Fracture HealingPhase 2STARTT-HipNCT01081678
Study To Assess FRacTure Healing With SclerosTin Antibody - Hip
A Phase 2 study testing Romosozumab in people with Fracture Healing, run by Amgen at 99 sites in 24 countries.
Trial summary
This is an international, multi-center study to determine the efficacy, safety, and tolerability of romosozumab (AMG 785) in adults with a fresh unilateral hip fracture, status post surgical fixation. Read more about this study
- Who is it for?
- Ages 55 to 95 years
- Conditions the study is for
- Fracture Healing
- What is being tested?
- Romosozumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 332 participants
- Where
- 99 sitesin 24 countries
- Study dates
- 20 Jun 2010to 10 May 2013
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 55 to 95 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Males and females, age 55 to 95 years
- fresh unilateral low energy intertrochanteric or femoral neck fracture as the primary injury, confirmed by X-ray and in the opinion of the treating surgeon amenable to repair by internal fixation
- internal fixation of the fracture with devices approved by local regulatory agency, performed no later than 7 days after injury for intertrochanteric or undisplaced femoral neck fractures and no later than 2 days after injury for displaced femoral neck fractures
- intertrochanteric fracture: sliding hip screw or IM nail
- femoral neck fracture: sliding hip screw or at least 3 cancellous screws
Who cannot join
- severe symptomatic osteoarthritis of the lower extremity
- inability to independently rise from armchair or walk 200 meters before hip fracture
- presence of concomitant injuries such as rib fractures, wrist fractures, or acute symptomatic vertebral fractures which severely impair the ability to rise from a chair
- associated extremity injuries including ipsilateral or contralateral fractures of the foot, tibia or fibula, wrist, humerus, femoral shaft, femoral head or hip dislocation, that may delay weight-bearing beyond one week after surgery
- head-injury, as defined by Glasgow Coma Scale < 13 prior to randomization
- use of bone grafts or bone substitutes at the time of fracture fixation
Show all 15Show fewer
- major polytrauma or significant axial trauma, with Injury Severity Score > 16
- pathological fracture or history of metabolic or bone disease (except osteoporosis) that may interfere with the interpretation of the results, such as Paget's disease, rheumatoid arthritis, osteomalacia, osteopetrosis, ankylosing spondylitis, Cushing's disease, hyperprolactinemia
- history of symptomatic spinal stenosis that has not been surgically corrected. If surgically corrected, the subject must be asymptomatic to be eligible for the study.
- history of facial nerve paralysis
- malignancy (except fully resected cutaneous basal cell or squamous cell carcinoma, cervical carcinoma in situ) within the last 5 years
- history of solid organ or bone marrow transplants
- evidence of elevated transaminases (≥ 2.0 x upper limits of normal) or significantly impaired renal function (creatinine clearance of ≤ 30 mL/min)
- evidence of current hypercalcemia or hypocalcemia (outside of 1.1 x the normal range)
- bone morphogenic proteins (BMP)-2 or BMP-7 at the time of definitive fracture fixation
Trial locations and contacts
99 sites in 24 countries.
99 sites in 24 countries
United States12 sites
Research Site
Altoona, Pennsylvania, 16602
Research Site
Aurora, Colorado, 80012
Research Site
Birmingham, Alabama, 35294
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Brooklyn, New York, 11220
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Denver, Colorado, 80204
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Indianapolis, Indiana, 46202
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Philadelphia, Pennsylvania, 19104
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Pomona, California, 91767
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Rochester, New York, 14642
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St Louis, Missouri, 63110
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State College, Pennsylvania, 16801
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Woodbury, Minnesota, 55125
Canada9 sites
Research Site
Cambridge, Ontario, N1R 3G2
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Guelph, Ontario, N1E 4J4
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Montreal, Quebec, H4J 1C5
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Ottawa, Ontario, K1Y 4E9
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Québec, Quebec, G1J 1Z4
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Québec, Quebec, G1R 2J6
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Red Deer, Alberta, T4N 6V7
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Toronto, Ontario, M5C 1R6
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Waterloo, Ontario, N2J 1C4
India9 sites
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Bangalore, Karnataka, 560 054
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Hyderabad, Andhra Pradesh, 500 063
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Jaipur, Rajasthan, 302 022
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Mangalore, Karnataka, 575 002
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Mangalore, 575 001
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Nashik, Maharashtra, 422 002
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Nashik, 422 009
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Pune, Maharashtra, 411 005
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Pune, Maharashtra, 411 044
Belgium5 sites
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Bruges, 8000
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Genk, 3600
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Leuven, 3000
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Liège, 4020
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Liège, 4000
Greece5 sites
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Athens, 12462
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Athens, 14561
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Larissa, 41110
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Pátrai, 26500
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Thessaloniki, 56429
Netherlands5 sites
