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MONTREAL — A history of unresponsiveness to bisphosphonate therapies does not appear to diminish the bone-building effects of teriparatide in women with osteoporosis, judging from the findings of a small, uncontrolled, 18-month study.
The anabolic effects of teriparatide (Forteo), an injectable form of recombinant human parathyroid hormone, on bone mineral density (BMD) were apparent by 6 months into treatment and were accompanied by significant changes in biomarkers of bone turnover and positive changes in bone structure on MicroCT imaging, Dr. Burkhard Muche said at the annual meeting of the American Society for Bone and Mineral Research.
The results suggest that patients who are resistant to oral bisphosphonate therapy could use teriparatide in treatment cycles lasting at least 6 months, followed by an antiresorptive agent such as raloxifene (Evista), strontium ranelate, or an intravenous bisphosphonate, in order to optimize the beneficial effects of the anabolic agent, said Dr. Muche of the department of metabolic diseases/osteology at Immanuel-Krankenhaus, Berlin.
Of 25 women in the study with a mean age of 69 years, 14 had a new fragility fracture and 11 had a significant decline in BMD of greater than 3.5%, despite previous treatment with oral bisphosphonates lasting at least 12 months. Half had taken risedronate (Actonel) and half had taken alendronate (Fosamax) for a mean of 3.5 years (range of 1–7 years). The women also received 500 mg of calcium and 400 IU of vitamin D3 each day.
The investigators detected significant increases in BMD at the lumbar spine after 6, 12, and 18 months of teriparatide. By 18 months, the women had a mean 9% increase in BMD at the lumbar spine. No significant changes developed in the total BMD of the femoral neck or the hip.
Intermittent asymptomatic hypercalcemia occurred in four patients.
Levels of the bone formation marker bone alkaline phosphatase significantly increased from 15 ng/L at baseline to 28 ng/L at 6 months, but then decreased through 18 months. Concentrations of a marker of bone resorption, beta C-terminal telopeptide of type I collagen (α-CTX), followed the same trend.
Dr. Muche and his colleagues obtained paired bone biopsies from the dorsal iliac crest at baseline, from the opposite side at 6 months, and again from the original side at 18 months. Parameters of bone structure on MicroCT imaging increased early during the course of treatment.
Dr. Muche received a travel grant from Lilly Germany, which funded the study. Eli Lilly & Co. makes teriparatide.
MONTREAL — A history of unresponsiveness to bisphosphonate therapies does not appear to diminish the bone-building effects of teriparatide in women with osteoporosis, judging from the findings of a small, uncontrolled, 18-month study.
The anabolic effects of teriparatide (Forteo), an injectable form of recombinant human parathyroid hormone, on bone mineral density (BMD) were apparent by 6 months into treatment and were accompanied by significant changes in biomarkers of bone turnover and positive changes in bone structure on MicroCT imaging, Dr. Burkhard Muche said at the annual meeting of the American Society for Bone and Mineral Research.
The results suggest that patients who are resistant to oral bisphosphonate therapy could use teriparatide in treatment cycles lasting at least 6 months, followed by an antiresorptive agent such as raloxifene (Evista), strontium ranelate, or an intravenous bisphosphonate, in order to optimize the beneficial effects of the anabolic agent, said Dr. Muche of the department of metabolic diseases/osteology at Immanuel-Krankenhaus, Berlin.
Of 25 women in the study with a mean age of 69 years, 14 had a new fragility fracture and 11 had a significant decline in BMD of greater than 3.5%, despite previous treatment with oral bisphosphonates lasting at least 12 months. Half had taken risedronate (Actonel) and half had taken alendronate (Fosamax) for a mean of 3.5 years (range of 1–7 years). The women also received 500 mg of calcium and 400 IU of vitamin D3 each day.
The investigators detected significant increases in BMD at the lumbar spine after 6, 12, and 18 months of teriparatide. By 18 months, the women had a mean 9% increase in BMD at the lumbar spine. No significant changes developed in the total BMD of the femoral neck or the hip.
Intermittent asymptomatic hypercalcemia occurred in four patients.
Levels of the bone formation marker bone alkaline phosphatase significantly increased from 15 ng/L at baseline to 28 ng/L at 6 months, but then decreased through 18 months. Concentrations of a marker of bone resorption, beta C-terminal telopeptide of type I collagen (α-CTX), followed the same trend.
Dr. Muche and his colleagues obtained paired bone biopsies from the dorsal iliac crest at baseline, from the opposite side at 6 months, and again from the original side at 18 months. Parameters of bone structure on MicroCT imaging increased early during the course of treatment.
Dr. Muche received a travel grant from Lilly Germany, which funded the study. Eli Lilly & Co. makes teriparatide.
MONTREAL — A history of unresponsiveness to bisphosphonate therapies does not appear to diminish the bone-building effects of teriparatide in women with osteoporosis, judging from the findings of a small, uncontrolled, 18-month study.
The anabolic effects of teriparatide (Forteo), an injectable form of recombinant human parathyroid hormone, on bone mineral density (BMD) were apparent by 6 months into treatment and were accompanied by significant changes in biomarkers of bone turnover and positive changes in bone structure on MicroCT imaging, Dr. Burkhard Muche said at the annual meeting of the American Society for Bone and Mineral Research.
The results suggest that patients who are resistant to oral bisphosphonate therapy could use teriparatide in treatment cycles lasting at least 6 months, followed by an antiresorptive agent such as raloxifene (Evista), strontium ranelate, or an intravenous bisphosphonate, in order to optimize the beneficial effects of the anabolic agent, said Dr. Muche of the department of metabolic diseases/osteology at Immanuel-Krankenhaus, Berlin.
Of 25 women in the study with a mean age of 69 years, 14 had a new fragility fracture and 11 had a significant decline in BMD of greater than 3.5%, despite previous treatment with oral bisphosphonates lasting at least 12 months. Half had taken risedronate (Actonel) and half had taken alendronate (Fosamax) for a mean of 3.5 years (range of 1–7 years). The women also received 500 mg of calcium and 400 IU of vitamin D3 each day.
The investigators detected significant increases in BMD at the lumbar spine after 6, 12, and 18 months of teriparatide. By 18 months, the women had a mean 9% increase in BMD at the lumbar spine. No significant changes developed in the total BMD of the femoral neck or the hip.
Intermittent asymptomatic hypercalcemia occurred in four patients.
Levels of the bone formation marker bone alkaline phosphatase significantly increased from 15 ng/L at baseline to 28 ng/L at 6 months, but then decreased through 18 months. Concentrations of a marker of bone resorption, beta C-terminal telopeptide of type I collagen (α-CTX), followed the same trend.
Dr. Muche and his colleagues obtained paired bone biopsies from the dorsal iliac crest at baseline, from the opposite side at 6 months, and again from the original side at 18 months. Parameters of bone structure on MicroCT imaging increased early during the course of treatment.
Dr. Muche received a travel grant from Lilly Germany, which funded the study. Eli Lilly & Co. makes teriparatide.