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Phase 2 N=12 Treatment

Burosumab for Fibroblast Growth Factor-23 Mediated Hypophosphatemia in Fibrous Dysplasia

Fibrous Dysplasia Of Bone

Enrolled (actual)
12
Serious AEs
16.7%
Results posted
Feb 2026
Primary outcome: Primary: Proportion of Participants With Serum Phosphate Levels Within the Target Range at Week 48 — 1 Proportion of participant

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Burosumab (Drug)
Age
Pediatric, Adult, Older Adult · 1+ yrs
Sex
All
Sponsor
National Institute of Dental and Craniofacial Research (NIDCR)
Primary completion
Nov 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Proportion of Participants With Serum Phosphate Levels Within the Target Range at Week 48
1
SECONDARY
Participants With Adverse Event by Grade
9; 6; 1; 0; 0
SECONDARY
Participants With Related Adverse Event
8
SECONDARY
Proportion of Participants With Serum Phosphate Levels Within the Target Range at Week 24
0.92
SECONDARY
Proportion of Participants With Serum Phosphate Levels Above the Target Range (Z-score >+2)
0.5
SECONDARY
Change in Serum Phosphate Level
1.5
SECONDARY
Percent Change in Serum Phosphate Level
55.5
SECONDARY
Change in Serum 1,25-dihydroxyvitamin D Level
7.5
SECONDARY
Percent Change in Serum 1,25-dihydroxyvitamin D Level
29.3
SECONDARY
Change in Serum Ratio of Renal Tubular Maximum Reabsorption Rate of Phosphate to Glomerular Filtration Rate (TmP/GFR)
0.51
SECONDARY
Percent Change in Serum Ratio of Renal Tubular Maximum Reabsorption Rate of Phosphate to Glomerular Filtration Rate (TmP/GFR)
68.05
SECONDARY
Change in Fibrous Dysplasia Lesion Activity Using Fluorine-18 Sodium Fluoride Positron Emission Tomography/Computed Tomography (18F-NaF PET/CT) Scan
8.4
SECONDARY
Change in Serum Procollagen 1 N-terminal Propeptide (P1NP) Level
8.5
SECONDARY
Percent Change in Serum Procollagen 1 N-terminal Propeptide (P1NP) Level
12.45
SECONDARY
Change in Serum Beta Crosslaps C-telopeptides (CTX) Level
0.515
SECONDARY
Percent Change in Serum Beta Crosslaps C-telopeptides (CTX) Level
1.69
SECONDARY
Change in Serum Osteocalcin Level
21.95
SECONDARY
Percent Change in Serum Osteocalcin Level
24.9
SECONDARY
Change in Serum Alkaline Phosphatase Level
-531.5
SECONDARY
Percent Change in Serum Alkaline Phosphatase Level
-48.3
SECONDARY
Change in Fibrous Dysplasia Lesion Cellularity
-0.0001163
SECONDARY
Change in Muscle Strength Using the Manual Muscle Test Scale
0; 0; 0; 0; 0; 0
SECONDARY
Change in Muscle Range-of-motion
0; 0; 0; 0; 0; 0
SECONDARY
Change in Walking Speed Measured by the 9-minute Walk Test (9MWT)
3
SECONDARY
Change in Quality of Life Measured by the 36-Item Short Form Health Survey (SF-36) Score
5
SECONDARY
Change in Health-related Quality of Life Measured by the 10-Item Short Form Health Survey (SF-10) - Physical Summary Score (PHS)
16.63
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Pediatric and Parent Proxy Version 1.0) - Pain Intensity Domain
-1
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Adult Version 2.0) - Pain Intensity Domain
5.8
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Pediatric and Parent Proxy Version 2.0) - Pain Inference Domain
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Adult Version 1.1) - Pain Inference Domain
0.2
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Pediatric and Parent Proxy Version 2.0) - Mobility Lower Extremity Domain
11.1
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Adult Version 2.0) - Mobility Lower Extremity Domain
0.5
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) Score (Pediatric and Parent Proxy Version 2.0) - Fatigue Domain
-6.5
SECONDARY
Change in Patient Reported Outcome Measurement Information System (PROMIS) - Short Form - Fatigue 13a (Adult FACIT 13a v1.0)
SECONDARY
Proportion of Participants With Change in Activities of Daily Living (ADL) Questions
0.67

Summary

Background: Fibrous dysplasia (FD) is a disorder that affects bone growth. Affected bone tissue is weakened, and people with FD are prone to deformities, fractures, and other problems. People with FD may also have low blood phosphate levels. This can make bones even weaker. Better treatments are needed. Objective: To test a study drug (burosumab) in people with FD who have low blood phosphate levels. Eligibility: People aged 1 year or older who have FD and low blood phosphate levels. Design: Participants will visit the NIH 3 times in 48 weeks. Each visit will last 5 to 7 days. Participants will self-inject burosumab under the skin in their belly, upper arm, or thigh. They (or a caregiver) will do this at home 1 or 2 times a month. They will be trained in person on how to inject the drug. Home injections will be guided via telehealth. During NIH visits, participants will have a physical exam with blood and urine tests. They will have x-rays of different parts of their body. They will have a radioactive tracer injected into their vein; then they will have a bone scan. They will have tests to assess their strength, walking, and movement. They will complete questionnaires about their pain, mobility, and fatigue levels. Adult participants may have bone biopsies. These will be done under anesthesia with sedation. Small samples of FD-affected bone will be removed for study. Between NIH visits, participants will go to a local laboratory for blood and urine tests. Child participants will have an additional follow-up visit 2 weeks after the final NIH visit.

Eligibility Criteria

  • INCLUSION CRITERIA:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

  • Confirmed diagnosis of fibrous dysplasia
  • Serum phosphate =30 pg/mL
  • Age >=1 year
  • Provision of signed and dated informed consent/assent form
  • Stated willingness of subject or Legally Authorized Representative (LAR) to comply with all study procedures and availability for the duration of the study
  • For females of reproductive potential: agreement to use highly effective contraception for during study participation. Highly effective contraception methods include:
  • Total abstinence (when this is in line with the preferred and usual lifestyle of the participant). Periodic abstinence (e.g., calendar, ovulation, symptothermal, postovulation methods) and withdrawal are not acceptable methods of contraception
  • Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment.
  • Male sterilization (at least 6 months prior to screening). For female participants on the study the vasectomized male partner should be the sole partner for that participant.
  • Combination of the following (a+b or a+c, or b+c):
  • Use of oral, injected or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate <1%), for example hormone vaginal ring or transdermal hormone contraception
  • Placement of an intrauterine device (IUD) or intrauterine system (IUS)
  • Barrier methods of contraception: Condom or Occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository
  • For males of reproductive potential: use of condoms or other methods described above to ensure effective contraception with partner
  • Minimum body weight of 7.5 kilograms

EXCLUSION CRITERIA

An individual who meets any of the following criteria will be excluded from participation in this study:

  • Pregnancy or lactation
  • Known allergic reactions to burosumab or drug component
  • Treatment with another investigational drug within 30 days of screening
  • Treatment with burosumab within 30 days of screening
  • Have any condition which in the opinion of the PI could present a concern for subject safety or difficulty with data interpretation
  • Severe renal impairment or end stage renal disease, defined as: pediatric patients with estimated glomerular filtration rate (eGFR) 15 mL/min/1.73m2 to 29 mL/min/1.73m2 or end stage renal disease (eGFR < 15 mL/min/1.73m2), adult patients with creatinine clearance (CLcr) 15 mL/min to 29 mL/min or end stage renal disease (CLcr < 15 mL/min)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05509595). 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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