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Amsterdam, 1061 AE
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Amsterdam, 1091 AC
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Amsterdam, 1105 AZ
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Haarlem, 2035 RC
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Nieuwegein, 3435 CM
United Kingdom5 sites
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Barnet, EN5 3DJ
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Leeds, LS1 3EX
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London, E1 1BB
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Newcastle, NE1 4LP
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Norwich, NR4 7UY
Denmark4 sites
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Ã…rhus C, 8000
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Hvidovre, 2650
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København NV, 2400
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Viborg, 8800
Germany4 sites
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Aachen, 52074
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Berlin, 12200
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München, 80336
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Münster, 48149
Hungary4 sites
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Budapest, 1081
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Miskolc, 3526
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Nyíregyháza, 4400
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Szeged, 6725
Italy4 sites
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Florence, 50139
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Milan, 20142
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Roma (RM), 00133
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Verona, 37126
Poland4 sites
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Kraków, 31-826
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Lublin, 20-718
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Warsaw, 00-739
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Warsaw, 03-242
Slovenia4 sites
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Celje, 3000
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Izola, 6310
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Jesenice, 4270
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Sempeter pri Gorici, 5290
Switzerland4 sites
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Basel, 4031
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Lausanne, 1011
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Lucerne, 6000
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Zurich, 8063
Bulgaria3 sites
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Blagoevgrad, 2700
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Pleven, 5800
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Plovdiv, 4002
Finland3 sites
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Kuopio, 70211
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Oulu, 90220
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Turku, 20520
Argentina2 sites
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Buenos Aires, C1012AAR
Research Site
Buenos Aires, C1419AHN
Australia2 sites
Research Site
Footscray, Victoria, 3011
Research Site
Liverpool, New South Wales, 2170
About this study
Official title: A Multi-center, Randomized, Double-blind, Placebo-controlled Study to Determine the Efficacy, Safety, and Tolerability of AMG 785 in Adults With a Fresh Unilateral Hip Fracture, Status Post Surgical Fixation
This is an international, multi-center study to determine the efficacy, safety, and tolerability of romosozumab (AMG 785) in adults with a fresh unilateral hip fracture, status post surgical fixation.
- Conditions
- Fracture Healing
- Being tested
- Placebo, Romosozumab
- Keywords
- AMG 785, Proximal Femur, Fracture Healing, Hip Fracture
- Medical subject headings
- Hip Fractures
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PlaceboDrug
Administered by subcutaneous (under the skin) injection
RomosozumabDrug
Also called AMG 785, Evenity
Administered by subcutaneous injection
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Participants received placebo to romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. Receives: Drug: Placebo |
| Romosozumab 70 mg | Experimental | Participants received 70 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. Receives: Drug: Romosozumab |
| Romosozumab 140 mg | Experimental | Participants received 140 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. Receives: Drug: Romosozumab |
| Romosozumab 210 mg | Experimental | Participants received 210 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. Receives: Drug: Romosozumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Timed-Up-and-Go (TUG) Over Week 6 Through Week 20
Functional healing was measured by the timed-up-and-go test (TUG) over Weeks 6 through 20. During this assessment, the clinician timed the participant while they stood up from a seated position in a chair, walked three meters, turned around, walked three meters back to the chair, and returned to the seated position. A TUG value of ten seconds or less was considered normal for a healthy elderly person. Higher TUG values after hip fracture have been shown to be a predictor of future falls.
Least squares mean (LSM) estimates were based on a repeated measures model fitted with the log-transformed TUG values at weeks 2, 6, 12, 16, 20, 24, 36, 52 as the dependent variable and adjusted for treatment, randomized strata, gender, country category, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction and back-transformed using the exponential transformation.
Measured: Weeks 6, 12, 16, and 20
Secondary outcomes (5)
Timed-Up-and-Go (TUG) at Each Visit
During the timed-up-and-go test the clinician timed the participant while they stood up from a seated position in a chair, walked 3 meters, turned around, walked 3 meters back to the chair, and returned to a seated position. A TUG value of ≤ 10 seconds is considered normal for a healthy elderly person.
LSMs were based on a repeated measures model adjusting for treatment, randomized strata, gender, country category, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.
