Trial Outcomes & Findings for Abaloparatide Before Total Knee Arthroplasty (NCT NCT04167163)

NCT ID: NCT04167163

Last Updated: 2026-06-05

Results Overview

Bone mineral density change at the 25% ROI of the surgical leg. Dual-energy X-ray absorptiometry (DXA) measured BMD was obtained at a point (ROI) 25% the length of the total surgical femur. Percent change at 25% ROI was calculated from baseline to 18 months.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

58 participants

Primary outcome timeframe

Baseline and approximately 18 months on study (15 months post-TKA)

Results posted on

2026-06-05

Participant Flow

Participants were recruited from the UW Total Joint Program at the American Center and enrolled from January 2020 to August 2023.

Participant milestones

Participant milestones
Measure
Treatment Group
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Comparator Group
Those with clinical osteopenia who receive no treatment.
Overall Study
COMPLETED
25
28
Overall Study
NOT COMPLETED
4
1
Overall Study
STARTED
29
29

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment Group
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Comparator Group
Those with clinical osteopenia who receive no treatment.
Overall Study
Lost to Follow-up
3
1
Overall Study
Adverse Event
1
0

Baseline Characteristics

Abaloparatide Before Total Knee Arthroplasty

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment Group
n=29 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Comparator Group
n=29 Participants
Those with clinical osteopenia who receive no treatment.
Total
n=58 Participants
Total of all reporting groups
Age, Continuous
70.6 years
STANDARD_DEVIATION 7.1 • n=20 Participants
65.8 years
STANDARD_DEVIATION 7.0 • n=20 Participants
69.4 years
STANDARD_DEVIATION 7.2 • n=40 Participants
Sex: Female, Male
Female
23 Participants
n=20 Participants
26 Participants
n=20 Participants
49 Participants
n=40 Participants
Sex: Female, Male
Male
6 Participants
n=20 Participants
3 Participants
n=20 Participants
9 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
29 Participants
n=20 Participants
29 Participants
n=20 Participants
58 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
Asian
1 Participants
n=20 Participants
0 Participants
n=20 Participants
1 Participants
n=40 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
White
28 Participants
n=20 Participants
29 Participants
n=20 Participants
57 Participants
n=40 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Region of Enrollment
United States
29 participants
n=20 Participants
29 participants
n=20 Participants
58 participants
n=40 Participants

PRIMARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Bone mineral density change at the 25% ROI of the surgical leg. Dual-energy X-ray absorptiometry (DXA) measured BMD was obtained at a point (ROI) 25% the length of the total surgical femur. Percent change at 25% ROI was calculated from baseline to 18 months.

Outcome measures

Outcome measures
Measure
Comparator Group
n=28 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Distal Femoral Bone Mineral Density (BMD) at the 25% Regions of Interest (ROIs)
-2.42 percent change
Standard Error 1.08
3.25 percent change
Standard Error 1.11

SECONDARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Population: In concurrent projects, 60% femur ROI did not show clinical association. Given the time to manually collect these data, the investigator decided not to test this objective in the current study, therefore this data was not collected from any participants.

Bone mineral density percent change at the 15% and 60% ROI of the surgical leg

Outcome measures

Outcome measures
Measure
Comparator Group
n=29 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Distal Femoral BMD at the 15% and 60% ROI
15 percent ROI
-0.97 percent change
Standard Error 1.46
6.60 percent change
Standard Error 1.50

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

Population: In concurrent projects, 60% femur ROI did not show clinical association. Given the time to manually collect these data, the investigator decided not to test this objective in the current study, therefore this data was not collected from any participants.

Trabecular bone score (TBS) assessment by Texture Research Investigation (Platform (TRIP) software change at the 15% and 25% femur ROIs (TBS \>1.350 is normal; TBS between 1.200 and 1.350 is indicative of partially degraded microarchitecture; and TBS \<1.200 equals degraded microarchitecture).

