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Charcot FootPhase 3NCT04547348

The DENOCHARCOT Trial

A Phase 3 study testing Denosumab Injection in people with Charcot Foot and Diabetes Mellitus, run by Ole Lander Svendsen at 8 sites in Denmark.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The aim of the present trial is to assess the efficacy of treatment of acute Charcot foot in diabetes patients with Prolia® on clinical relevant Outcomes in a randomized, double blind, placebo-controlled trial. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Charcot Foot, Diabetes Mellitus
What is being tested?
Denosumab Injection
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
38 participants
Where
8 sitesDenmark
Study dates
1 Nov 2020to 1 Oct 2030
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18-80 years
  • Type 1 or type 2 diabetes (diagnosed diabetes for more than 3 months)
  • Diagnosed with acute Charcot foot defined as a unilateral red, swollen and warm foot, with a difference of skin temperature of more than 2 °C compared with the unaffected foot and with sign of Charcot on either x-rays of the foot, MRI, bone scintigram or PET/CT.
  • Peripheral neuropathy: Previously diagnosed and/or biothesiometri: > 25 V or lack of sensation of 10 grams monofilament on 1. toe at the acute Charcot foot.

Who cannot join

  • Duration of the acute Charcot foot for more than 3 months (at the screening visit).
  • Existing foot ulcer on the affected foot
  • Previous acute or chronic Charcot of the affected foot
  • Planned surgery on the acute Charcot foot
  • Infection (cellulitis or osteomyelitis) of the affected foot (clinically and/or radiologically proven)
  • Previous midfoot or proximal to mid foot amputation of the affected foot
Show all 24Show fewer
  • Hypocalcemia (Serum Calcium <2.1 mmol/L or Calcium ion < 1.12 mmol/L)
  • Vitamin D deficiency (Serum 25-hydroxyvitamin D < 50 nmol/L)
  • Renal failure (serum creatinine >200 mmol/L or eGFR < 30 ml/min).
  • Treatment with Denosumab within the last 12 months. • Have a known hypersensitivity to Denosumab • History of osteonecrosis of the jaw.
  • Poor oral hygiene, which is defined as within 3 months of a tooth extraction, dental implants or mandibular surgery
  • Planned mandibular surgery or dental implants within the next 12 months.
  • Prior non-traumatic vertebral fracture
  • Treatment with medication known to affect bones within the last 12 months (such as bisphosphonates, Forsteo®, calcitonin, Protelos®, selective estrogen receptor modulators, glucocorticoids and sex hormones)
  • Active or chronic liver disease *Chronic liver disease is defined as clinical history of decompensated chronic liver disease (ascites, encephalopathy or variceal bleeding) *Acute Liver disease is defined as an INR of > 1.5 (in the absence of the use of Warfarin) and AST and ALT > 2 x ULN
  • History of inflammatory arthropathies (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, autoimmune arthropathy)
  • Pre-existing medical condition judged to preclude safe participation in the study
  • Current treatment with cytotoxic drugs or with systemically administered glucocorticoids
  • Abuse of alcohol or drugs, or presence of any condition that in the Investigators opinion may lead to poor adherence to study protocol
  • Pregnancy, breast feeding or planning pregnancy or not using adequate contraceptive methods. The following contraceptive products are considered to be safe: Intrauterine devices or hormonal contraception (oral contraceptive pills, implants, transdermal patches, vaginal rings or long-acting injections).
  • Likely inability to comply with the visits because of planned activity
  • Use of any investigational product with the last month.
  • Use of any drug or any other reason which in the Investigator's opinion could interfere with the outcome of the treatment of the acute Charcot foot.
  • Cancer, or any clinically significant disease or disorder, except for conditions associated to the diabetes, which in the Investigator's opinion could interfere with the results of the trial

Trial locations and contacts

8 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Ole Lander Svendsen, MD contact

