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The effectiveness of teriparatide in the clinical practice--attenuation of the bone mineral density outcome by increasing age and bisphosphonate pretreatment.

AbstractBACKGROUND:
Teriparatide is a potent anabolic agent for severe osteoporosis.
OBJECTIVES:
A primary objective of this retrospective study was to define the efficacy of teriparatide in terms of bone mineral density (BMD) changes and relief of back pain in clinical practice.
METHODS:
The patient population comprises 119 osteoporotic patients treated with teriparatide for median 539 (range 179-926) days.
RESULTS:
The mean BMD gain was 0.9% in the total hip (P = 0.0075), 2.1% in the femoral neck (P = 0.0006), and 8.5% in the lumbar spine (P = 0.0085). In the whole patient population age associated inversely with BMD changes in the total hip (P = 0.019) and in the femoral neck (P = 0.0036). A history of significant bisphosphonate pretreatment (n = 90) reduced BMD response in the total hip (P = 0.039). The total exposure of any prior bisphosphonate was negatively correlated with BMD response in the total hip (P = 0.0421). Half of the patients reported relief of back pain during the treatment. Leg pain, nausea, and dizziness were most frequent adverse concerns.
CONCLUSIONS:
Teriparatide works in clinical practice as well as in clinical trials. Younger subjects benefited more than older patients from teriparatide in the total hip and in the femoral neck. Bisphosphonate pretreatment attenuated teriparatide-induced BMD gain.
AuthorsAnna-Mari Koski, Eliisa Löyttyniemi, Hannu Väänänen, Hanna Laine, Leo Niskanen, Pasi I Nevalainen, Eeva Korpi-Hyövälti, Matti J Välimäki
JournalAnnals of medicine (Ann Med) Vol. 45 Issue 3 Pg. 230-5 (May 2013) ISSN: 1365-2060 [Electronic] England
PMID23330730 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Bone Density Conservation Agents
  • Collagen Type I
  • Diphosphonates
  • Peptides
  • Procollagen
  • collagen type I trimeric cross-linked peptide
  • Teriparatide
Topics
  • Absorptiometry, Photon
  • Age Factors
  • Aged
  • Analysis of Variance
  • Back Pain (prevention & control)
  • Bone Density
  • Bone Density Conservation Agents (therapeutic use)
  • Collagen Type I (blood, urine)
  • Diphosphonates (adverse effects)
  • Female
  • Femur Neck (radiography)
  • Hip Joint (radiography)
  • Humans
  • Lumbar Vertebrae (radiography)
  • Male
  • Middle Aged
  • Osteoporosis (drug therapy)
  • Osteoporotic Fractures (prevention & control)
  • Peptides (urine)
  • Procollagen (blood)
  • Retrospective Studies
  • Teriparatide (therapeutic use)

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