Missing TUG values for participants still on study were imputed using the last observation carried forward (LOCF) when possible. If no observation could be carried forward, the maximum TUG value observed among all participants at a given visit was used. TUG values obtained after unplanned revision surgery were replaced by carrying forward the last available observed or imputed value prior to unplanned revision surgery.
Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Time to Radiographic Healing
Time to radiographic healing is the time interval from the surgery date for the eligible hip fracture to the date of radiographic healing, defined as effacement of the fracture lines by newly formed bone along the cortices and within the trabecular bone on anteroposterior and lateral (or oblique) radiographs. Radiographic fracture healing was determined by a panel of independent reviewers blinded to treatment.
The cumulative incidence function (CIF) method was used to estimate the median time to radiographic healing and the confidence intervals. Unplanned revision surgery to promote healing was considered a competing risk in CIF estimate.
Measured: 52 weeks
Radiographic Union Scale for Hip (RUSH) Score At Each Visit
The radiographic Union Scale for Hip (RUSH) is a semiquantitative scoring assessment to assess hip fracture healing after surgical repair. The RUSH has 4 key domains based on radiographic parameters used by orthopedic surgeons and radiologists in routine clinical practice including cortical bridging (4 to 12 points), cortical fracture line disappearance (4 to 12 points), trabecular consolidation (1 to 3 points), and trabecular index disappearance of fracture line (1 to 3 points). The score has a minimum of 10 points (definitely not healed) and a maximum of 30 points (definitely healed).
Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Harris Hip Score At Each Visit
The Harris Hip Score is a clinician-based outcome that assesses pain, function, deformity, and range of motion. The pain domain measures pain severity and its effect on activities and need for pain medication. The function domain consists of daily activities and gait. Deformity takes into account hip flexion, adduction, internal rotation, and extremity length discrepancy. Range of motion measures hip flexion, abduction, external and internal rotation, and adduction. The score ranges form 0-100 (best possible outcome) covering pain (0-44 points), function (0-47 points), absence of deformity (4 points), and range of motion (5 points). LSMs were based on a repeated measures model fitted with the Harris hip score values at weeks 2, 6, 12, 16, 20, 24, 36, and 52 as the dependent variable and adjusted for treatment, randomized strata, gender, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.
Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Hip Pain Score at Each Visit
Hip pain was assessed using a visual analog scale (VAS). Participants were asked to rate their pain as a result of the hip fracture on a 100 mm vertical scale with 0 indicating no pain at all and 100 indicating the worst pain they could imagine.
LSMs were based on a repeated measures model fitted with hip pain score values at weeks 2, 6, 12, 16, 20, 24, 36, and 52 as the dependent variable and adjusted for treatment, randomized strata, gender, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction.
Measured: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Mar 2010 (estimated)
- Study start20 Jun 2010
- Primary completion30 Jun 2012
- Study completion10 May 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Fracture HealingStudies of the same condition, open and under way.
- More trials run by AmgenThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 332 participants (actual)
Sponsor and investigators
- Lead sponsor
- Amgen
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- MD, Study director, Amgen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01081678
- Sponsor's protocol ID
- 20080394
- Acronym
- STARTT-Hip
- Status last verified
- Sep 2022
- First submitted
- 4 Mar 2010
- Last updated
- 21 Sep 2022
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Schemitsch EH, Miclau T, Karachalios T, Nowak LL, Sancheti P, Poolman RW, Caminis J, Daizadeh N, Dent-Acosta RE, Egbuna O, Chines A, Maddox J, Grauer A, Bhandari M. A Randomized, Placebo-Controlled Study of Romosozumab for the Treatment of Hip Fractures. J Bone Joint Surg Am. 2020 Apr 15;102(8):693-702. doi: 10.2106/JBJS.19.00790.