+4521490547

Ole.Lander.Svendsen@regionh.dk

Michael Zaucha Sørensen, MD contact

+4526836584

mzs@dadlnet.dk

8 sites in 1 country

Denmark8 sites, 8 recruiting
  • Steno Diabetes Center North

    Aalborg

    Niels Ejskjær

    Recruiting
  • Steno Diabetes Center Aarhus

    Aarhus

    Christian Buhl

    Recruiting
  • Bispebjerg Hospital

    Copenhagen NV, 2400

    Ole L Svendsen, Professor

    Recruiting
  • Steno Diabetes Center Copenhagen

    Gentofte Municipality

    Anne Rasmussen

    Recruiting
  • Nordsjællands Hospital

    Hillerød

    Peter Lommer

    Recruiting
  • Hvidovre hospital

    Hvidovre

    Ole Snorgaard

    Recruiting
  • Zealand University Hospital

    Køge

    Christoffer Hedetoft

    Recruiting
  • Steno Diabetes Center Odense

    Odense

    Lena Snogdal

    Recruiting

Other trials in Denmark

About this study

Official title: Efficacy of Treatment With DENOsumab of an Acute CHARCOT Foot in Patients With Diabetes. A Multicenter, Double-blind, Randomized, Placebo-controlled Trial.

The aim of the present trial is to assess the efficacy of treatment of acute Charcot foot in diabetes patients with Prolia® on clinical relevant Outcomes in a randomized, double blind, placebo-controlled trial.

Read the detailed description

After giving informed consent and being enrolled, patients will be randomized to one of two group given either Denosumab treatment or injection with placebo. The patients will then undergo a 52 week follow up with regular controls to asses if clinical signs of Charcot is in remission, which will be verified using relevant radiological modalities. Upon final visit the patients will be examined using radiology, blood samples, biothesiometry and objective examinations, following up on the same examinations being made upon inclusion.

Primary outcome will be time until full remission of the Charcot foot defined as clinical healing (The acute Charcot foot is clinically healed when the temperature difference at the site maximum temperature on the affected Charcot foot is < 2 degrees Celsius compared to the similar site on the contra-lateral foot, measured using an infrared thermometer, and edema and redness of the skin has subsided) followed up by radiological signs of healing.

Being tested
Denosumab Injection
Medical subject headings
Diabetes Mellitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Denosumab InjectionDrug

    Injections made subcutaneously per standard description

Study groups in NCT04547348
Study groupRoleWhat they receive
Denosumab treated groupExperimentalParticipants will receive a 60 mg subcutaneous injection of Prolia upon randomization and on week 28 after the first injection provided remission of the Charcot foot has not been achieved by then
Receives: Drug: Denosumab Injection
Placebo treated groupPlacebo comparatorParticipants will receive an injection of placebo (saline) instead of Prolia
Receives: Drug: Denosumab Injection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time until remission

    Time from first injection of IP until the time point where the acute Charcot foot is clinically healed/in remission, ie. the temperature difference at the site maximum temperature on the affected Charcot foot is < 2 degrees Celsius compared to the similar site on the contra-lateral foot, measured using an infrared thermometer, and edema and redness of the skin has subsided - at two subsequent visits 4 weeks apart. The off-loading regime will be continued until the second visit. The first of the two visits is the timepoint of healing of the acute Charcot foot.

    Measured: 52 weeks

Secondary outcomes (9)
  1. Fraction of clinical healed participants at each study visit.

    Measured: 52 weeks

  2. Fraction of healing on X-rays and MRI (or PET/CT or Scintigram) at the time of clinical healing and at the End of trial.

    Measured: 52 weeks

  3. Number of relapses (defined as need for/prescription of off- loading with cast of the Charcot foot again)

    Measured: 52 weeks

  4. Time without relapse (the time from clinical healing/remission to the relapse or to End of Trial at 12 months).

    Measured: 52 weeks

  5. Number of patients with development of complications to the acute Charcot foot, as well as number of development of foot ulcer, deformity, need for special footwear or surgery and fractures of bones in the foot, respectively.

    Measured: 52 weeks

  6. Changes in BMD (lumbar spine, hip)

    Measured: 52 weeks

  7. Changes in markers of bone turnover (CTX and P1NP)

    Measured: 52 weeks

  8. Changes in markers of glycemic control (HbA1c)

    Measured: 52 weeks

  9. Incidence of Adverse Events and Serious Adverse Events

    Measured: 52 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Sep 2020
  2. Study start1 Nov 2020
  3. Primary completion1 Aug 2030 (estimated)
  4. Study completion1 Oct 2030 (estimated)

Resources

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
38 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04547348
Sponsor's protocol ID
CODIF-008
Status last verified
Oct 2026
First submitted
7 Sep 2020
Last updated
13 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Jeffcoate WJ. Charcot foot syndrome. Diabet Med. 2015 Jun;32(6):760-70. doi: 10.1111/dme.12754. Epub 2015 Apr 15.

    PubMed 25818542
  • Christensen TM, Gade-Rasmussen B, Pedersen LW, Hommel E, Holstein PE, Svendsen OL. Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker. J Diabetes Complications. 2012 Sep-Oct;26(5):430-4. doi: 10.1016/j.jdiacomp.2012.05.006. Epub 2012 Jun 12.

    PubMed 22699112
  • Pitocco D, Ruotolo V, Caputo S, Mancini L, Collina CM, Manto A, Caradonna P, Ghirlanda G. Six-month treatment with alendronate in acute Charcot neuroarthropathy: a randomized controlled trial. Diabetes Care. 2005 May;28(5):1214-5. doi: 10.2337/diacare.28.5.1214. No abstract available.

    PubMed 15855594
  • Anderson JJ, Woelffer KE, Holtzman JJ, Jacobs AM. Bisphosphonates for the treatment of Charcot neuroarthropathy. J Foot Ankle Surg. 2004 Sep-Oct;43(5):285-9. doi: 10.1053/j.jfas.2004.07.005.

    PubMed 15480402
  • Jude EB, Selby PL, Burgess J, Lilleystone P, Mawer EB, Page SR, Donohoe M, Foster AV, Edmonds ME, Boulton AJ. Bisphosphonates in the treatment of Charcot neuroarthropathy: a double-blind randomised controlled trial. Diabetologia. 2001 Nov;44(11):2032-7. doi: 10.1007/s001250100008.

    PubMed 11719835
  • Bem R, Jirkovska A, Fejfarova V, Skibova J, Jude EB. Intranasal calcitonin in the treatment of acute Charcot neuroosteoarthropathy: a randomized controlled trial. Diabetes Care. 2006 Jun;29(6):1392-4. doi: 10.2337/dc06-0376. No abstract available.

    PubMed 16732029
  • Pakarinen TK, Laine HJ, Maenpaa H, Mattila P, Lahtela J. The effect of zoledronic acid on the clinical resolution of Charcot neuroarthropathy: a pilot randomized controlled trial. Diabetes Care. 2011 Jul;34(7):1514-6. doi: 10.2337/dc11-0396. Epub 2011 May 18.

    PubMed 21593295
  • Petrova NL, Dew TK, Musto RL, Sherwood RA, Bates M, Moniz CF, Edmonds ME. Inflammatory and bone turnover markers in a cross-sectional and prospective study of acute Charcot osteoarthropathy. Diabet Med. 2015 Feb;32(2):267-73. doi: 10.1111/dme.12590. Epub 2014 Oct 17.

    PubMed 25251588
  • Jansen RB, Christensen TM, Bulow J, Rordam L, Jorgensen NR, Svendsen OL. Markers of Local Inflammation and Bone Resorption in the Acute Diabetic Charcot Foot. J Diabetes Res. 2018 Aug 2;2018:5647981. doi: 10.1155/2018/5647981. eCollection 2018.

    PubMed 30155488
  • Busch-Westbroek TE, Delpeut K, Balm R, Bus SA, Schepers T, Peters EJ, Smithuis FF, Maas M, Nieuwdorp M. Effect of Single Dose of RANKL Antibody Treatment on Acute Charcot Neuro-osteoarthropathy of the Foot. Diabetes Care. 2018 Mar;41(3):e21-e22. doi: 10.2337/dc17-1517. Epub 2017 Dec 22. No abstract available.

    PubMed 29273577
  • Tsourdi E, Langdahl B, Cohen-Solal M, Aubry-Rozier B, Eriksen EF, Guanabens N, Obermayer-Pietsch B, Ralston SH, Eastell R, Zillikens MC. Discontinuation of Denosumab therapy for osteoporosis: A systematic review and position statement by ECTS. Bone. 2017 Dec;105:11-17. doi: 10.1016/j.bone.2017.08.003. Epub 2017 Aug 5.

    PubMed 28789921

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Denosumab Injection in people with Charcot Foot and Diabetes Mellitus, run by Ole Lander Svendsen at 8 sites in Denmark.

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 24 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: looking for participants now, as of the sponsor's last update on 13 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Denmark. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ole Lander Svendsen, MD (+4521490547, Ole.Lander.Svendsen@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time until remission (time frame: 52 weeks). 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 NCT04547348, which also lists 11 linked publications.

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 13 Oct 2026.

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