So-Young Kim1, Meng Zhang2, Richard Bockman1,2. 1. Division of Endocrinology and Metabolism, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY 10065 USA. 2. Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Abstract
BACKGROUND: A review of data from large clinical trials reported more than 90% of subjects significantly improved their bone mineral density (BMD) at the lumbar spine (LS) with teriparatide (TPTD) (bone 39:1268-1275, 1). However, our clinical experience suggests that many patients may be non-responders, raising questions as to the true efficacy of TPTD in improving BMD in osteoporotic patients. QUESTIONS/PURPOSES: The purpose of the study is to determine the rate of improvement in BMD following 18-24 months of teriparatide (TPTD) in patients with osteoporosis within an orthopedic hospital setting. METHODS: This is a retrospective chart review of patients with osteoporosis who completed 18-24 months of TPTD therapy. The primary endpoint was the change in BMD at lumbar spine (LS) and hip-femoral neck (FN) and total hip (TH) following treatment. Secondary endpoints included the effect of prior bisphosphonate therapy, age, body mass index (BMI) and family history of fracture on BMD response, and the changes in bone-specific markers during active treatment. RESULTS: Seventy-eight women and men with mean T-scores at the LS = -2.63 met the inclusion criteria. The overall group showed a 10.7% increase in LS-BMD after 24 months of TPTD. Eighty-three percent were considered responders defined as ≥3.0% increase in LS-BMD. Non-responders (16.7%) had mean LS-BMD change = -1.41%. No difference in baseline vitamin D, calcium, creatinine, BMI, age, gender, prior fracture history, or bisphosphonate use was observed between responders and non-responders. No consistent pattern of change in measures of bone markers was noted between responders and non-responders. CONCLUSION: Eighty-three percent of patients with osteoporosis showed a >3% increase in BMD after TPTD treatment. Baseline parameters, prior bisphosphonate therapy, and the changes in bone markers showed no correlation with final BMD outcome.
BACKGROUND: A review of data from large clinical trials reported more than 90% of subjects significantly improved their bone mineral density (BMD) at the lumbar spine (LS) with teriparatide (TPTD) (bone 39:1268-1275, 1). However, our clinical experience suggests that many patients may be non-responders, raising questions as to the true efficacy of TPTD in improving BMD in osteoporoticpatients. QUESTIONS/PURPOSES: The purpose of the study is to determine the rate of improvement in BMD following 18-24 months of teriparatide (TPTD) in patients with osteoporosis within an orthopedic hospital setting. METHODS: This is a retrospective chart review of patients with osteoporosis who completed 18-24 months of TPTD therapy. The primary endpoint was the change in BMD at lumbar spine (LS) and hip-femoral neck (FN) and total hip (TH) following treatment. Secondary endpoints included the effect of prior bisphosphonate therapy, age, body mass index (BMI) and family history of fracture on BMD response, and the changes in bone-specific markers during active treatment. RESULTS: Seventy-eight women and men with mean T-scores at the LS = -2.63 met the inclusion criteria. The overall group showed a 10.7% increase in LS-BMD after 24 months of TPTD. Eighty-three percent were considered responders defined as ≥3.0% increase in LS-BMD. Non-responders (16.7%) had mean LS-BMD change = -1.41%. No difference in baseline vitamin D, calcium, creatinine, BMI, age, gender, prior fracture history, or bisphosphonate use was observed between responders and non-responders. No consistent pattern of change in measures of bone markers was noted between responders and non-responders. CONCLUSION: Eighty-three percent of patients with osteoporosis showed a >3% increase in BMD after TPTD treatment. Baseline parameters, prior bisphosphonate therapy, and the changes in bone markers showed no correlation with final BMD outcome.
Entities:
Keywords:
bone; bone markers; clinical outcome; osteoporosis; teriparatide treatment
Authors: Benjamin Z Leder; Joy N Tsai; Robert M Neer; Alexander V Uihlein; Paul M Wallace; Sherri-Ann M Burnett-Bowie Journal: J Clin Densitom Date: 2016-02-15 Impact factor: 2.617
Authors: Felicia Cosman; Erik Fink Eriksen; Chris Recknor; Paul D Miller; Núria Guañabens; Christian Kasperk; Philemon Papanastasiou; Aimee Readie; Hanumantha Rao; Jürg A Gasser; Christina Bucci-Rechtweg; Steven Boonen Journal: J Bone Miner Res Date: 2011-03 Impact factor: 6.741
Authors: Somnath Sarkar; Bruce H Mitlak; Mayme Wong; John L Stock; Dennis M Black; Kristine D Harper Journal: J Bone Miner Res Date: 2002-01 Impact factor: 6.741
Authors: Dennis M Black; Susan L Greenspan; Kristine E Ensrud; Lisa Palermo; Joan A McGowan; Thomas F Lang; Patrick Garnero; Mary L Bouxsein; John P Bilezikian; Clifford J Rosen Journal: N Engl J Med Date: 2003-09-20 Impact factor: 91.245
Authors: Christian Muschitz; Roland Kocijan; Astrid Fahrleitner-Pammer; Solveig Lung; Heinrich Resch Journal: J Bone Miner Res Date: 2013-01 Impact factor: 6.741
Authors: Anne L Schafer; Deborah E Sellmeyer; Lisa Palermo; Jean Hietpas; Richard Eastell; Dolores M Shoback; Dennis M Black Journal: J Clin Endocrinol Metab Date: 2012-07-12 Impact factor: 5.958