Antiepileptic Drugs and Osteoporotic Prevention Trial



Status:Completed
Conditions:Osteoporosis, Neurology, Orthopedic, Orthopedic, Epilepsy
Therapuetic Areas:Neurology, Rheumatology, Orthopedics / Podiatry, Other
Healthy:No
Age Range:18 - 85
Updated:4/21/2016
Start Date:June 2006
End Date:January 2013

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Study Design: (e.g., Controlled, Double-Blind, Randomized, Parallel):

Randomized, double-blind, placebo controlled of a bisphosphonate in the prevention of bone
loss associated with the use of antiepileptic drugs.

The study is planned to last two years. You will be required to make a total of 6 visits to
the clinic during this two year study period. At the first visit, 12 months and,
approximately 24 months, you will have a bone mineral density test (BMD) of your hip and
spine. A BMD is similar to having an x-ray and is a test that measures the amount of bone.
This test takes approximately 15 minutes. Radiation exposure during this test is very low.
It has been estimated that the total radiation exposure from a bone mineral density
measurement is lower than that of a dental x-ray. At each follow up visit an assessment will
be made for side effects and whether or not you followed the prescribed treatment.

Initially, information collected will include height, weight, seizure history and seizure
medication history, other medical conditions, bone and muscle symptoms you currently have,
dietary calcium intake, and exercise. Blood will be drawn at the initial and 5 follow-up
visits. The purpose of this is to test your blood for organ function, calcium levels,
vitamin D levels and levels of markers that show high bone turnover. Also at each visit your
height and weight will be checked and you will be asked questions regarding side effects,
adherence to treatment and quality of life.

When you agree to participate, you will be randomized to either risedronate 35mg tablet
(Actonel ®) or placebo (a fake pill) to take once a week. Randomization is a process in
which you will have an equal chance (like the flip of a coin) to be assigned to either
risedronate (Actonel ®) or placebo. A computer program will determine your treatment
assignment. Also during the study you will be provided with calcium and vitamin D tablets to
take either two or three times each day depending on your dietary calcium intake.

At the first visit you will be assessed for changeable risk factors for osteoporosis. These
include smoking, alcohol consumption, and lack of physical activity, poor nutrition and lack
of vitamin intake. Also, blood will be drawn to see if you have a low male hormone. If you
are found to have low male hormone, you will be referred to your primary care provider. If
you have low male hormone levels, you will be eligible to participate in the study if
testosterone replacement has been offered to you and you have declined treatment. If you
decide to be treated with testosterone you are not eligible to participate in this study.
Education will be provided on exercises for bones. If you smoke, you will be counseled on
quitting although quitting is not a requirement to participate in the study. If you drink a
lot of alcohol you will be counseled on reducing your intake and offered help. Reducing or
quitting alcohol is not a requirement for your participation in this study. You can also
meet with a registered dietician for nutritional counseling.

Inclusion Criteria:

- Male gender

- Epilepsy

- Anti-epileptic drug treatment with phenytoin, or phenobarbital or valproate sodium

- Normal renal function and normal Vitamin D and calcium levels

Exclusion Criteria:

- Female gender

- Organ transplant

- Use of oral glucocorticoids

- Renal insufficiency (eGFR < 30ml/min)

- Severe swallowing disorder

- Severe esophagitis

- Patients taking sodium valproate for reasons other than epilepsy

- Previous treatment with osteoporosis drugs such as bisphosphonates, calcitonin or PTH
analog
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Boston, Massachusetts 02130
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Boston, MA
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