or bone anabolic medication during the last 24 months (for bisphosphonates it is only during the last 12 months)
  • Former or present malignant disease (except skin basal or planocellular carcinoma)
  • Previous external beam or implant radiation therapy to the skeleton
  • Patients who have undergone a kidney transplantation within the last 12 months
  • 25 hydroxyvitamin D2 and D3 \<50 nmol/l *Patients may be rescreened after correction
  • Inability to administer teriparatide
  • Reduced liver function * (ALAT) >3x or > 2x upper limit of normal
  • Pregnancy, lactation or fertile women ( females are not considered fertile) not using safe anticonception (the following methods are considered appropriate: Intrauterine device (IUD) or hormonal anticontraceptive (oral contraceptives, implant, transdermal patches, vaginal ring or depot injection)).
  • to the active substance in teriparatide or to any of the or content
  • Inability to provide
  • Medical conditions or treatments that may interfere with assessments of the outcomes of the trial
  • Drug or alcohol abuse
  • Unable to participate in a clinical study based on the judgement by the local investigator
  • For those participating in the bone procedure: 1) Hypersensitivity to any of the tetracyclines or to any of the excipients or content, 2) Treatment with anticoagulants (vitamin K antagonists, Non-vitamin K Antagonist Oral Anticoagulants (NOAC), unfractionated or low-molecular heparin or antiplatelet agents that, due to clinical indication can't be paused, 3) Disturbances in thrombosis and/or haemostasis
  • For those participating in pulse wave measurements: 1) Atrial fibrillation, 2) Aorta stenosis
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
48 participants (estimated)

Study arms

  • Experimental
    Teriparatide

    Patients receive teriparatide 20 micrograms once daily for 18 months

    Drug: Teriparatide · Diagnostic Test: DXA,VFA, X-ray, HR-pQCT, 18-F NAF PET/CT · Procedure: Bone biopsy · Diagnostic Test: Cardiac tests · Other: Blood and urine samples and physical examination

  • Other
    Controls

    Controls receive no treatment with teriparatide

    Diagnostic Test: DXA,VFA, X-ray, HR-pQCT, 18-F NAF PET/CT · Procedure: Bone biopsy · Diagnostic Test: Cardiac tests · Other: Blood and urine samples and physical examination

Interventions

  • 20 micrograms

    Also known as: Terrosa

  • Diagnostic testDXA,VFA, X-ray, HR-pQCT, 18-F NAF PET/CT

    All participants undergo DXA and VFA or X-ray scans 3 times during the study. Some participants (those connected to Herlev) are offered 18F NAF PET/CT scans at baseline and after 12 months and some participants (those connected to Odense University Hospital and Aalborg University Hospital) are offered HR-pQCT scans at baseline and after 12 months. The 18F-NAF PET/CT and HR-pQCT are optional, so it is not a must to have these procedures done to participate in the study.

  • ProcedureBone biopsy

    All participants are invited to undergo a bone biopsy after 12 months, but it is not a must to have the procedure done to participate in the study.

  • Diagnostic testCardiac tests

    All participants are invited to undergo 24-hour blood pressure measurements and pulse wave measurements at baseline and after 18 months, but it is not a must to have these procedures done to participate in the study.

  • OtherBlood and urine samples and physical examination

    All participants must undergo a physical examination and deliver blood and urine samples in order to participate in the study.

06

What researchers measure

Primary outcomes

  1. Changes in bone specific alkaline phosphatase (BSAP)

    The difference between treated and controls in changes from baseline to 18 months in bone specific alkaline phosphatase

    Time frame: Baseline and 18 months

Secondary outcomes

  1. Number of patients who no longer has adynamic bone disorder based on a BSAP >21 µg/l

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. It is also measured through study completion, an average of 30 months

  2. BMD at the lumbar spine, antebrachium, femoral neck and total hip

    Changes between baseline and 18 months as well as differences between treated and controls

    Time frame: Baseline and 18 months. The scan is also performed at 30 months

  3. Incidence of fragility fractures and vertebral fractures assessed using x-ray of columna or vertebral fracture assessment (VFA)

    Changes between baseline and 18 months as well as differences between treated and controls

    Time frame: Baseline and 18 months. The scan is also performed at 30 months

  4. Bone microarchitecture assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT)

    Changes between baseline and 12 months as well as differences between treated and controls. The HR-pQCT scan is a voluntary procedure.

    Time frame: Baseline and 12 months

  5. Volumetric BMD assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT)

    Changes between baseline and 12 months as well as differences between treated and controls. The HR-pQCT scan is a voluntary procedure.

