Parkinson DiseasePhase 4TOPAZNCT03924414
Trial of Parkinson's And Zoledronic Acid
A Phase 4 study testing Zoledronic Acid 5Mg/Bag 100Ml Inj in people with Parkinson Disease and Osteoporosis, run by California Pacific Medical Center Research Institute at 77 sites in United States.
Trial summary
This home-based study is a randomized (1:1) placebo-controlled trial of a single infusion of zoledronic acid-5 mg (ZA) for the prevention of fractures in men and women aged 60 years and older with Parkinson's disease and parkinsonism with at least 2 years of follow-up. Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Parkinson Disease, Osteoporosis, Parkinsonism
- What is being tested?
- Zoledronic Acid 5Mg/Bag 100Ml Inj
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 2,721 participants
- Where
- 77 sitesUnited States
- Study dates
- 15 Nov 2019to 28 Feb 2026
- Phase
- Phase 4
- Are there results?
- None posted in the registry
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 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Men and women age 60 years or older
- Current Parkinson's Disease diagnosis or neurodegenerative parkinsonism diagnosis (including progressive supranuclear palsy, multiple system atrophy, cortical basal degeneration, vascular parkinsonism, dementia with Lewy bodies or another form of neurodegenerative parkinsonism) based on an expert assessment (neurologist diagnosis via medical records confirmation or Telemedicine Screening Assessment)
- Willing and able to continue in follow-up for at least 2 years
- Willing and able to provide informed consent
Who cannot join
- History of hip fracture
- Any use of a bisphosphonate drug within the last 12 months
- Use of any other osteoporosis treatment (such as SERMs and denosumab) within the last 6 months
- Tooth extraction or invasive dental procedures within the past 30 days or planned/scheduled extraction/procedure in the next 12 months
- Non-ambulatory, i.e., unable to walk without assistance of another person.
- Undergoing kidney dialysis
Show all 9Show fewer
- A diagnosis of multiple myeloma or Paget's disease
- Unable to speak or read English sufficiently to complete informed consent
- Any other criteria, which would make the patient unsuitable to participate in this study as determined by the study staff (e.g., an uncontrolled drug and/or alcohol addiction)
Trial locations and contacts
77 sites in 1 country.
77 sites in 1 country
United States77 sites
Albany Medical College
Albany, New York, 12208
Morehouse School of Medicine
Atlanta, Georgia, 30310
Emory University School of Medicine
Atlanta, Georgia, 30322
Augusta University
Augusta, Georgia, 30912
University of Colorado, Denver
Aurora, Colorado, 80045
Sutter Health
Berkeley, California, 94705
Massachusetts General Hospital
Boston, Massachusetts, 02114
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
Boston University
Boston, Massachusetts, 02215
University of Vermont
Burlington, Vermont, 05405
Medical University of South Carolina
Charleston, South Carolina, 29425
Northwestern Medicine
Chicago, Illinois, 60611
Cook County Health & Hospitals System
Chicago, Illinois, 60612
Rush University
Chicago, Illinois, 60612
University of Chicago
Chicago, Illinois, 60637
Loyola University
Chicago, Illinois, 60660
University of Cincinnati
Cincinnati, Ohio, 45219
Case Western Reserve University, UH Cleveland
Cleveland, Ohio, 44106
The Ohio State University
Columbus, Ohio, 43210
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
Duke University
Durham, North Carolina, 27708
Michigan State University
East Lansing, Michigan, 48824
Stony Brook University Medical Center
East Setauket, New York, 11733
University of Connecticut
Farmington, Connecticut, 06030
University of Connecticut
Farmington, Connecticut, 06032
Quest Research Institute
Farmington Hills, Michigan, 48334
Washington Regional Medical Center
Fayetteville, Arkansas, 72703
Parkinson's and Movement Disorder Institute
Fountain Valley, California, 92708
University of Florida
Gainesville, Florida, 32611
Northwell Health
Glen Cove, New York, 11542
