Randomized controlled trial of an oral gastrin receptor antagonist for the treatment of postmenopausal osteoporosis
Abstract
High gastrin levels may help to explain the association between several conditions and osteoporosis, such as pernicious anemia, the use of proton pump inhibitors, and atrophic gastritis. This study aimed to determine whether administering a gastrin receptor antagonist (GRA) to older women would lower their bone turnover markers (BTM) and, therefore, be a suitable preventive measure for osteoporosis. We conducted a randomized, double-blind, placebo-controlled clinical trial to assess the efficacy, safety, and tolerability of an oral GRA (netazepide) 100 mg administered daily for 90 d in postmenopausal women. Our primary endpoint was the change in the BTM plasma CTX (automated immunoassay analyzer) at days 0, 7, 28, 56, and 90. We also measured other BTMs, and gastrin and group I pepsinogens (ELISA assays). We studied the effect of the drug on the log-transformed baseline scaled ratio for BTM and gastric markers using mixed-model ANOVA for the fixed effects of treatment, time, and the treatment-by-time interaction, with the baseline value included as a covariate. We studied 99 women, with a mean age of 60 yr and bone mineral density (BMD) T-scores for the spine and total hip (TH) of -0.96 and -0.09, respectively. We found that gastrin increased by 90% in response to GRA as early as 7 d (p-value for treatment: .0008), and group I pepsinogens decreased by 15% as early as 7 d (p-value: .0002). There was no significant change in plasma CTX. A high percentage of women (81/99)…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 99 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.