Clinical trial focuses on quality of bone

The UW Osteoporosis Research Group is conducting a study focusing on how treatment with the synthetic hormone calcitonin affects bone quality.

The clinical trial, called the QUEST study, is supported by a $1,624,725 grant from Novartis Pharmaceuticals of East Hanover, N.J., and Basel, Switzerland. The trial began last December and will continue for another two years. Ninty participants are enrolled.

The study is being conducted at UW Medical Center-Roosevelt, using Department of Radiology facilities, and at UWMC’s General Clinical Research Center.

Salmon calcitonin, a hormone originally found in salmon but now produced synthetically, may prevent or slow the action of cells that break down bone, according to Dr. Charles Chesnut III, UW professor of medicine and radiology and an internationally recognized researcher in osteoporosis treatment.

The nasal spray salmon calcitonin has already been approved to treat osteoporosis and to reduce the incidence of spinal fractures. It is often prescribed for women who cannot use estrogen replacement therapy.

In the current study, new technologies are being used to investigate the quality, as well as the quantity, of bone that the women develop over time. Bone turnover, or the amount built up and broken down, will also be studied.

Along with traditional methods to examine bone density, such as ultrasound and bone densitometry, the current study uses magnetic resonance imaging and micro-computerized tomography.

“This study represents the first investigations into the mechanism of action of osteoporosis therapies such as calcitonin in reducing fractures,” Chesnut said. “As such, it may establish a new paradigm by demonstrating that such therapies reduce fractures primarily through effects on bone quality (structure and strength), rather than through the effects on bone quantity that we have been able to measure with traditional techniques of bone densitometry.”

The study is double-blinded, so that neither the participants or study managers know who is receiving the drug.

“I can’t say enough about the dedication of the women who enroll for a study like this,” Chesnut said. “It’s quite a demanding study, with many procedures. They don’t know if they will have any benefit for themselves, but they say they are doing it for their daughters and granddaughters.” ¶

Claire Dietz