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Sponsored by: |
Duke University |
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Information provided by: | Duke University |
ClinicalTrials.gov Identifier: | NCT00462098 |
Osteonecrosis of the jaw (ONJ) has recently been recognized as associated with bisphosphonate therapy, however there is little information on the natural history, treatment or prevention strategies for this condition. The purpose of this study is to determine the effectiveness of hyperbaric oxygen as a treatment. We will randomize 35 out of 70 ONJ patients to receive HBO in addition to their routine oral surgery care and follow both groups over a 2-year period.
Condition | Intervention | Phase |
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Osteonecrosis |
Device: hyperbaric oxygen Device: non-treated control group |
Phase II Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Parallel Assignment, Efficacy Study |
Official Title: | Randomized Controlled Trial of Hyperbaric Oxygen in Patients Who Have Taken Bisphosphonates |
Estimated Enrollment: | 70 |
Study Start Date: | August 2006 |
Estimated Study Completion Date: | December 2012 |
Estimated Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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HBO: Experimental
Subject receives 40 HBO sessions at 2 atmospheres of pressure over 4 weeks
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Device: hyperbaric oxygen
40 sessions of 100% oxygen at 2 atmospheres of pressure for 2 hours each
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Control: Active Comparator
non-HBO comparison group
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Device: non-treated control group
no change from routine care, no HBO
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Osteonecrosis of the jaw (ONJ) has recently been recognized as associated with bisphosphonate (BP) therapy, however there is little information on the natural history, treatment or prevention strategies for this condition1. Bisphosphonates, particularly compounds containing an aliphatic chain with an amino group in the R2 position, (pamidronate, alendronate and zoledronate) are extremely effective and widely used in the treatment of breast cancer, prostate cancer, multiple myeloma and non-malignant bone disease. Although ONJ appears to develop in less than one percent of patients taking these drugs, the seriousness of the disease plus the current lack of treatment options makes this a very difficult clinical problem This study will randomize 35 out of 70 patients to receive HBO in addition to their routine oral surgery therapy for ONJ and follow both groups over a 2-year period. The study design is an interventional, prospective, randomized trial with a 2-year follow up period. Seventy subjects meeting the inclusion criteria for ONJ will be recruited by participating physicians and randomized to receive 40 HBO treatments over a 4 week period or to continue their normal oral care. No subject, HBO treated or not, will be asked to change, initiate or discontinue any ongoing therapies they may be receiving from their primary care giver for ONJ or any other medical condition. The analysis will compare remission rates between the two groups while controlling for age, gender, race, previous local trauma or surgery, tumor type, diabetes, immunosuppression, bisphosphonate duration, indication (hypercalcemia), infection, corticosteroids, and thalidomide and dental hygiene. All subjects will be closely followed throughout the 24 month course of the study with weekly contacts by phone or email to log jaw pain level as well as to record any change in general medical condition. The 17 question Duke Health Profile will be used to measure quality of life indicators at 4 key points during the study.
Comparison(s): 1) clinical remission rate in patients receiving and not receiving HBO. 2) Bone turnover and molecular measures of osteoclast signaling in ONJ patients before and after HBO and relative to non-diseased controls (labs from non-diseased controls to be obtained from a companion study).
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Rebecca Padilla-Burgos | 919-684-6726 | rebecca.padillaburgos@duke.edu |
Contact: John J Freiberger, MD | 919 684 6726 | freib002@mc.duke.edu |
United States, North Carolina | |
Duke University Medical Center | Recruiting |
Durham, North Carolina, United States, 27710 | |
Contact: Rebecca Padilla-Burgos 919-684-6726 rebecca.padillaburgos@duke.edu | |
Contact: John J Freiberger, MD 919-684-6726 freib002@mc.duke.edu |
Principal Investigator: | John Freiberger, MD | Duke University |
Responsible Party: | Duke University Medical Center, Deptartment of Anesthesiology, Hyperbaric division ( John J Freiberger, Md, MPH ) |
Study ID Numbers: | 8731-06-6R0 |
Study First Received: | April 17, 2007 |
Last Updated: | June 3, 2008 |
ClinicalTrials.gov Identifier: | NCT00462098 |
Health Authority: | United States: Institutional Review Board |
Osteonecrosis of the jaw hyperbaric oxygen bisphosphonates |
Necrosis Diphosphonates Musculoskeletal Diseases Osteonecrosis Bone Diseases |
Pathologic Processes Physiological Effects of Drugs Bone Density Conservation Agents Pharmacologic Actions |