Outcome measures

Outcome measures
Measure
Comparator Group
n=28 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=29 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
TBS Assessment by TRIP at the 15%, 25%, and 60% Femur ROIs
baseline (15% femur ROI)
0.912 score
Standard Deviation 0.126
0.917 score
Standard Deviation 0.113
TBS Assessment by TRIP at the 15%, 25%, and 60% Femur ROIs
18 months (15% femur ROI)
0.927 score
Standard Deviation 0.125
0.934 score
Standard Deviation 0.092
TBS Assessment by TRIP at the 15%, 25%, and 60% Femur ROIs
baseline (25% femur ROI)
1.161 score
Standard Deviation 0.178
1.127 score
Standard Deviation 0.140
TBS Assessment by TRIP at the 15%, 25%, and 60% Femur ROIs
18 months (25% femur ROI)
1.171 score
Standard Deviation 0.155
1.116 score
Standard Deviation 0.141

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

Population: Not all participants completed or returned the surveys.

Patient reported knee function score. The KOOS, JR was developed from the original long version of the Knee injury and Osteoarthritis Outcome Score (KOOS) survey using Rasch analysis. The KOOS, JR contains 7 items from the original KOOS survey. Items are coded from 0 to 4, none to extreme respectively. KOOS, JR is scored by summing the raw response (range 0-28) and then converting it to an interval score (0-100). The interval score ranges from 0 to 100 where 0 represents total knee disability and 100 represents perfect knee health.

Outcome measures

Outcome measures
Measure
Comparator Group
n=25 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Knee Injury & Osteoarthritis Outcome Score (KOOS) JR
baseline
56.5 score on a scale
Standard Deviation 12.7
48.8 score on a scale
Standard Deviation 13.1
Knee Injury & Osteoarthritis Outcome Score (KOOS) JR
18 months
77.1 score on a scale
Standard Deviation 14.4
79.8 score on a scale
Standard Deviation 14.3

SECONDARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Population: Not all participants completed or returned the surveys.

12 Item Health Survey using patient's self assessment of their perspective of their health and ability to do daily functions. Scores are derived using an algorithm that is referenced to a metric centered at 50.0 where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Outcome measures

Outcome measures
Measure
Comparator Group
n=25 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Veterans RAND 12 (VR-12) Question Health Survey Score: Physical Health Component
Baseline
39.2 score on a scale
Standard Deviation 10.3
35.3 score on a scale
Standard Deviation 10.8
Change in Veterans RAND 12 (VR-12) Question Health Survey Score: Physical Health Component
18 months on study
47.2 score on a scale
Standard Deviation 9.8
47.9 score on a scale
Standard Deviation 8.9

SECONDARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Population: Not all participants completed or returned the surveys.

12 Item Health Survey using patient's self assessment of their perspective of their health and ability to do daily functions. Scores are derived using an algorithm that is referenced to a metric centered at 50.0 where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Outcome measures

Outcome measures
Measure
Comparator Group
n=25 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Veterans RAND 12 (VR-12) Question Health Survey Score: Mental Health Component
Baseline
43.2 score on a scale
Standard Deviation 5.3
42.3 score on a scale
Standard Deviation 3.8
Change in Veterans RAND 12 (VR-12) Question Health Survey Score: Mental Health Component
18 months on study
42.6 score on a scale
Standard Deviation 6.3
42.4 score on a scale
Standard Deviation 5.0

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

Population: Some participants did not complete assessment at 18 month time point.

FJS-12 consists of 12 questions and is scored using a 5-point response format with the raw scores transformed onto a 0- to 100-point scale. High scores indicate good outcome, that is, a high degree of forgetting the joint in everyday life (forgotten joint phenomenon).

Outcome measures

Outcome measures
Measure
Comparator Group
n=27 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=25 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Forgotten Joint Survey(FJS) Score
49.5 score on a scale
Standard Deviation 26.4
62.8 score on a scale
Standard Deviation 27.3

SECONDARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Change in total body composition using bioelectrical impedance analysis of lean mass.

