Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial

Dempster, David W.; Zhou, Hua; Recker, Robert R.; Brown, Jacques P.; Bolognese, Michael A.; Recknor, Christopher; Kendler, David L.; Lewiecki, E. Michael; Hanley, David A.; Rao, D. Sudhaker; Miller, Paul D.; Woodson, Grattan C.; Lindsay, Robert; Binkley, Neil; Wan, Xiaohai; Ruff, Valerie A.; Janos, Boris; Taylor, Kathleen A.

doi:10.1210/jc.2012-1262

Cited by 79 publications

(60 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both effects increase bone formation rate in cancellous, endocortical, and periosteal envelopes and augment the thickness of bone packets. (6)(7)(8)(9)(10) Both anabolic and potent antiresorptive agents (bisphosphonates, denosumab) improve bone mineral density (BMD) and reduce risk of fracture in patients who have not been on prior osteoporosis treatments. (11)(12)(13)(14)(15)(16)(17) Effects of most osteoporosis medications differ, however, in patients who have already been pretreated with other potent osteoporosis medications.…”

Section: Introductionmentioning

confidence: 99%

Treatment Sequence Matters: Anabolic and Antiresorptive Therapy for Osteoporosis

Cosman

Nieves

Dempster

2016

Journal of Bone and Mineral Research

203

129

View full text Add to dashboard Cite

The effects of anabolic medications (teriparatide [TPTD] and parathyroid hormone [PTH]) differ in patients who have received recent treatment with potent antiresorptives. This perspective reviews studies evaluating bone density (BMD) and histomorphometric effects of treatment sequences beginning with TPTD/PTH followed by potent antiresorptives and those beginning with potent antiresorptives followed by switching to or adding TPTD. Effect of treatment sequence on spine BMD outcome is minor, with modest quantitative differences. However, when individuals established on potent bisphosphonates are switched to TPTD, hip BMD declines below baseline for at least the first 12 months after the switch to TPTD. This transient hip BMD loss is more prominent when the antiresorptive is denosumab; in this setting, hip BMD remains below baseline for almost a full 24 months. In a controlled comparison of those who switched from alendronate to TPTD versus those who added TPTD to ongoing alendronate, the effect on hip BMD was improved with combination therapy. Furthermore, hip strength improved with the addition of TPTD to ongoing alendronate, whereas it was neutral after switching from alendronate to TPTD, primarily due to the effect on cortical bone. Bone biopsy studies indicate that TPTD stimulates bone formation in patients who have not been treated previously as well as in patients on prior and ongoing bisphosphonates. Histomorphometric evidence suggests that use of alendronate with TPTD blocks the TPTD-induced increase in cortical porosity. When possible, we suggest anabolic therapy first, followed by potent antiresorptive therapy. The common practice of switching to TPTD only after patients have an inadequate response to antiresorptives (intercurrent fracture or inadequate BMD effect) is not the optimal utilization of anabolic treatment. In fact, this may result in transient loss of hip BMD and strength. In this setting, continuing a potent antiresorptive while starting TPTD might improve hip outcomes.

show abstract

Section: Introductionmentioning

confidence: 99%

Treatment Sequence Matters: Anabolic and Antiresorptive Therapy for Osteoporosis

Cosman

Nieves

Dempster

2016

Journal of Bone and Mineral Research

203

129

View full text Add to dashboard Cite

show abstract

“…These drugs act by suppressing bone resorption but also decrease bone formation (4). Teriparatide (TPTD-hPTH 1-34) is the only currentlyavailable anabolic agent and acts by a mechanism that involves stimulating new bone formation (along with resorption), and reconstituting internal bone microarchitecture (5)(6)(7). The effects of teriparatide on bone mineral density (BMD) are superior to antiresorptive agents at the spine, but its effects at the hip are more modest, and often delayed until the second year of a 2-year course of therapy (8,9).…”

mentioning

confidence: 99%

Effects of Abaloparatide, a Human Parathyroid Hormone-Related Peptide Analog, on Bone Mineral Density in Postmenopausal Women with Osteoporosis

Leder

O’Dea

Zanchetta

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

215

188

View full text Add to dashboard Cite

show abstract

“…The increase in spine bone mineral density (BMD) after TPTD is also most rapid within the first 6 months, consistent with the biochemistry (2-4, 6, 10, 11). Furthermore, histomorphometric analyses of the iliac crest indicate that there is dramatic stimulation of bone formation and remodeling at 6 months (8,13); however, after 18 -36 months of TPTD, there is no evidence of ongoing stimulation of bone formation or remodeling, at least in cancellous bone (7,14,15). Thus, there appears to be tachyphylaxis associated with daily administration over this time.…”

mentioning

confidence: 99%

Daily or Cyclical Teriparatide Treatment in Women With Osteoporosis on no Prior Therapy and Women on Alendronate

Cosman

Nieves

Zion

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

Self Cite

View full text Add to dashboard Cite

show abstract

Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial

Cited by 79 publications

References 18 publications

Treatment Sequence Matters: Anabolic and Antiresorptive Therapy for Osteoporosis

Treatment Sequence Matters: Anabolic and Antiresorptive Therapy for Osteoporosis

Effects of Abaloparatide, a Human Parathyroid Hormone-Related Peptide Analog, on Bone Mineral Density in Postmenopausal Women with Osteoporosis

Daily or Cyclical Teriparatide Treatment in Women With Osteoporosis on no Prior Therapy and Women on Alendronate

Contact Info

Product

Resources

About