St. Mary's Medical Center
Grand Junction, Colorado, 81501
Northwell Health
Great Neck, New York, 11021
Hartford Healthcare
Hartford, Connecticut, 06103
Edward Hines, Jr. VA Hospital
Hines, Illinois, 60141
Queens Medical Center
Honolulu, Hawaii, 96813
Houston Methodist Neurological Institute
Houston, Texas, 77030
University of Texas Health Houston Medical Center
Houston, Texas, 77030
University of California, Irvine
Irvine, California, 92697
Mayo Clinic
Jacksonville, Florida, 32224
University of Kansas Medical Center
Kansas City, Kansas, 66160
Booth Gardner Parkinson's Care Center at EvergreenHealth
Kirkland, Washington, 98034
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03766
University of Kentucky
Lexington, Kentucky, 40506
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Loma Linda University
Loma Linda, California, 92350
Cedars-Sinai Medical Center
Los Angeles, California, 90048
University of California, Los Angeles
Los Angeles, California, 90095
Valley Parkinson Clinic
Los Gatos, California, 95032
University of Wisconsin
Madison, Wisconsin, 53706
Northwell Health
Manhasset, New York, 11030
Veracity Neuroscience LLC
Memphis, Tennessee, 38157
Parkinson's Foundation
Miami, Florida, 33131
University of Miami
Miami, Florida, 33146
Intermountain Medical Center
Murray, Utah, 84107
Vanderbilt University Medical Center
Nashville, Tennessee, 37240
Ochsner Health System
New Orleans, Louisiana, 70119
New York University Langone Health
New York, New York, 10017
Mount Sinai Beth Israel
New York, New York, 10019
Columbia University
New York, New York, 10032
Weill Cornell Medicine
New York, New York, 10065
Parkinson's Disease and Movement Disorder Center of Silicon Valley
Palo Alto, California, 94301
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University
Philadelphia, Pennsylvania, 19107
University of Pittsburgh
Pittsburgh, Pennsylvania, 15260
Oregon Health & Science University
Portland, Oregon, 97239
University of California, Riverside
Riverside, California, 92521
Mayo Clinic
Rochester, Minnesota, 55905
University of Rochester
Rochester, New York, 14642
Sutter Health
Sacramento, California, 95816
University of California, Davis
Sacramento, California, 95816
University of Utah
Salt Lake City, Utah, 84112
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
University of California, San Francisco
San Francisco, California, 94115
Mayo Clinic
Scottsdale, Arizona, 85259
Stony Brook University Medical Center
Stony Brook, New York, 11794
Wake Forest University
Winston-Salem, North Carolina, 27109
Lankenau Medical Center
Wynnewood, Pennsylvania, 19096
About this study
Official title: TOPAZ: Trial of Parkinson's And Zoledronic Acid A Randomized Placebo-controlled Trial of Zoledronic Acid for the Prevention of Fractures in Patients With Parkinson's Disease
This home-based study is a randomized (1:1) placebo-controlled trial of a single infusion of zoledronic acid-5 mg (ZA) for the prevention of fractures in men and women aged 60 years and older with Parkinson's disease and parkinsonism with at least 2 years of follow-up. A total of 2650 participants will be enrolled and randomized in the United States. Participants, follow-up outcome assessors, and study investigators will be blinded to assigned study treatment. This trial is funded by the National Institute of Aging.
Read the detailed description
This home-based randomized clinical trial is designed to test the efficacy of ZA-5 mg in Parkinson's disease (PD) and parkinsonism patients. This trial will also address barriers to treatment of patients with PD and parkinsonism by providing rigorous evidence about whether ZA reduces fracture risk in patients with PD and parkinsonism, simplifying treatment by giving ZA at home without extra medical visits and BMD testing, and overcoming poor persistence with oral therapies because one infusion may prevent bone loss for at least 2 years. The outcome of this trial will demonstrate how a home-based fracture prevention can reach older PD patients who would not otherwise receive treatment to reduce their high risk of fractures.
