The teriparatide in the treatment of severe senile osteoporosis

Manuele, Sara; Sorbello, Leonardo; Puglisi, N; Grasso, Sebastiano; Malfa, L. La; D’Urbino, G.; Rizzotto, Maurizio; Strano, Salvatore; Maugeri, D.

doi:10.1016/j.archger.2007.01.034

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…As a result US and EU health authorities recommended severe restriction on the use of HRT as a first-line treatment for postmenopausal osteoporosis. However, further analysis of the data suggests that this may have been an over-reaction 96 – 99. Further advice from health authorities is awaited.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Recombinant human parathyroid hormone (rh PTH 1–34; teriparatide) has recently shown promise in the treatment of postmenopausal and corticosteroid-induced osteoporosis, increasing BMD and reducing the occurrence of fractures 99 100. In a 1-year randomised study comparing BMD in women taking 5–20 mg/day prednisone equivalent concomitantly with oestrogen alone or oestrogen and teriparatide, those on oestrogen and teriparatide had an increase in lumbar spine BMD compared with no increase in those on oestrogen alone 101.…”

Section: Treatment Optionsmentioning

confidence: 99%

See 1 more Smart Citation

Gut, inflammation and osteoporosis: basic and clinical concepts

Tilg

Moschen

Kaser

et al. 2008

Gut

248

167

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Chronic inflammatory disorders such as inflammatory bowel diseases (IBD) affect bone metabolism and are frequently associated with the presence of osteoporosis. Bone loss is regulated by various mediators of the immune system such as the pro-inflammatory cytokines tumour necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-6, or interferon-gamma. TNF-alpha, a master cytokine in human IBD, causes bone erosions in experimental models and these effects are exerted by osteoclasts. Other TNF-related cytokines such as receptor activator of nuclear factor kappa B (RANK), its ligand, RANKL, and osteoprotegerin are important mediators in inflammatory processes in the gut and are critically involved in the pathophysiology of bone loss. The awareness and early diagnosis of osteoporosis in states of chronic inflammation, together with applied therapies such as bisphosphonates, may be beneficial in inflammation-associated osteoporosis. Although several mechanisms may contribute to osteoporosis in patients with IBD and coeliac disease, inflammation as an important factor has so far been neglected. As key inflammatory mediators in IBD such as TNF-alpha are involved in the disease process both in gut and bone, we hypothesise that neutralisation of TNF-alpha could prove an efficient strategy in the treatment of inflammation-related osteoporosis in the future.

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Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Gut, inflammation and osteoporosis: basic and clinical concepts

Tilg

Moschen

Kaser

et al. 2008

Gut

248

167

View full text Add to dashboard Cite

show abstract

“…Subsequently, more osteoblasts in the BMU will form more new bone and induce an increase in the remodeling rate (through the activation of osteoclasts), both of which will increase the amount of bone tissue and trabecular thickness. 71 Currently, PTH and its analog teriparatide (recombinant PTH ) are the only approved anabolic treatments for osteoporosis. 72 Intermittent daily dosing of PTH induces osteoblast differentiation, inhibits adipogenesis, and suppresses osteoblast apoptosis.…”

Section: Anabolic Treatment Of Senile Osteoporosismentioning

confidence: 99%

Understanding the Mechanisms of Senile Osteoporosis: New Facts for a Major Geriatric Syndrome

Duque

Troen

2008

J American Geriatrics Society

134

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Knowledge of the underlying mechanisms of osteoporosis in older adults has significantly advanced in recent years. There is an acute loss of bone mineral density in the peri-menopausal period, followed by a more gradual and progressive decline, which is also seen in men. Markedly increased bone resorption leads to the initial fall in bone mineral density. With increasing age, there is also a significant reduction in bone formation. This is mostly due to a shift from osteoblastogenesis to predominant adipogenesis in the bone marrow. This study reviews new evidence on the pathophysiology of senile osteoporosis, with emphasis upon the mechanism of action of current osteoporosis treatments. New potential treatments are also considered, including therapeutic approaches to osteoporosis in elderly people that focus on the pathophysiology and potential reversal of the adipogenic shift in bone.

