Effects of Previous Antiresorptive Therapy on the Bone Mineral Density Response to Two Years of Teriparatide Treatment in Postmenopausal Women with Osteoporosis

Boonen, Steven; Marín, Fernando; Obermayer–Pietsch, Barbara; Simões, Maria E; Barker, Clare; Glass, Emmett V.; Hadji, Peyman; Lyritis, George P.; Oertel, H; Nickelsen, Thomas; McCloskey, Eugène

doi:10.1210/jc.2007-0711

Cited by 224 publications

(146 citation statements)

References 22 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…Moreover, the increase in remodeling occurs on the trabecular surface or close to the endosteal surface of the bone where the mechanical effect is minimal. Furthermore, this transient loss may be compensated for by periosteal apposition, which maintains the overall resistance of the bone, thus preventing mechanical deterioration (14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Short-term bone marker responses to teriparatide and strontium ranelate in patients with osteoporosis previously treated with bisphosphonates

Sousa

Diniz

Marques

et al. 2010

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

OBJECTIVE: To evaluate the responses of serum β-CTX and osteocalcin in patients who were undergoing treatment with teriparatide or strontium ranelate (SR). SUBJECTS AND METHODS: We analyzed 14 patients (12 women and 2 men; mean age of 71 years) taking teriparatide, and 13 female patients (mean age of 70 years) taking SR; all the patients having previously been on bisphosphonates. Serum β-CTX and osteocalcin levels were determined before and after the first and third months of teriparatide treatment and up to the fourth month of treatment with SR. RESULTS: We observed an initial significant increase in osteocalcin levels during the first month (165%, p = 0.01) followed by a peak of β-CTX (180%, p = 0.02) after the third month of treatment with teriparatide. An increase in these markers was also observed with SR: 49% in osteocalcin (p = 0.002) and 80% in β-CTX (p = 0.008). CONCLUSION: SR had a predominantly short-term bone-forming effect in postmenopausal women with osteoporosis previously treated with bisphosphonates in a lesser degree than with teriparatide.

show abstract

Section: Discussionmentioning

confidence: 99%

Short-term bone marker responses to teriparatide and strontium ranelate in patients with osteoporosis previously treated with bisphosphonates

Sousa

Diniz

Marques

et al. 2010

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…(11,12) Based on finite-element simulation, the patients from both the EUROFORS and OPTAMISE studies had significantly improved predicted mechanical bone properties after teriparatide, with the prior risedronate group having a greater increase in stiffness and vertebral failure load (13,14) than the group of patients previously treated with alendronate. Recently, teriparatide also was shown to reduce the accumulation of microdamage in patients who were treated previously with alendronate.…”

Section: J Jbmrmentioning

confidence: 99%

“…In the EUROFORS and OPTAMISE studies, the increase in boneformation markers after initiation of teriparatide treatment was delayed in the first few months in subjects previously treated with alendronate compared with those previously treated with risedronate. (11,12) Thus it could have been expected that the faster increase in bone turnover in the priorRIS group would induce larger changes in BMDD compared with the priorALN group. However, this was not observed, and there were minor differences only in some BMDD variables between the two bisphosphonate groups after 1 year of teriparatide treatment.…”

Section: Normal Baseline Bmdd Of Prioraln and Priorrismentioning

confidence: 99%

Effects of 1 year of daily teriparatide treatment on iliacal bone mineralization density distribution (BMDD) in postmenopausal osteoporotic women previously treated with alendronate or risedronate

Misof

Paschalis

Blouin

et al. 2010

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Anabolic treatment with teriparatide of postmenopausal osteoporotic patients previously treated with bisphosphonates is a new therapeutic approach. However, its effects on the bone mineralization density distribution (BMDD) are unknown. We studied paired transiliac bone biopsy samples taken before and after 1 year of treatment with recombinant human parathyroid hormone peptide 1-34 (teriparatide) from 16 osteoporotic women treated with either alendronate (priorALN) or risedronate (priorRIS) for at least 2 years and subsequently treated for 12 months with teriparatide. Cancellous (Cn.) and cortical (Ct.) BMDD values were measured using quantitative backscattered electron imaging. At baseline, BMDD values of priorALN and priorRIS women were similar and within the normal range. One year of teriparatide treatment caused significant effects on the BMDD. Analyzing changes from baseline for each bisphosphonate group separately, priorALN patients revealed increases in the portion of low mineralized bone areas (Cn.Ca Low þ25.9%, Ct.Ca Low þ62.0%, both p < .05) and Ct. heterogeneity of mineralization (Ct.Ca Width þ22.8%, p < .001). PriorRIS patients showed increased mineralization heterogeneity (Cn.Ca Width þ14.8%, p < .05, and Ct.Ca Width þ15.8%, p < .001). Analysis of the influence of the prior bisphosphonate treatment showed that the BMDD response to 1 year of teriparatide treatment did not depend on the type of prior bisphosphonate. In consequence, priorALN and priorRIS groups were combined. The pooled groups revealed increased Cn.Ca Width and Ct.Ca Width (þ10.7%, p < .01, and þ19.6%, p < .001, respectively) as well as increased Cn.Ca Low and Ct.Ca Low (þ18.2%, p < .05, and þ36.6%, p < .01, respectively). In summary, our findings indicate a significant effect of teriparatide on BMDD when administered subsequent to a bisphosphonate in agreement with teriparatide's anabolic action. ß

