Abstract | CONTEXT: OBJECTIVE: We evaluated two novel approaches to the use of 6 months of PTH therapy over 2 yr. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: We conducted a randomized, double-blinded trial of two combinations of daily PTH(1-84) and monthly ibandronate in 44 postmenopausal women with low bone mass. Participants received either 6 months of concurrent PTH and ibandronate, followed by 18 months of ibandronate (concurrent) or two sequential courses of 3 months of PTH followed by 9 months of ibandronate (sequential) over 2 yr. MAIN OUTCOME MEASURES: Bone turnover markers were measured. Areal and volumetric BMD were assessed by dual-energy x-ray absorptiometry and quantitative computed tomography, respectively. RESULTS: Over 2 yr, areal BMD at the spine and hip increased similarly in both groups, with 7.5 and 8.2% increases in spine BMD in the concurrent and sequential arms, respectively (difference -0.6%, 95% confidence interval=-3.4-2.1%). Volumetric BMD also increased similarly between groups. With concurrent therapy, mean N-propeptide of type I collagen increased 75% between baseline and month 1 and then declined. With sequential therapy, the second 3-month PTH course increased N-propeptide of type I collagen markedly (209%), although to a lesser absolute degree than the first. CONCLUSIONS: Six months of PTH(1-84), used over 2 yr with a bisphosphonate in either of our dosing regimens increased BMD substantially. Short PTH courses may provide the benefits of anabolic osteoporosis therapy with reduced burden for patients.
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Authors | Anne L Schafer, Deborah E Sellmeyer, Lisa Palermo, Jean Hietpas, Richard Eastell, Dolores M Shoback, Dennis M Black |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 97
Issue 10
Pg. 3522-9
(Oct 2012)
ISSN: 1945-7197 [Electronic] United States |
PMID | 22791766
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Bone Density Conservation Agents
- Diphosphonates
- Parathyroid Hormone
- Ibandronic Acid
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Topics |
- Aged
- Aged, 80 and over
- Biomarkers
(metabolism)
- Bone Density
(drug effects)
- Bone Density Conservation Agents
(administration & dosage, adverse effects)
- Diphosphonates
(administration & dosage, adverse effects)
- Drug Therapy, Combination
(methods)
- Female
- Fractures, Bone
(prevention & control)
- Humans
- Ibandronic Acid
- Middle Aged
- Osteoporosis, Postmenopausal
(drug therapy)
- Parathyroid Hormone
(administration & dosage, adverse effects)
- Pilot Projects
- Treatment Outcome
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