    Time frame: Baseline and 12 months

  6. Bone geometry assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT)

    Changes between baseline and 12 months as well as differences between treated and controls. The HR-pQCT scan is a voluntary procedure.

    Time frame: Baseline and 12 months

  7. Bone strength assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT)

    Changes between baseline and 12 months as well as differences between treated and controls. The HR-pQCT scan is a voluntary procedure.

    Time frame: Baseline and 12 months

  8. Regional bone formation using 18F-Sodium Fluoride Positron Emission Tomography/Computed Tomography (18F-NAF PET/CT)

    Changes between baseline and 12 months as well as differences between treated and controls. The 18F-NAF PET/CT is a voluntary procedure.

    Time frame: Baseline and 12 months

  9. Changes in p-PTH

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. Some of them are also measured during follow up.

  10. Changes in p-phosphate

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. Some of them are also measured during follow up.

  11. Changes in p-magnesium

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. Some of them are also measured during follow up.

  12. Changes in calcium

    P-ionised calcium. Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. Some of them are also measured during follow up.

  13. Bone histomorphometry

    Static and dynamic bone histomorphometry classified by the bone Turnover Mineralization Volume (TMV) classification assessed by bone biopsy. Performed after 12 months. This is a voluntary procedure.

    Time frame: 12 months

  14. Changes in Intact Procollagen type 1 N-terminal Propeptide (P1NP)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  15. Changes in total P1NP

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  16. Changes in Tartrate-Resistant Acid Phosphatase 5b (TRAP5b)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  17. Changes in sclerostin

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  18. Changes in Receptor Activator of Nuclear factor Kappa-B Ligand (RANKL)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  19. Changes in Osteoprotegerin (OPG)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  20. Changes in Fibroblast Growth Factor 23 (FGF-23)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months. They are also measured during follow up

  21. 24-hour blood pressure

    Changes between baseline and 18 months as well as differences between treated and controls. These are voluntary procedures.

    Time frame: Baseline and 18 months

  22. Pulse wave measurements including velocity

    Changes between baseline and 18 months as well as differences between treated and controls. These are voluntary procedures.

    Time frame: Baseline and 18 months

  23. Changes in cardiovascular marker Calciprotein Particles (CPP)/T50

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months

  24. Changes in cardiovascular marker N-Terminal pro B-type Natriuretic Peptide (NT-proBNP)

    Changes between baseline and 18 months as well as differences between treated and controls.

    Time frame: Baseline and 18 months

  25. Adverse reactions

    The incidence of adverse reactions in treated patients. This is examined during the entire study.

    Time frame: From baseline to 18 months

  26. Bone microstructure

    Bone mictrostructure by micro-compyter tomography of the bone biopsy

    Time frame: 12 months

  27. Bone histology

    Detailed histology of underlying cellular mechanisms using a combination of immunostainings and advanced in situ hybridizations on the bone biopsy

    Time frame: 12 months

07

Study locations

1 of 4 sites recruiting
08

References and documents

Individual participant data

Plan to share: No — As of now we have no plan to share Individual Participant Data (IPD) with other researchers

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Dec 2021 (actual). Primary completion is estimated for Sep 2026, 56 months after the start.

Of 100 non-industry phase 4 interventional studies under Renal Insufficiency, Chronic, half reached primary completion within 46 months of starting (the median), counting those still running; a quarter within 24 and three quarters within 67. This study's planned 56 months is above that.

Counting every sponsor, half of 116 studies reached it within 43 months; a quarter within 22 and three quarters within 67.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 13, 2020
First posted
Aug 21, 2020
StartActual
Dec 15, 2021
Primary completionEst.
Sep 1, 2026
CompletionEst.
Sep 1, 2027
Last update
Apr 23, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 23, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04522622
Lead sponsor
Ditte Hansen
Responsible party
Ditte Hansen (MD, PhD, Herlev Hospital) — Sponsor-investigator
First posted
Aug 21, 2020
Start date
Dec 15, 2021
Primary completion
Sep 1, 2026 (estimated)
Completion
Sep 1, 2027 (estimated)
Last update
Apr 23, 2024

Study contacts

Sabina C Hauge, MD
Contact
sabina.chaudhary.hauge@regionh.dk
+4528965887
Ditte Hansen, MD, PhD
Contact
ditte.hansen.04@regionh.dk
+4538682056
Ditte Hansen, MD, PhD
principal investigator · Department of Nephrology, Herlev and Gentofte Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Teriparatide

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