Patients with PD will be recruited throughout the US by participating neurologists and health networks as well as the Parkinson's Foundation. Patients may also self-refer to the study. Interested patients can access study information on a study website (topaz.eurekaplatform.org) as well as through the Parkinson's Foundation Helpline. Patients who wish to enroll will be directed to an interactive electronic consent (eConsent). Following eConsent, participants complete a screening questionnaire (to confirm eligibility), followed by a baseline questionnaire. If a participant is determined to be eligible following these steps, they may be scheduled for a Telemedicine assessment to further confirm the PD or parkinsonism diagnosis, unless they have been referred directly from a participating neurologist. If confirmed, the participant will be mailed a supply of vitamin D3 800-1000 IU and instructed to take one vitamin D tablet every day for 2 months. Lastly, a Nurse Home Visit will be scheduled and conducted to confirm final eligibility, randomization, and administration of the study drug, if appropriate. Participants who are randomized will be contacted every 4 months for at least 2 years to determine if they have had any fractures.
- Conditions
- Parkinson Disease, Osteoporosis, Parkinsonism, Parkinson's Disease and Parkinsonism, Atypical Parkinsonism, Progressive Supranuclear Palsy
- Being tested
- Zoledronic Acid 5Mg/Bag 100Ml Inj, Placebo
- Keywords
- Parkinson Disease, Parkinson's Disease, Osteoporosis, Zoledronic acid, Neurology, Bone, Fracture, Parkinsonism, Atypical Parkinsonism, Progressive Supranuclear Palsy, Multiple System Atrophy, Vascular Parkinsonism, Dementia with Lewy Bodies
- Medical subject headings
- Parkinson Disease, Osteoporosis, Parkinsonian Disorders, Supranuclear Palsy, Progressive, Multiple System Atrophy, Lewy Body Disease, Fractures, Bone
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Zoledronic Acid 5Mg/Bag 100Ml InjDrug
Also called Reclast
Zoledronic acid 5mg/100 ml IV infusion: Zoledronic acid-5 mg (ZA) is an FDA approved therapy for men and postmenopausal women for the treatment and prevention of osteoporosis.
PlaceboOther
Normal Saline 100 ml (placebo) IV infusion
| Study group | Role | What they receive |
|---|---|---|
| Zoledronic acid (ZA) | Active comparator | A single intravenous infusion of Zoledronic acid (5 mg) infused over 45 minutes Receives: Drug: Zoledronic Acid 5Mg/Bag 100Ml Inj |
| Placebo | Placebo comparator | A single intravenous infusion of placebo infused over 45 minutes Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants with Clinical Fractures
All clinical fractures
Measured: 2 years
Number of Participants with Clinical Fractures
All clinical fractures
Measured: 5 years
Secondary outcomes (4)
Number of Participants Hip Fractures
Hip fractures
Measured: 2 years
Number of Participants Hip Fractures
Hip fractures
Measured: 5 years
Mortality
All-cause mortality
Measured: 2 years
Mortality
All-cause mortality
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Apr 2019
- Study start15 Nov 2019
- Primary completion28 Feb 2026
- Study completion28 Feb 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Parkinson DiseaseStudies of the same condition, open and under way.
- 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study is a randomized (1:1) placebo-controlled trial of a single infusion of zoledronic acid-5 mg (ZA) for the prevention of fractures in men and women aged 60 years and older with Parkinson's Disease or parkinsonism with at least 2 years of follow-up.