Outcome measures

Outcome measures
Measure
Comparator Group
n=25 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=22 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Body Composition Using Bioelectrical Impedance Analysis of Lean Mass
baseline
7616 grams
Standard Deviation 1363
8180 grams
Standard Deviation 2023
Change in Body Composition Using Bioelectrical Impedance Analysis of Lean Mass
18 months
7436 grams
Standard Deviation 1451
7567 grams
Standard Deviation 1987

SECONDARY outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Change in total body composition using bioelectrical impedance analysis of fat mass.

Outcome measures

Outcome measures
Measure
Comparator Group
n=25 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=22 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Change in Body Composition Using Bioelectrical Impedance Analysis of Fat Mass.
baseline
5737 grams
Standard Deviation 2088
6412 grams
Standard Deviation 2388
Change in Body Composition Using Bioelectrical Impedance Analysis of Fat Mass.
18 months
5498 grams
Standard Deviation 2145
6179 grams
Standard Deviation 2383

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

TKA complications: Number of participants needed revision surgery

Outcome measures

Outcome measures
Measure
Comparator Group
n=29 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=29 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
TKA Complications: Number of Participants Needed Revision Surgery
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

TKA complications: Number of participants had fracture

Outcome measures

Outcome measures
Measure
Comparator Group
n=29 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=29 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
TKA Complications: Number of Participants Had Fracture
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 18 months on study (15 months post-TKA)

Precision assessment in the field of bone densitometry is the process whereby the ability of the instrument and the technologist to reproduce similar results, given no real biologic change, is tested. To achieve statistical power, the investigators will take duplicate knee bone density measurements on 30 participants at either their 6 month or 15 month visit. The standard deviation for each participant is calculated, then the root mean square standard deviation for the group is calculated. The mathematical result of precision assessment is displayed as percent coefficient of variation (CV).

Outcome measures

Outcome measures
Measure
Comparator Group
n=29 Participants
Those with clinical osteopenia who receive no treatment.
Treatment Group
n=29 Participants
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Precision Error on Knee Bone Density Measurement
1.50 percent coefficient of variation (CV)
1.90 percent coefficient of variation (CV)

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and approximately 18 months on study (15 months post-TKA)

Cortical thickness change at the 15% and 60% ROI of the surgical leg

Outcome measures

Outcome data not reported

Adverse Events

Treatment Group

Serious events: 3 serious events
Other events: 8 other events
Deaths: 0 deaths

Comparator Group

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Treatment Group
n=29 participants at risk
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Comparator Group
n=29 participants at risk
Those with clinical osteopenia who receive no treatment.
Cardiac disorders
Myocardial infarction
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
3.4%
1/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
Respiratory, thoracic and mediastinal disorders
Pneumonia
3.4%
1/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
General disorders
Chest Pain
3.4%
1/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
Injury, poisoning and procedural complications
Motor Vehicle Accident
3.4%
1/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)

Other adverse events

Other adverse events
Measure
Treatment Group
n=29 participants at risk
Those with clinical osteoporosis who elect ABL treatment. ABL therapy will begin 3 months pre-TKA and continue for a total of 18 months. ABL will be administered by injection pen with dose of 80 mcg SC qDay. Abaloparatide: 18 month ABL treatment
Comparator Group
n=29 participants at risk
Those with clinical osteopenia who receive no treatment.
Nervous system disorders
Lightheadedness
10.3%
3/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
3.4%
1/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
Cardiac disorders
Tachycardia
10.3%
3/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
Gastrointestinal disorders
Nausea
6.9%
2/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)
0.00%
0/29 • up to 18 months on study
Participants questioned regarding adverse events, falls and fractures at treatment follow up, pre-TKA study visit, 6 month follow up for TKA, and 15 month follow up (up to 18 months on study)

Additional Information

Dr. Neil Binkley

University of Wisconsin - Madison

Phone: 608-265-6410

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place