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NCT Number: NCT03292146

Effects of Denosumab on Bone Mineral Density in Women With Anorexia Nervosa: A Pilot Study

This protocol is a randomized, double-blind, placebo-controlled clinical trial which aims to investigate the effect of denosumab on BMD in women with anorexia nervosa. The investigators hypothesize that 12 months of denosumab administration will result in an increase in bone mineral density, decrease in markers of bone resorption and improvement in bone microarchitecture in osteopenic women with anorexia nervosa compared with placebo.

An optional extension study will offer subjects 12-month administration of open-label alendronate (an oral bisphosphonate) after the initial 12 month administration of denosumab or placebo. We hypothesize that 12 months of denosumab followed by 12 months of open-label alendronate will result in a greater increase in BMD compared to 12 months of placebo followed by 12 months of open-label alendronate. Within the group of women who receive sequential therapy with 12 months of denosumab followed by 12 months of alendronate, we hypothesize that BMD will be maintained between 12 and 24 months while on alendronate.

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Key information

Conditions

Bone Density Anorexia Nervosa Atypical Anorexia Nervosa Bone Diseases Bone Diseases, Metabolic Bone Loss Eating Disorder Feeding and Eating Disorders Mental Disorders Metabolic Diseases Musculoskeletal Diseases Nutritional and Metabolic Diseases Pathological Conditions, Signs and Symptoms Signs and Symptoms Signs and Symptoms, Digestive

Age range

20 year–60 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 3

Primary location

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion/Exclusion Criteria:

Inclusion criteria

  • Female
  • Age 20-60 years, skeletally mature with closed epiphyses
  • Anorexia nervosa or atypical anorexia nervosa defined by DSM-V diagnostic criteria
  • BMD T-score < -1.0
  • Normal serum 25-OH vitamin D (>30 ng/mL) and calcium levels
  • For women of reproductive age, agree to use an effective contraceptive method. Highly effective methods of birth control include:
  • Combined (estrogen and progestogen) hormonal methods (pills, vaginal ring, or skin patch)
  • Intrauterine device (IUD)
  • Intraduterine hormonal-releasing system (IUS)
  • Surgery to tie both fallopian tubes (bilateral tubal ligation/occlusion)
  • Your male partner has had a vasectomy and testing shows there is no sperm in the semen
  • Dental check up within the past year

Exclusion criteria

  • Any disease known to affect bone, including untreated thyroid dysfunction, Cushing's or renal failure
  • Subjects with a known esophageal disease cannot participate in the alendronate extension study
  • Any medication known to affect bone metabolism within 3 months of the study, excluding oral contraceptives or other forms of estrogen administration. Bisphosphonates must have been discontinued for at least one year before participation
  • Immunodeficiency or taking immunosuppressive therapy
  • Serum potassium <3.0 meq/L
  • Serum ALT >3 times upper limit of normal
  • eGFR of less than 30 ml/min
  • Hypocalcemia
  • Diabetes mellitus
  • Active substance abuse, including alcohol
  • History of malignancy
  • Paget disease of bone
  • Osteomalacia
  • Osteonecrosis of the jaw (ONJ) or risk factor for ONJ, such as invasive dental procedures (eg, tooth extraction, dental implants, oral surgery in the past 6 months), poor oral hygiene, periodontal and/or pre-existing dental disease, and current use of corticosteroids.
  • Planned invasive dental procedure over the next 24 months.
  • Known senstivity to any of the products or components to be administered during dosing or known sensitivity to mammalian cell derived drug products
  • Sensitivity to calcium or vitamin D supplements
  • Pregnant, planning to become pregnant with 7 months after the end of treatment and/or breastfeeding

Treatment and study plan

Denosumab 60 MG [Prolia]

Drug

Denosumab 60mg injection at baseline and 6 months

Placebo injection

Drug

Placebo Injection at baseline and 6 months

Alendronate 70Mg Tab

Drug

Alendronate 70mg PO weekly starting at Month 12 through 24 months.

Primary outcomes

  1. Postero-anterior (PA) Lumbar Spine Bone Mineral Density by Dual-energy X-ray Absorptiometry (DXA)

    Time frame: 12 months (Period 1)

    Postero-anterior (PA) lumbar spine bone mineral density was assessed by dual-energy x-ray absorptiometry (DXA). The DXA scanner used was a Hologic Horizon A (Hologic, Inc., Waltham, MA).

Secondary outcomes

  1. Percent Change Postero-anterior (PA) Lumbar Spine Bone Mineral Density by DXA

    Time frame: Baseline to 24 months

  2. Percent Change Postero-anterior (PA) Lumbar Spine Bone Mineral Density by DXA

    Time frame: 12 months to 24 months (Period 2)

Sponsors and collaborators

Lead sponsor

Massachusetts General Hospital

Other

Collaborators

  • Amgen

Registry information

Official study title

Effects of Denosumab on Bone Mineral Density, Markers of Bone Metabolism and Bone Microarchitecture in Women With Anorexia Nervosa: A Pilot Study

Important dates

Study start
2017
Primary completion
2021
Study completion
2021
First posted
Sep 25, 2017
Registry last updated
Nov 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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