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Once-weekly teriparatide improves glucocorticoid-induced osteoporosis in patients with inadequate response to bisphosphonates.

Seno T, Yamamoto A, Kukida Y, Hirano A, Kida T, Nakabayashi A, Fujioka K, Nagahara H, Fujii W, Murakami K, Oda R, Fujiwara H, Kohno M, Kawahito Y - Springerplus (2016)

View Article: PubMed Central - PubMed

Affiliation: Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan.

ABSTRACT

Background: Patients with glucocorticoid-induced osteoporosis (GIOP) are at very high risk of fracture, and patients with severe GIOP often experience fractures during treatment with bisphosphonates. Teriparatide (TPTD) is the only currently available anabolic agent expected to be effective for GIOP. Once-weekly TPTD decreased bone resorption marker with primary osteoporosis different from daily TPTD, but it has not yet been tested with GIOP.

Objectives: To evaluate the efficacy of once-weekly TPTD for patients with GIOP and inadequate response to bisphosphonates.

Methods: Patients with GIOP and collagen diseases treated with prednisolone for at least 6 months with inadequate responses to bisphosphonates were administered once-weekly TPTD. Bone density of the lumbar spine and femoral neck, measured as percent young adult mean (YAM); serum concentrations of cross-linked N-terminal telopeptides of type I collagen (NTx), bone alkaline phosphatase (BAP), and calcium; and FRAX were measured at baseline and 6, 12 and 18 months after starting TPTD.

Results: Of the 12 GIOP patients with collagen diseases enrolled, nine (seven females, two males; mean age 57.4 ± 11.1 years) completed treatment, including six with systemic lupus erythematosus, two with rheumatoid arthritis, and one with adult onset still disease. Only one new fracture event, a lumbar compression fracture, occurred during the study period, although seven patients experienced eight fracture events within 18 months before starting TPTD (p = 0.04). Lumbar spine YAM significantly improved at 18 months (p = 0.04), whereas femoral neck YAM did not (p = 0.477). Serum NTx, BAP, Ca, and FRAX were not significantly affected by TPTD treatment.

Conclusions: Once-weekly TPTD reduces fracture events and increases bone density of the lumbar spine of GIOP patients with inadequate response to bisphosphonates.

No MeSH data available.


Related in: MedlinePlus

Mean FRAX score during TPTD treatment. Changes over time in FRAX scores. a Major fractures; and b Hip fractures. Differences were compared using ANOVA; bars indicate 95 % CI
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Fig4: Mean FRAX score during TPTD treatment. Changes over time in FRAX scores. a Major fractures; and b Hip fractures. Differences were compared using ANOVA; bars indicate 95 % CI

Mentions: FRAX for hip and major fractures remained constant during TPTD administration (Fig. 4a, b). The number of fracture events and patients with new fractures 18 months before or after TPTD treatment in Table 2. During the 18 months before TPTD treatment, seven patients experienced eight fracture events. During the 18 months of TPTD treatment, only one patient, a female with SLE, experienced a new radiographic vertebral fracture or investigator-assessed non-vertebral fracture (p = 0.04). This patient had three fracture events within 18 months before the start of the study, and showed a significant reduction from baseline in BAP concentration.Fig. 4


Once-weekly teriparatide improves glucocorticoid-induced osteoporosis in patients with inadequate response to bisphosphonates.

Seno T, Yamamoto A, Kukida Y, Hirano A, Kida T, Nakabayashi A, Fujioka K, Nagahara H, Fujii W, Murakami K, Oda R, Fujiwara H, Kohno M, Kawahito Y - Springerplus (2016)

Mean FRAX score during TPTD treatment. Changes over time in FRAX scores. a Major fractures; and b Hip fractures. Differences were compared using ANOVA; bars indicate 95 % CI
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940355&req=5

Fig4: Mean FRAX score during TPTD treatment. Changes over time in FRAX scores. a Major fractures; and b Hip fractures. Differences were compared using ANOVA; bars indicate 95 % CI
Mentions: FRAX for hip and major fractures remained constant during TPTD administration (Fig. 4a, b). The number of fracture events and patients with new fractures 18 months before or after TPTD treatment in Table 2. During the 18 months before TPTD treatment, seven patients experienced eight fracture events. During the 18 months of TPTD treatment, only one patient, a female with SLE, experienced a new radiographic vertebral fracture or investigator-assessed non-vertebral fracture (p = 0.04). This patient had three fracture events within 18 months before the start of the study, and showed a significant reduction from baseline in BAP concentration.Fig. 4

View Article: PubMed Central - PubMed

Affiliation: Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan.

ABSTRACT

Background: Patients with glucocorticoid-induced osteoporosis (GIOP) are at very high risk of fracture, and patients with severe GIOP often experience fractures during treatment with bisphosphonates. Teriparatide (TPTD) is the only currently available anabolic agent expected to be effective for GIOP. Once-weekly TPTD decreased bone resorption marker with primary osteoporosis different from daily TPTD, but it has not yet been tested with GIOP.

Objectives: To evaluate the efficacy of once-weekly TPTD for patients with GIOP and inadequate response to bisphosphonates.

Methods: Patients with GIOP and collagen diseases treated with prednisolone for at least 6 months with inadequate responses to bisphosphonates were administered once-weekly TPTD. Bone density of the lumbar spine and femoral neck, measured as percent young adult mean (YAM); serum concentrations of cross-linked N-terminal telopeptides of type I collagen (NTx), bone alkaline phosphatase (BAP), and calcium; and FRAX were measured at baseline and 6, 12 and 18 months after starting TPTD.

Results: Of the 12 GIOP patients with collagen diseases enrolled, nine (seven females, two males; mean age 57.4 ± 11.1 years) completed treatment, including six with systemic lupus erythematosus, two with rheumatoid arthritis, and one with adult onset still disease. Only one new fracture event, a lumbar compression fracture, occurred during the study period, although seven patients experienced eight fracture events within 18 months before starting TPTD (p = 0.04). Lumbar spine YAM significantly improved at 18 months (p = 0.04), whereas femoral neck YAM did not (p = 0.477). Serum NTx, BAP, Ca, and FRAX were not significantly affected by TPTD treatment.

Conclusions: Once-weekly TPTD reduces fracture events and increases bone density of the lumbar spine of GIOP patients with inadequate response to bisphosphonates.

No MeSH data available.


Related in: MedlinePlus