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“…In a study conducted by Maugeri et al (24), the efficacy of teriparatide therapy was investigated among osteoporotic subjects with severe fractures and significant improvements were observed particulary at the end of 18 months in all parameters of the quality of life index-QUALEFFO scale, which were maintained up to 24 months. Manuele et al (25) stated that teriparatide therapy is an effective therapeutic option for osteoporotic patients with severe fractures who are refractory to other treatments and showed positive effects mainly on pain and physical function and all other indicators of quality of life.…”

Section: Discussionmentioning

confidence: 99%

The Effect Of Teriparatide Therapy On Regulators Of Bone Turnover And Qualeffo-41

Harman¹,

Bayram²,

Ünal³

et al. 2013

Tepecik Dergisi

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SUMMARY Aim:The aim of this cross-sectional study was to compare the effects of teriparatide therapy on anabolic hormones and bone turnover markers and quality of life in patients with osteoporotic fractures. Material and method:Patients with severe osteoporosis defined as lumbar total T-score or femur neck T-score ≤ -4.0 and at least 2 lumbar vertebral compression fractures were enrolled. 15 patients were on teriparatide therapy and 15 patiens had no therapy. ALP, osteocalcin, GH, IGF-1, IGFBP and SHBG levels were determined. QUALEFFO-41 was used for QOL evaluation. Findings:In the teriparatide group ALP and osteocalcin levels were significantly higher (p<0.05). GH, IGF-1, IGFBP and SHBG levels did not differ significantly (P>0.05). In teriparatide patients, physical function (a,b,c,d,e), general health evaluation (f) and total QUALEFFO-41 scores were significantly lower, while mental function (g) scores were significantly higher (p<0.05). Physical function scores b and c were negatively correlated with IGF-1 (p<0.05). Treatment duration in teriparatide group was negatively correlated with physical function scores a, b, c, d and general health score (f) (p<0.05). Conclusion:In this study teriparatide therapy was shown to raise the levels of bone turnover markers significantly and affect quality of life positively in osteoporotic patients with vertebral fractures and these improvements were correlated with treatment duration. Gereç ve Yöntem:Çalışmaya kemik mineral yoğunluğu ölçüm değerlerine göre ileri osteoporotik (toplam lomber omurga veya femur bölgesi T skoru ≤ -4.0 ) ve en az iki vertebrada kompresyon fraktürü olan olgular (Grup B, s=15, teriparatid alan / Grup A, s=15, tedavi almayan) alındı. Serum ALP, osteokalsin, BH, IBF-1, IBFBP-3 ve SHBG değerlendirildi. Yaşam kalitesi özel bir anket olan QUALEFFO-41 ile değerlendirildi. Bulgular:Tedavi grubunda alkalen fosfataz ve osteokalsin değerleri kontrol grubuna göre anlamlı yüksekti (p<0,05). BH, IBF-1, IBFBP-3 ve SHBG açısından gruplar arasında anlamlı fark yoktu (p>0,05). Tedavi alan grupta fiziksel işlev (a,b,c,d,e), genel sağlık değerlendirmesi (f) ve toplam QUALEFFO puanları düşük (p<0,05); zihinsel işlev (g) değerlendirme puanı ise yüksek bulundu (p<0,05). Tedavi alan grupda yaşam kalite dizininde yeralan fiziksel işlev "b" ve "c" skorları ile "IBF-1" arasındaki ilişki olumsuz idi(p<0,05). Tedavi edilen olguların yaşam kalite dizin skorları ile tedavi süresi incelendiğinde; fiziksel işlev skoru "a,b,c,d" ve genel sağlık skoru "f" ile tedavi süresi arasında olumsuz ilişki saptandı (p<0,05).Sonuç: Osteoporotik vertebral kırıklı olgularda teriparatid tedavisinin kemik formasyon belirteçlerinde artış sağladığı, yaşam kalitesini olumlu yönde etkilediği ve bu durumun tedavi süresiyle ilişkili olduğu saptanmıştır.

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The teriparatide in the treatment of severe senile osteoporosis

Cited by 14 publications

References 15 publications

Gut, inflammation and osteoporosis: basic and clinical concepts

Gut, inflammation and osteoporosis: basic and clinical concepts

Understanding the Mechanisms of Senile Osteoporosis: New Facts for a Major Geriatric Syndrome

The Effect Of Teriparatide Therapy On Regulators Of Bone Turnover And Qualeffo-41

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