Evidence map›Paper›PMID 26556736›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016

A phase 2 study of MK-5442, a calcium-sensing receptor antagonist, in postmenopausal women with osteoporosis after long-term use of oral bisphosphonates.

F Cosman, N Gilchrist, M McClung, J Foldes, T de Villiers, A Santora, A Leung, S Samanta, N Heyden, J P McGinnis and 2 more

Registry-linked trialAbstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00996801 (A Phase IIb, Randomized, Double-Blind, Placebo- and Active-Controlled, Dose-Range-Finding Study to Evaluate the Effects of MK-5442 on Bone Mineral Density), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00996801 phase2completednot on this map

A Phase IIb, Randomized, Double-Blind, Placebo- and Active-Controlled, Dose-Range-Finding Study to Evaluate the Effects of MK-5442 on Bone Mineral Density (BMD) in the Treatment of Osteoporosis in Postmenopausal Women Previously Treated With an Oral Bisphosphonate

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2009 to 2011Enrolled526ConditionsOsteoporosis, Postmenopausal OsteoporosisArmsMK-5442, Placebo to MK-5442, Alendronate Sodium, Vitamin D3, Calcium carbonate
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Early changes in bone turnover and bone mineral density after discontinuation of long-term oral bisphosphonates: a post hoc analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Trial
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 4 countries.

F CosmanHelen Hayes Hospital, West Haverstraw, NY, USA. cosmanf@helenhayeshosp.org.
N GilchristCGM Research Trust, The Princess Margaret Hospital Christchurch, Christchurch, New Zealand.
M McClungOregon Osteoporosis Center, Portland, OR, USA.
J FoldesDepartment of Orthopaedics, Hadassah Hebrew University Hospital, Jerusalem, Israel.
T de VilliersMediclinic Panorama, Cape Town, South Africa.
A SantoraMerck & Co, Inc., Kenilworth, NJ, USA.
A LeungMerck & Co, Inc., Kenilworth, NJ, USA.
S SamantaMerck & Co, Inc., Kenilworth, NJ, USA.
N HeydenMerck & Co, Inc., Kenilworth, NJ, USA.
J P McGinnisMerck & Co, Inc., Kenilworth, NJ, USA.
E RosenbergMerck & Co, Inc., Kenilworth, NJ, USA.
A E DenkerMerck & Co, Inc., Kenilworth, NJ, USA.
Merck & Co., Inc., Rahway, NJ, USA (United States) · USBone Health and Osteoporosis Foundation · USHebrew University of Jerusalem · ILHelen Hayes Hospital · USPrincess Margaret Hospital · NZStellenbosch University · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelledIn women with osteoporosis treated with alendronate for >12 months and oral bisphosphonates for >3 of the last 4 years, switching to MK-5442, a calcium receptor antagonist, stimulated endogenous parathyroid hormone (PTH) secretion and increased bone turnover marker levels, but produced a decline in bone mineral density (BMD) at all sites.

introductionThis study assessed the effects of switching from long-term oral bisphosphonate therapy to the calcium-sensing receptor antagonist MK-5442 on BMD and bone turnover markers (BTMs) in post-menopausal women with osteoporosis.

methodsThis randomized, active and placebo-controlled, dose-ranging study enrolled 526 postmenopausal women, who had taken alendronate (ALN) for ≥12 months preceding the trial and any oral bisphosphonate for ≥3 of the preceding 4 years and had spine or hip BMD T-scores ≤-2.5 or ≤-1.5 with ≥1 prior fragility fracture. Women were randomized to continue ALN 70 mg weekly or switch to MK-5442 (5, 7.5, 10, or 15 mg daily) or placebo.

resultsSwitching from ALN to MK-5442 produced a dose-dependent parathyroid hormone (PTH) pulse of threefold to sixfold above baseline at 1 h, with PTH levels that remained twofold to threefold above baseline at 4 h and returned to baseline by 24 h. Switching to MK-5442 or placebo increased BTM levels compared to baseline within 3 months and MK-5442 10 mg increased BTM levels compared to placebo by 6 months. With all MK-5442 doses and placebo, spine and hip BMD declined from baseline, and at 12 months, BMD levels were below those who continued ALN (all groups P < 0.05 vs ALN). There was also a dose-dependent increase in the incidence of hypercalcemia with MK-5442.

conclusionSwitching from ALN to MK-5442 resulted in a pulsatile increase in PTH and increases in BTMs, but a decline in BMD compared with continued ALN. MK-5442 is not a viable option for the treatment of osteoporosis.

Indexed as

Administration, OralAgedBenzoatesBiomarkersBone DensityBone Density Conservation AgentsDiphosphonatesDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleFemur NeckHip JointHumansLumbar VertebraeMiddle AgedBenzoatesBiomarkersBone Density Conservation AgentsDiphosphonatesJTT 305Parathyroid HormonePropanolaminesReceptors, Calcium-SensingBisphosphonateCalcium-sensing receptor antagonistOsteoporosisPostmenopausalPTHRandomized clinical trial

Identifiers

PMID26556736
OpenAlexW2231789276

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.