Biochemical Parameters in Patients Using Teriparatide

Radu, Lucreţiu; Cârșote, Mara; Predescu, Anca Mihaela; Cojan, Tiberiu Ștefăniță Țenea; Socea, Bogdan; Bãleanu, Vlad Dumitru; Popescu, M; Ionovici, Nina; Albulescu, Dana Maria

doi:10.37358/rc.18.12.6774

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…A mild increase of PTH above normal limit was registered in one case from Cagroup after 12 months of TPT (of 71.36 pg/mL, normal level between 15 and 65 pg/mL) but this was proven to be related to low 25-hydroxyvitamin D level and immediate correction was provided to the patient. As positive aspect of the current study we mention the fact that a limited number of studies including Romanian protocol of TPT prescription are published online until this moment [10]. TPT is available only based on endocrinologist decision and prescription since 2013-2014 when it was first released the national TPT protocol [13,14].…”

Section: Resultsmentioning

confidence: 99%

“…The bone promoting medicine has a hepatic metabolism through proteolysis and it requires subcutaneous self-administration every day for 18 months or 24 months depending on protocol [1,7,8]. When it comes to assessment of bone parameters under teriparatide (TPT), an expected anabolic window of blood or urinary bone turnover markers is found in addition to bone mineral density (BMD) increase as detected by central DXA (Dual-Energy X-Ray Absorptiometry) since DXA remains the golden standard in daily practice for osteoporosis assays [9][10][11]. Transitory hypercalcemia has been reported in osteoporotic patients treated with TPT [12].…”

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confidence: 99%

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Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Bechir¹,

Ţuculină²,

Cârșote³

et al. 2019

Rev. Chim.

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Teriparatide (TPT) (C181H291N55O51S2) represents a recombinant molecule acting as human osteoanabolic agent. Transitory hypercalcemia (TH) has been reported in osteoporotic patients treated with daily TPT. Our purpose is to analyze the biochemical features as well as clinical risk factors for fractures in patients with severe osteoporosis treated with TPT who developed TH during first 12 months. This is an observational real-life study. In patients with TH biochemical blood markers like osteocalcin, CrossLaps and P1NP assessed at one year have statistically significant higher values than in subjects associating serum calcium within normal limits under the drug.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Bechir¹,

Ţuculină²,

Cârșote³

et al. 2019

Rev. Chim.

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“…In Paget's disease or multiple myeloma the markers may reach to extremely high values (10,12). Under biphosphonates the markers get low opposite to teriparatide therapy as an osteoanabolic option (13,14,15). In this case we do not currently consider clinically relevant the value of CrossLaps.…”

Section: Discussionmentioning

confidence: 99%

Forearm lump and osteoporosis

Cârșote¹,

Albu²,

Şandru³

et al. 2019

Ro J Med Pract.

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We introduce a case of a menopausal woman newly diagnosed with primary osteoporosis who has been detected with a forearm lump. A 57-year old female is confirmed with osteoporosis at DXA. The patient developed within 10 days a painful lump with local redness at dorso-medial part of left forearm. Apparently no local trauma was identified. Neither had she a general infection or any other condition in the mean time. The ultrasound identified a hypoechoic area of 4 by 1.3 by 4 cm, with positive Doppler signal. A local infection was considered and she was offered antibiotics for 10 days. However, since the patient also accused bone pain, she was re-referred for an endocrine assessment. The hormonal panel was consistent with the first assays. Also a mild inflammatory syndrome was detected based on erythrocytes sedimentation rate of 31 mm/1-hour (normal: < 25 mm/1-h) and C reactive protein of 1.4 mg/dl (normal: < 1 ng/ml). An X-Ray of the region was done and showed no anomaly. The bone whole body scintigram was negative at forearm but a fracture rib at the level of 9th left rib was identified and considered osteoporotic. A computed tomography showed the subcutaneous localisation of the lump with small calcifications and no bone involvement. Paget's disease of the bone was excluded based on normal bone turnover markers and negative bone scintigram. The proximity with a bone disease diagnosis needs to differentiate a subcutaneous lesion from a potential bone deformity caused by a metabolic bone condition.

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“…The causes of dermatomyositis are autoimmune or cancer-related but sometimes as in mentioned case they remain as "idiopathic" (1,2,3,4). In this particular situation we avoid the use of an osteoanabolic drug as teriparatide for complicate glucocorticoid osteoporosis since an active neoplasia was not entirely excluded (7,8).…”

Section: Discussionmentioning

confidence: 99%

From dermatomyositis to osteoporosis

Şandru¹,

Valea²,

Albu³

et al. 2019

Ro J Med Pract.

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Our aim is to describe a case of a menopausal woman who started with dermatomyositis and then became a patient at endocrinology because of complicated glucocorticoid osteoporosis. This is a 63-year old female who suddenly started to accuse intense muscle pain associated with redness of the skin. She was confirmed with dermatomyositis and offered high doses of oral metilprednisolone. The thyroid ultrasound showed micronodular background and a small nodule of 0.7 cm without clinical relevance with an increase of antibodies thyroperoxidase antibody and normal thyroid function. Bone turnover markers were within normal in addition to decrease of serum 25-hydroxyvitamin D of 20 ng/ml. DXA (Dual-Energy X-Ray Absorptiometry) showed ostepenia based on a minimum T-score of-2.4 SD. The patient was offered high doses of cholecalciferol 2,000 UI per day and 500 mg of calcium daily in addition to weekly alendronate due to the high risk of fracture because of the glucocorticoid doses. 6 months later she suffered and accidental fall and a hip fracture was confirmed and required surgery. Further on the therapy was switched to zolendronic acid one injection per year. The dermatological and muscle progressively improved thus the doses of corticoids were reduced. As particular observation the presence of autoimmune thyroid condition may increase the risk of a second autoimmune disease like dermatomyositis, also the specific antibodies panel was negative. A multidisciplinary team needs to be involved in associated therapy for dermatomyositis and complications of glucocorticoids use.

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Biochemical Parameters in Patients Using Teriparatide

Cited by 11 publications

References 10 publications

Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Clinical Data on Transitory Teriparatide-related Hypercalcemia in Daily Practice Treatment for Severe Menopausal Osteoporosis

Forearm lump and osteoporosis

From dermatomyositis to osteoporosis

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