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 2,721 participants (actual)
Sponsor and investigators
- Lead sponsor
- California Pacific Medical Center Research Institute
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Aging (NIA), University of California, San Francisco, Duke University, University of Pittsburgh, Parkinson's Foundation
- Responsible party
- Sponsor
- Investigators
- Steve Cummings, MD, Principal investigator, CPMC Research Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03924414
- Sponsor's protocol ID
- 20180456
- Other IDs
- 1R01AG059417-01A1
- Acronym
- TOPAZ
- Status last verified
- Jun 2026
- First submitted
- 2 Apr 2019
- Last updated
- 25 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Tanner CM, Cummings SR, Schwarzschild MA, Brown EG, Dorsey ER, Espay AJ, Galifianakis NB, Goldman SM, Litvan I, Luthra N, McFarland NR, Mitchell KT, Standaert DG, Bauer DC, Greenspan SL, Beck JC, Lyles KW. The TOPAZ study: a home-based trial of zoledronic acid to prevent fractures in neurodegenerative parkinsonism. NPJ Parkinsons Dis. 2021 Mar 1;7(1):16. doi: 10.1038/s41531-021-00162-1.
PubMed 33649343
Study at a glance
From the registry record, last updated by the sponsor on 25 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- TOPAZ: Trial of Parkinson's And Zoledronic Acid A Randomized Placebo-controlled Trial of Zoledronic Acid for the Prevention of Fractures in Patients With Parkinson's Disease
- ClinicalTrials.gov ID
- NCT03924414
- Acronym / sponsor ID
- TOPAZ / 20180456
- Conditions
- Parkinson Disease, Osteoporosis, Parkinsonism, Parkinson's Disease and Parkinsonism, Atypical Parkinsonism, Progressive Supranuclear Palsy
- Keywords
- Parkinson Disease, Parkinson's Disease, Osteoporosis, Zoledronic acid, Neurology, Bone, Fracture, Parkinsonism
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 2,721 participants (actual)
- Lead sponsor
- California Pacific Medical Center Research InstituteUniversity, hospital or other
- Collaborators
- National Institute on Aging (NIA), University of California, San Francisco, Duke University, University of Pittsburgh, Parkinson's Foundation
- Study start
- 15 Nov 2019 (actual)
- Primary completion
- 28 Feb 2026 (actual)
- Study completion
- 28 Feb 2026 (actual)
- First posted
- 23 Apr 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This home-based study is a randomized (1:1) placebo-controlled trial of a single infusion of zoledronic acid-5 mg (ZA) for the prevention of fractures in men and women aged 60 years and older with Parkinson's disease and parkinsonism with at least 2 years of follow-up. A total of 2650 participants will be enrolled and randomized in the United States. Participants, follow-up outcome assessors, and study investigators will be blinded to assigned study treatment. This trial is funded by the National Institute of Aging.
Detailed description
This home-based randomized clinical trial is designed to test the efficacy of ZA-5 mg in Parkinson's disease (PD) and parkinsonism patients. This trial will also address barriers to treatment of patients with PD and parkinsonism by providing rigorous evidence about whether ZA reduces fracture risk in patients with PD and parkinsonism, simplifying treatment by giving ZA at home without extra medical visits and BMD testing, and overcoming poor persistence with oral therapies because one infusion may prevent bone loss for at least 2 years. The outcome of this trial will demonstrate how a home-based fracture prevention can reach older PD patients who would not otherwise receive treatment to reduce their high risk of fractures.
Patients with PD will be recruited throughout the US by participating neurologists and health networks as well as the Parkinson's Foundation. Patients may also self-refer to the study. Interested patients can access study information on a study website (topaz.eurekaplatform.org) as well as through the Parkinson's Foundation Helpline. Patients who wish to enroll will be directed to an interactive electronic consent (eConsent). Following eConsent, participants complete a screening questionnaire (to confirm eligibility), followed by a baseline questionnaire. If a participant is determined to be eligible following these steps, they may be scheduled for a Telemedicine assessment to further confirm the PD or parkinsonism diagnosis, unless they have been referred directly from a participating neurologist. If confirmed, the participant will be mailed a supply of vitamin D3 800-1000 IU and instructed to take one vitamin D tablet every day for 2 months. Lastly, a Nurse Home Visit will be scheduled and conducted to confirm final eligibility, randomization, and administration of the study drug, if appropriate. Participants who are randomized will be contacted every 4 months for at least 2 years to determine if they have had any fractures.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- This study is a randomized (1:1) placebo-controlled trial of a single infusion of zoledronic acid-5 mg (ZA) for the prevention of fractures in men and women aged 60 years and older with Parkinson's Disease or parkinsonism with at least 2 years of follow-up.
