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Phase 4 N=36 Randomized Quadruple-blind Prevention

Denosumab to Prevent High-Turnover Bone Loss After Bariatric Surgery

Bariatric Surgery Candidate · Bone Loss

Enrolled (actual)
36
Serious AEs
16.7%
Results posted
Oct 2025
Primary outcome: Primary: Percentage Change in Total Hip Bone Mineral Density — 0.60; -6.44 percentage of change

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Denosumab (Drug); Placebo (Drug); Zoledronic Acid (Drug)
Age
Adult, Older Adult · 25+ yrs
Sex
All
Sponsor
Massachusetts General Hospital
Primary completion
Aug 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage Change in Total Hip Bone Mineral Density
0.60; -6.44

Summary

Bariatric surgery leads to bone loss and increases fracture risk. This study evaluates whether denosumab can prevent the high-turnover bone loss that occurs after Roux-en-Y Gastric Bypass (RYGB) and sleeve gastrectomy (SG) surgery.

Eligibility Criteria

Inclusion criteria

  • Postmenopausal women who are planning RYGB or SG surgery
  • Men aged ≥ 50 years who are planning RYGB or SG surgery

Exclusion criteria

  • Prior bariatric surgery
  • Weight = 400 lbs (due to limitations of bone imaging equipment)
  • Renal disease
  • Hypercalcemia or hypocalcemia
  • Hypomagnesemia
  • Serum 25-OH vitamin D (25OHD) 2 x upper normal limit)
  • HCT < 32%
  • History of malignancy (except basal cell carcinoma) in the past 1 year
  • Significant cardiopulmonary disease
  • Major psychiatric disease
  • History of celiac disease or inflammatory bowel disease
  • Excessive alcohol or substance abuse
  • Paget's disease, primary hyperparathyroidism, or any other known congenital or acquired bone disease other than osteoporosis
  • Current hyperthyroidism or use of levothyroxine with TSH < 0.1 uIU/mL
  • Current use of loop diuretics
  • Current use or use in the past 12 months of oral bisphosphonates or DMAB
  • Current use or use within the past 3 months of SERMs or calcitonin
  • Current use or use within the past 3 months of estrogen
  • Use of testosterone therapy if dose has changed within the last 3 months, or if dose change or discontinuation is planned in the upcoming 18 months
  • Any current or previous use of teriparatide, strontium, or any parenteral bisphosphonate
  • Use of oral or parenteral glucocorticoids for more than 14 days within the past 6 months
  • Extensive dental work involving extraction or dental implant within the past 2 months or planned in the upcoming 18 months
  • DXA BMD T-score of < -3.0 at PA spine, total hip, or femoral neck
  • Current use of anti-VEGF drug
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04087096). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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