PubMed 31977817
Study at a glance
From the registry record, last updated by the sponsor on 21 Sep 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-center, Randomized, Double-blind, Placebo-controlled Study to Determine the Efficacy, Safety, and Tolerability of AMG 785 in Adults With a Fresh Unilateral Hip Fracture, Status Post Surgical Fixation
- ClinicalTrials.gov ID
- NCT01081678
- Acronym / sponsor ID
- STARTT-Hip / 20080394
- Conditions
- Fracture Healing
- Keywords
- AMG 785, Proximal Femur, Fracture Healing, Hip Fracture
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 332 participants (actual)
- Lead sponsor
- AmgenIndustry (pharma, biotech, devices)
- Study start
- 20 Jun 2010 (actual)
- Primary completion
- 30 Jun 2012 (actual)
- Study completion
- 10 May 2013 (actual)
- First posted
- 5 Mar 2010 (estimated)
- Results
- Posted 2 May 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is an international, multi-center study to determine the efficacy, safety, and tolerability of romosozumab (AMG 785) in adults with a fresh unilateral hip fracture, status post surgical fixation.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: PlaceboParticipants received placebo to romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. |
| Romosozumab 70 mg | Experimental | Drug: RomosozumabParticipants received 70 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. |
| Romosozumab 140 mg | Experimental | Drug: RomosozumabParticipants received 140 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. |
| Romosozumab 210 mg | Experimental | Drug: RomosozumabParticipants received 210 mg romosozumab administered by subcutaneous injection on day 1 and at weeks 2, 6, and 12. |
Who may qualify
- Ages
- 55 to 95 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Males and females, age 55 to 95 years
- fresh unilateral low energy intertrochanteric or femoral neck fracture as the primary injury, confirmed by X-ray and in the opinion of the treating surgeon amenable to repair by internal fixation
- internal fixation of the fracture with devices approved by local regulatory agency, performed no later than 7 days after injury for intertrochanteric or undisplaced femoral neck fractures and no later than 2 days after injury for displaced femoral neck fractures
Key exclusion criteria (15 listed)
- severe symptomatic osteoarthritis of the lower extremity
- inability to independently rise from armchair or walk 200 meters before hip fracture
- presence of concomitant injuries such as rib fractures, wrist fractures, or acute symptomatic vertebral fractures which severely impair the ability to rise from a chair
- associated extremity injuries including ipsilateral or contralateral fractures of the foot, tibia or fibula, wrist, humerus, femoral shaft, femoral head or hip dislocation, that may delay weight-bearing beyond one week after surgery
- head-injury, as defined by Glasgow Coma Scale < 13 prior to randomization
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PlaceboAdministered by subcutaneous (under the skin) injection | Drug | Placebo |
| RomosozumabAlso: AMG 785, EvenityAdministered by subcutaneous injection | Drug | Romosozumab 140 mg, Romosozumab 210 mg, Romosozumab 70 mg |
Primary outcome
Timed-Up-and-Go (TUG) Over Week 6 Through Week 20
Time frame: Weeks 6, 12, 16, and 20
Functional healing was measured by the timed-up-and-go test (TUG) over Weeks 6 through 20. During this assessment, the clinician timed the participant while they stood up from a seated position in a chair, walked three meters, turned around, walked three meters back to the chair, and returned to the seated position. A TUG value of ten seconds or less was considered normal for a healthy elderly person. Higher TUG values after hip fracture have been shown to be a predictor of future falls. Least squares mean (LSM) estimates were based on a repeated measures model fitted with the log-transformed TUG values at weeks 2, 6, 12, 16, 20, 24, 36, 52 as the dependent variable and adjusted for treatment, randomized strata, gender, country category, pre-fracture community-dwelling status, pre-fracture walking aid use, quality of surgical fixation, visit, and treatment-by-visit interaction and back-transformed using the exponential transformation.
5 secondary outcomes
Timed-Up-and-Go (TUG) at Each Visit
Time frame: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Time to Radiographic Healing
Time frame: 52 weeks
Radiographic Union Scale for Hip (RUSH) Score At Each Visit
Time frame: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Harris Hip Score At Each Visit
Time frame: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Hip Pain Score at Each Visit
Time frame: Weeks 2, 6, 12, 16, 20, 24, 36, and 52
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Sep 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 31977817Schemitsch EH, Miclau T, Karachalios T, Nowak LL, Sancheti P, Poolman RW, Caminis J, Daizadeh N, Dent-Acosta RE, Egbuna O, Chines A, Maddox J, Grauer A, Bhandari M. A Randomized, Placebo-Controlled Study of Romosozumab for the Treatment of Hip Fractures. J Bone Joint Surg Am. 2020 Apr 15;102(8):693-702. doi: 10.2106/JBJS.19.00790.
- AmgenTrials clinical trials websiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
MD study director
Amgen
99 sites in 24 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Romosozumab in people with Fracture Healing, run by Amgen at 99 sites in 24 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Sep 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 99 sites in United States, Canada, India, Belgium, Greece and 19 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 2 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Timed-Up-and-Go (TUG) Over Week 6 Through Week 20 (time frame: Weeks 6, 12, 16, and 20). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01081678, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2022.