| Arm | Type | Receives |
|---|---|---|
| Zoledronic acid (ZA) | Active comparator | Drug: Zoledronic Acid 5Mg/Bag 100Ml InjA single intravenous infusion of Zoledronic acid (5 mg) infused over 45 minutes |
| Placebo | Placebo comparator | Other: PlaceboA single intravenous infusion of placebo infused over 45 minutes |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Men and women age 60 years or older
- Current Parkinson's Disease diagnosis or neurodegenerative parkinsonism diagnosis (including progressive supranuclear palsy, multiple system atrophy, cortical basal degeneration, vascular parkinsonism, dementia with Lewy bodies or another form of neurodegenerative parkinsonism) based on an expert assessment (neurologist diagnosis via medical records confirmation or Telemedicine Screening Assessment)
- Willing and able to continue in follow-up for at least 2 years
- Willing and able to provide informed consent
Key exclusion criteria (9 listed)
- History of hip fracture
- Any use of a bisphosphonate drug within the last 12 months
- Use of any other osteoporosis treatment (such as SERMs and denosumab) within the last 6 months
- Tooth extraction or invasive dental procedures within the past 30 days or planned/scheduled extraction/procedure in the next 12 months
- Non-ambulatory, i.e., unable to walk without assistance of another person.
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 |
|---|---|---|
| Zoledronic Acid 5Mg/Bag 100Ml InjAlso: ReclastZoledronic acid 5mg/100 ml IV infusion: Zoledronic acid-5 mg (ZA) is an FDA approved therapy for men and postmenopausal women for the treatment and prevention of osteoporosis. | Drug | Zoledronic acid (ZA) |
| PlaceboNormal Saline 100 ml (placebo) IV infusion | Other | Placebo |
Primary outcome
Number of Participants with Clinical Fractures
Time frame: 2 years
All clinical fractures
Number of Participants with Clinical Fractures
Time frame: 5 years
All clinical fractures
4 secondary outcomes
Number of Participants Hip Fractures
Time frame: 2 years
Number of Participants Hip Fractures
Time frame: 5 years
Mortality
Time frame: 2 years
Mortality
Time frame: 5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Jun 2026.
- Derived from this study: PubMed 33649343Tanner CM, Cummings SR, Schwarzschild MA, Brown EG, Dorsey ER, Espay AJ, Galifianakis NB, Goldman SM, Litvan I, Luthra N, McFarland NR, Mitchell KT, Standaert DG, Bauer DC, Greenspan SL, Beck JC, Lyles KW. The TOPAZ study: a home-based trial of zoledronic acid to prevent fractures in neurodegenerative parkinsonism. NPJ Parkinsons Dis. 2021 Mar 1;7(1):16. doi: 10.1038/s41531-021-00162-1.
- Individual participant dataSharing planned: No
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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.
Steve Cummings, MD principal investigator
CPMC Research Institute
77 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Zoledronic Acid 5Mg/Bag 100Ml Inj in people with Parkinson Disease and Osteoporosis, run by California Pacific Medical Center Research Institute at 77 sites in United States.
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 4 inclusion and 9 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 25 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 77 sites in United States. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Number of Participants with Clinical Fractures (time frame: 2 years). The study lists 2 primary outcomes in all. 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 NCT03924414, 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 25 Jun 2026.