Plain English Summary
Background and study aims
As people age, their bones naturally become less dense in minerals, but for some people this can lead to osteoporosis, an advanced stage of a condition that leads to brittle bones that break (fracture) easily. It is often seen in women who have been through the menopause, or people who are at risk of osteoporosis due to various health or lifestyle factors. In older people, osteoporosis is often diagnosed following a minor fall which has led to a bone fracture. The bones most often fractured are those of the hips and spine, and these injuries cause problems for millions of people around the world (9 million every year) as a result of pain, hospital admissions, lack of independence at home or the need to move into sheltered/nursing home care. There are some similarities between the bones of older people and the bones of people taking steroid medications. This is because steroids reduce bone mineral density. A new drug called AZD4017 has been developed to reduce the level of steroids that are naturally produced by the body in local tissues; it may help to reduce the loss of bone mineral density that occurs as people age. The aim of this study is to look at the effect of AZD4017 on bones in women diagnosed with osteopaenia, a condition where some bone density has been lost but it has not yet progressed to the stage of osteoporosis.
Who can participate?
Women aged 50 and over diagnosed with osteopaenia.
What does the study involve?
Participants are randomly allocated into one of two groups. Those in group 1 (intervention group) are given the drug AZD4017 to take for 90 days. Those in group 2 (control group) are given a placebo (dummy tablet with no drug in it) to take for 90 days. Participants have 5 visits to the clinic while taking the drug, and another 3 months later. Participants have blood tests and scans to check the effect of AZD4017 on bones, and urine tests to make sure that steroid production in the tissues is reduced in response to the drug. Participants also have muscle tests (walk, stand and grip tests) to see if blocking steroid production improves muscle strength.
What are the possible benefits and risks of participating?
Not provided at time of registration.
Where is the study run from?
University of Leeds (UK)
When is the study starting and how long is it expected to run for?
May 2015 to April 2016
Who is funding the study?
Medical Research Council (MRC) (UK)
Who is the main contact?
Dr L Flanagan
Phase II study of the impact of AZD4017, a selective 11bHSD1 inhibitor, on biochemical markers of bone turnover in post-menopausal osteopaenia
The drug AZD4017, which reduces steroid production in tissue, may reverse some of the bone changes that are seen with aging and improve muscle strength.
Multicentre Research Ethics Committee (MREC), 11/11/2013, ref: 13/SC/0523.
Randomised interventional treatment study
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Participants will take AZD4017, a selective 11ß-HSD1 inhibitor, for 90 days. Control group participants will take a placebo (dummy tablet with no drug in it) for 90 days.
Primary outcome measures
Change from baseline in serum osteocalcin after 90 days.
Secondary outcome measures
1. Change from baseline in serum ßCTx after 90 days
2. Change in bone density, microstructure and strength after 180 days
3. Change in bone remodelling after 90 days
4. Change in muscle strength after 90 days
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Provision of informed consent prior to any study specific procedures
2. Aged >50 and postmenopausal based on amenorrhoea for >12 months
3. Documented presence of osteopaenia (bone density T-score at lumbar spine or hip of less than -1 and greater than -2.5 by Dual-energy X-ray Absorptiometry (DXA) criteria)
4. Placebo treatment for the duration of the study must not be considered detrimental to the study subject
5. Must be able to understand the patient information sheet and consent form and comply with study requirements
Target number of participants
Planned Sample Size: 100; UK Sample Size: 100
Participant exclusion criteria
Bone related exclusion criteria:
1. Clinical or biochemical evidence of secondary causes of bone loss
2. 25-OH vitamin D level <20nmol/L
3. The current or recent use (within 2 years) of medication likely to have an impact on bone (oestrogens, aromatase inhibitors, bisphosphonates, fluoride, denosumab, strontium ranelate, anti-convulsants, teriparatide; and oral, inhaled or nasal glucocorticoids). Patients already on calcium/vitamin D supplementation will continue this for the study. Those with a 25-OH vitamin D level of 2050nmol/L at screening will be supplemented prior to inclusion
General exclusion criteria:
1. Women of child-bearing potential
2. eGFR calculated by MDRD equation <60ml/min/1.73m2
3. Any endocrine disorder, e.g. thyroid dysfunction
4. Suspicion of or known Gilbert's disease
5. CK > twice upper limit normal on 2 consecutive measurements
6. Liver transaminases > upper limit normal
7. Alkaline phosphatase > upper limit normal
8. Bilirubin (total) > upper limit normal
9. User of recreational or illicit drugs (including marijuana) or has had a recent history (within the last year) of drug or alcohol abuse or dependence
10. Uncontrolled systemic hypertension (BP >150/90); on 3 successive measurements on the morning of the screening visit
11. Systemic (including vaginal/rectal) or inhaled glucocorticoid treatment at the time of the screening visit
12. Probenicid therapy at the time of the screening visit
13. Any screening laboratory abnormality that, in the investigator’s judgement, is considered to be clinically significant
14. History of any clinically significant disease or disorder which, in the opinion of the investigator, may either put the
subject at risk because of participation in the study, or influence the results of the subject’s ability to participate in the
study. Specifically, a diagnosis of any inflammatory disorder that might reasonably need treatment with glucocorticoids
during the course of the study
15. History of any other condition known to interfere with absorption, distribution, metabolism, or excretion of drugs
16. Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of
IP as judged by the investigator
17. Hypersensitivity or intolerance to 11ß-HSD1 antagonists or to AZD4017
18. Involvement in the planning and/or conduct of the study
19. Participation in any other clinical study within 1 month prior to the screening visit
20. Previous randomisation for treatment in the present study
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Clinical Trials Research Unit (CTRU)
Clinical Trials Research House Fairbairn House 71-75 Clarendon Road
Medical Research Council (MRC) (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting