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Teriparatide vs. alendronate as a treatment for osteoporosis: changes in biochemical markers of bone turnover, BMD and quality of life.

Panico A, Lupoli GA, Marciello F, Lupoli R, Cacciapuoti M, Martinelli A, Granieri L, Iacono D, Lupoli G - Med. Sci. Monit. (2011)

Bottom Line: After 18 months, lumbar bone mineral density increased to 12.4% and femoral bone mineral density increased to 5.2% in group A.Group B lumbar bone mineral density increased to 3.85% and femoral bone mineral density increased to 1.99%.Only a new vertebral fracture occurred in group A (2.4%), whereas 6 fractures occurred in group B (15.7%).

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, Naples, Italy.

ABSTRACT

Background: We studied the use of teriparatide in postmenopausal women with severe osteoporosis.

Material/methods: Two groups (A and B) of patients affected by severe osteoporosis (T-score ≤-2.5 at bone mineral density were analyzed and 2 vertebral fractures on radiograph). Group A was treated for 18 months with 20 µg/day of teriparatide. Group B was treated with bisphosphonates 70 mg/week. Every woman assumed 1 g of calcium and 800 IU of vitamin D3 daily. We evaluated the effects of therapy after 18 months (T18) from the beginning with bone turnover markers (alkaline phosphatase, procollagen type 1 N-terminal propeptide, and N-telopeptide cross-links) and dual-energy X-ray absorptiometry.

Results: Group A, at T18 procollagen type 1 N-terminal propeptide levels, increased 127%; bone alkaline phosphatase levels increased to 65%; N-telopeptide cross-links levels increased to 110%. Group B, at T18 procollagen type 1 N-terminal propeptide levels, decreased to 74%; bone alkaline phosphatase levels decreased to 41%; N-telopeptide cross-links levels decreased to 72%. After 18 months, lumbar bone mineral density increased to 12.4% and femoral bone mineral density increased to 5.2% in group A. Group B lumbar bone mineral density increased to 3.85% and femoral bone mineral density increased to 1.99%. Only a new vertebral fracture occurred in group A (2.4%), whereas 6 fractures occurred in group B (15.7%). The quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO) revealed a significant improvement in daily living, performed domestic jobs, and locomotor function in groups A and B.

Conclusions: The use of rhPTH in patients with severe osteoporosis offers more protection against fractures and improves the QoL more than bisphosphonates.

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Related in: MedlinePlus

Values of the dimensions of the QUALEFFO-41 in patients treated and not treated with teriparatide.
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f4-medscimonit-17-8-cr442: Values of the dimensions of the QUALEFFO-41 in patients treated and not treated with teriparatide.

Mentions: We evaluated the teriparatide impact on several aspects of QoL by administering the patients Qualeffo-41 test at T0 and T18 (Figure 4).


Teriparatide vs. alendronate as a treatment for osteoporosis: changes in biochemical markers of bone turnover, BMD and quality of life.

Panico A, Lupoli GA, Marciello F, Lupoli R, Cacciapuoti M, Martinelli A, Granieri L, Iacono D, Lupoli G - Med. Sci. Monit. (2011)

Values of the dimensions of the QUALEFFO-41 in patients treated and not treated with teriparatide.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539612&req=5

f4-medscimonit-17-8-cr442: Values of the dimensions of the QUALEFFO-41 in patients treated and not treated with teriparatide.
Mentions: We evaluated the teriparatide impact on several aspects of QoL by administering the patients Qualeffo-41 test at T0 and T18 (Figure 4).

Bottom Line: After 18 months, lumbar bone mineral density increased to 12.4% and femoral bone mineral density increased to 5.2% in group A.Group B lumbar bone mineral density increased to 3.85% and femoral bone mineral density increased to 1.99%.Only a new vertebral fracture occurred in group A (2.4%), whereas 6 fractures occurred in group B (15.7%).

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, Naples, Italy.

ABSTRACT

Background: We studied the use of teriparatide in postmenopausal women with severe osteoporosis.

Material/methods: Two groups (A and B) of patients affected by severe osteoporosis (T-score ≤-2.5 at bone mineral density were analyzed and 2 vertebral fractures on radiograph). Group A was treated for 18 months with 20 µg/day of teriparatide. Group B was treated with bisphosphonates 70 mg/week. Every woman assumed 1 g of calcium and 800 IU of vitamin D3 daily. We evaluated the effects of therapy after 18 months (T18) from the beginning with bone turnover markers (alkaline phosphatase, procollagen type 1 N-terminal propeptide, and N-telopeptide cross-links) and dual-energy X-ray absorptiometry.

Results: Group A, at T18 procollagen type 1 N-terminal propeptide levels, increased 127%; bone alkaline phosphatase levels increased to 65%; N-telopeptide cross-links levels increased to 110%. Group B, at T18 procollagen type 1 N-terminal propeptide levels, decreased to 74%; bone alkaline phosphatase levels decreased to 41%; N-telopeptide cross-links levels decreased to 72%. After 18 months, lumbar bone mineral density increased to 12.4% and femoral bone mineral density increased to 5.2% in group A. Group B lumbar bone mineral density increased to 3.85% and femoral bone mineral density increased to 1.99%. Only a new vertebral fracture occurred in group A (2.4%), whereas 6 fractures occurred in group B (15.7%). The quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO) revealed a significant improvement in daily living, performed domestic jobs, and locomotor function in groups A and B.

Conclusions: The use of rhPTH in patients with severe osteoporosis offers more protection against fractures and improves the QoL more than bisphosphonates.

Show MeSH
Related in: MedlinePlus