show abstract

“…Prior studies evaluating combinations of PTH or teriparatide with antiresorptive agents have yielded inconsistent results, with differences related to which antiresorptive agent is used, (16)(17)(18)(19)(20)(21)(22) whether patients are treatment-naive or have been on antiresorptive therapy when combination treatment is started, (14,23) and, for patients on prior antiresorptives, whether the antiresorptive agent is continued or stopped when teriparatide is added. (24) In one study, (14) treatment-naive patients were randomized to alendronate or intact PTH(1-84) monotherapy versus combination therapy.…”

Section: Introductionmentioning

confidence: 99%

Effects of intravenous zoledronic acid plus subcutaneous teriparatide [rhPTH(1–34)] in postmenopausal osteoporosis

Cosman

Eriksen

Recknor

et al. 2010

Journal of Bone and Mineral Research

Self Cite

318

173

View full text Add to dashboard Cite

Clinical data suggest concomitant therapy with bisphosphonates and parathyroid hormone (PTH) may blunt the anabolic effect of PTH; rodent models suggest that infrequently administered bisphosphonates may interact differently. To evaluate the effects of combination therapy with an intravenous infusion of zoledronic acid 5 mg and daily subcutaneous recombinant human (rh)PTH(1-34) (teriparatide) 20 mg versus either agent alone on bone mineral density (BMD) and bone turnover markers, we conducted a 1-year multicenter, multinational, randomized, partial double-blinded, controlled trial. 412 postmenopausal women with osteoporosis (mean age 65 AE 9 years) were randomized to a single infusion of zoledronic acid 5 mg plus daily subcutaneous teriparatide 20 mg (n ¼ 137), zoledronic acid alone (n ¼ 137), or teriparatide alone (n ¼ 138). The primary endpoint was percentage increase in lumbar spine BMD (assessed by dual-energy X-ray absorptiometry [DXA]) at 52 weeks versus baseline. Secondary endpoints included change in BMD at the spine at earlier time points and at the total hip, trochanter, and femoral neck at all time points. At week 52, lumbar spine BMD had increased 7.5%, 7.0%, and 4.4% in the combination, teriparatide, and zoledronic acid groups, respectively ( p < .001 for combination and teriparatide versus zoledronic acid). In the combination group, spine BMD increased more rapidly than with either agent alone ( p < .001 versus both teriparatide and zoledronic acid at 13 and 26 weeks). Combination therapy increased total-hip BMD more than teriparatide alone at all times (all p < .01) and more than zoledronic acid at 13 weeks ( p < .05), with final 52-week increments of 2.3%, 1.1%, and 2.2% in the combination, teriparatide, and zoledronic acid groups, respectively. With combination therapy, bone formation (assessed by serum N-terminal propeptide of type I collagen [PINP]) increased from 0 to 4 weeks, declined minimally from 4 to 8 weeks, and then rose throughout the trial, with levels above baseline from 6 to 12 months. Bone resorption (assessed by serum b-C-telopeptide of type I collagen [b-CTX]) was markedly reduced with combination therapy from 0 to 8 weeks (a reduction of similar magnitude to that seen with zoledronic acid alone), followed by a gradual increase after week 8, with levels remaining above baseline for the latter half of the year. Levels for both markers were significantly lower with combination therapy versus teriparatide alone ( p < .002). Limitations of the study included its short duration, lack of endpoints beyond DXA-based BMD (e.g., quantitative computed tomography and finite-element modeling for bone strength), lack of teriparatide placebo, and insufficient power for fracture outcomes. We conclude that while teriparatide increases spine BMD more than zoledronic acid and zoledronic acid increases hip BMD more than teriparatide, combination therapy provides the largest, most rapid increments when both spine and hip sites are considered. ß

show abstract

Effects of Previous Antiresorptive Therapy on the Bone Mineral Density Response to Two Years of Teriparatide Treatment in Postmenopausal Women with Osteoporosis

Abstract: Teriparatide induces positive effects on BMD and markers of bone formation in postmenopausal women with established osteoporosis, regardless of previous long-term exposure to antiresorptive therapies.

Cited by 224 publications

References 22 publications

Short-term bone marker responses to teriparatide and strontium ranelate in patients with osteoporosis previously treated with bisphosphonates

Short-term bone marker responses to teriparatide and strontium ranelate in patients with osteoporosis previously treated with bisphosphonates

Effects of 1 year of daily teriparatide treatment on iliacal bone mineralization density distribution (BMDD) in postmenopausal osteoporotic women previously treated with alendronate or risedronate

Effects of intravenous zoledronic acid plus subcutaneous teriparatide [rhPTH(1–34)] in postmenopausal osteoporosis

Contact Info

Product

Resources

About