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Not yet recruitingNCT07435051Updated Feb 27, 2026

Prospective, Randomized, Multicenter Clinical Trial of Bisphosphonates Combined With Vancomycin for the Treatment of Cierny-Mader Type I and III Osteomyelitis

A Phase 3 interventional study of Bisphosphonates Combined with Vancomycin and Vancomycin in Osteomyelitis (Refractory), sponsored by Second Affiliated Hospital, School of Medicine, Zhejiang University. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-02-27.

Sponsored by Second Affiliated Hospital, School of Medicine, Zhejiang University · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
280
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Efficacy and Safety of Bisphosphonates Combined with Vancomycin in the Treatment of Refractory Osteomyelitis

02

Conditions studied

  • Osteomyelitis (Refractory)

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Keywords

  • Osteomyelitis
  • Vancomycin
  • Bisphosphonates
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients diagnosed with chronic osteomyelitis (Cierny-Mader type I and III) based on clinical manifestations (local pain, redness and swelling, sinus tract formation, etc.), laboratory findings (elevated white blood cell count, neutrophil ratio, CRP and ESR, positive pathogenic bacterial culture), and typical imaging features (X-ray, CT, MRI), and who require debridement surgery.
  • Pathogen susceptibility testing confirms the causative organism as Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA).
  • Subjects aged 18 to 65 years.
  • Male or female subjects.
  • Written informed consent is obtained from the subject and their family members.
  • The study protocol has been approved by the hospital ethics committee.
  • Willing and able to comply with the study protocol, scheduled follow-up, and toxicity management as judged by the study investigators.

Exclusion criteria

Exclusion Criteria:

  • Known hypersensitivity or resistance to the components of the product (bisphosphonates, vancomycin)NCBI.
  • Currently on long-term bisphosphonate therapy, or having received intravenous bisphosphonates within the past year.
  • Patients with systemic infectious diseases (sepsis, bacteremia, or septicemia) or immunocompromised status (HIV/AIDS or receiving immunosuppressive medications).
  • Patients with granulocytopenia (\< 1×10⁹/L).
  • Patients with poorly controlled diabetes (HbA1c > 8%).
  • History of gastrointestinal bleeding or active hemoptysis (at least half a teaspoon of bright red blood) within 3 weeks prior to the first dose of study medication.
  • Patients with unexplained hypocalcemia.
  • Patients with renal impairment (serum creatinine > 177 μmol/L or eGFR \< 50 mL/min).
  • Females who are breastfeeding or pregnant at screening or baseline.
  • Currently enrolled in another clinical trial, or having received any investigational drug or device within 30 days prior to providing informed consent.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
280 participants (estimated)

Study arms

  • Experimental
    Bisphosphonates Combined with Vancomycin

    To evaluate the infection control effect of bisphosphonate combined with vancomycin in treatment of refractory osteomyelitis.

    Drug: Bisphosphonates Combined with Vancomycin

  • Active comparator
    Vancomycin

    Effect of vancomycin on infection control of refractory osteomyelitis.

    Drug: Vancomycin

Interventions

  • DrugBisphosphonates Combined with Vancomycin

    After undergoing debridement surgery for osteomyelitis. 1. Bisphosphonates: fasting oral alendronate 70mg/w for 24 weeks. 2. Vancomycin: intravenous infusion of 2 g/d, given twice with an interval of 12 hours, 1 g each time, treatment for 1 weeks, sequential oral linezolid for total 6 weeks, during which strict attention was paid to drug side effects.

  • DrugVancomycin

    After undergoing debridement surgery for osteomyelitis. 1. Placebo: fasting oral placebo 1 piece/w for 24 weeks. 2. Vancomycin: intravenous infusion of 2 g/d, given twice with an interval of 12 hours, 1 g each time, treatment for 1 weeks, sequential oral linezolid for total 6 weeks, during which strict attention was paid to drug side effects.

05

What researchers measure

Primary outcomes

  1. Infection control rate at 6 months

    The primary outcome of this trial is the status of infection control within 6 months after treatment. Infection control is defined by meeting the following three criteria: (1) The patient's body temperature returns to normal, and the local wound heals well (no exudation or purulence, no redness, swelling, or pain). (2) Blood routine tests (white blood cell count, neutrophil ratio) and inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) show a progressive decrease until they return to normal levels. (3) X-ray imaging indicates the formation of new bone callus.

    Time frame: 6 months

Secondary outcomes

  1. Infection control rate within 1 year

    No clinical, biological, or radiological signs of infection (pain, fever); Or the same bacteria come back.

    Time frame: 1 year

06

Study locations

1 site
  • the Second Affiliated Hospital of Zhejiang University School of Medicine
    Hangzhou, Zhejiang 310000, China
07

References and documents

Individual participant data

Plan to share: Undecided — Due to policy constraints, it was not clear whether information could be shared.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07435051
Lead sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
Responsible party
Sponsor
First posted
Feb 27, 2026
Start date
May 1, 2026 (estimated)
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Feb 27, 2026

Study contacts

Zhao Ming Ye, PhD
Contact
yezhaominghz@163.com
86-1360651549
Zeng Jie Zhang, PhD
Contact
zhangzengjie330@163.com

Oversight

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

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