Four-Year Teriparatide Followed by Denosumab vs. Continuous Denosumab in Glucocorticoid-Induced Osteoporosis Patients With Prior Bisphosphonate Treatment.

Abstract

Objectives:

In our previous 24-month study, we observed that teriparatide had some advantages over denosumab for bone mineral density (BMD) in glucocorticoid-induced osteoporosis (GIO) patients with prior bisphosphonate treatment. We conducted this extension study to investigate whether the advantage of teriparatide obtained in the first 2 years would be maintained after the switch to denosumab.

Materials and Methods:

We switched patients who had completed 24-month daily teriparatide treatment to denosumab (switch group, n=18) and compared their BMD every 6 months up to 48 months with the group who continued to receive denosumab (denosumab group, n=16).

Results:

At 48 months, the lumbar spine BMD was significantly increased from baseline in both groups (denosumab: 10.4 ± 8.7%, p<0.001; switch: 14.2 ± 6.8%, p<0.001). However, a significant increase in femoral neck BMD from baseline occurred only in the switch group (11.2 ± 14.6%, p<0.05); denosumab (4.1 ± 10.8%). The total hip BMD increased significantly from baseline in both groups (denosumab: 4.60 ± 7.4%, p<0.05; switch: 7.2 ± 6.9%, p<0.01). Femoral neck BMD was significantly increased in the switch versus the denosumab group (p<0.05).

Conclusion:

In GIO patients with prior bisphosphonate treatment, the advantage of teriparatide may be maintained after the treatment period. A continuous increase in BMD can be expected with teriparatide followed by denosumab.

• Authors: Yasuaki Hirooka, Yuji Nozaki, Saki Okuda, Masafumi Sugiyama, Koji Kinoshita, Masanori Funauchi, Itaru Matsumura
• Journal: Frontiers in endocrinology (Front Endocrinol (Lausanne)) Vol. 12 Pg. 753185 ( 2021) ISSN: 1664-2392 [Print] Switzerland
• PMID: 34646240 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2021 Hirooka, Nozaki, Okuda, Sugiyama, Kinoshita, Funauchi and Matsumura.

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Glucocorticoids
• Teriparatide
• Denosumab

Topics

• Aged
• Bone Density
• Bone Density Conservation Agents (adverse effects, therapeutic use)
• Denosumab (adverse effects, therapeutic use)
• Diphosphonates (therapeutic use)
• Female
• Femur Neck (diagnostic imaging)
• Glucocorticoids (adverse effects)
• Hip (diagnostic imaging)
• Humans
• Male
• Middle Aged
• Osteoporosis (chemically induced, drug therapy)
• Prospective Studies
• Spine (diagnostic imaging)
• Teriparatide (adverse effects, therapeutic use)