Namki Hong1,2, Jo Eun Kim3, Su Jin Lee4, Se Hwa Kim5, Yumie Rhee1. 1. Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea. 2. Graduate School, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Gimpo Woori Hospital, Gimpo, Gyeonggi-do, Korea. 4. Department of Internal Medicine, Ilsan Hospital, Koyang, Korea. 5. Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.
Abstract
CONTEXT: Teriparatide (TPTD) therapy has been proposed as a potential treatment strategy in severe cases of pregnancy- and lactation-associated osteoporosis (PLO) characterized by the occurrence of fragility fractures in the third trimester or early postpartum. OBJECTIVE: To investigate the changes in bone mineral density (BMD) and bone turnover markers in patients with PLO with and without TPTD treatment. DESIGN: Retrospective cohort study. PATIENTS: Thirty-two patients with PLO who presented with multiple vertebral fractures to a tertiary institution between 2007 and 2015 were included. MEASUREMENTS: Changes in BMD at the lumbar spine (LSBMD) and proximal femur after 12 months of daily subcutaneous injections of 20 μg TPTD (n = 27) were assessed. Subjects who rejected the TPTD treatment were used as controls (n = 5). RESULTS: LSBMD increased in both subjects treated with TPTD and controls, with greater increases in the TPTD group (15.5 ± 6.6% vs 7.5 ± 7.1%, P = .020) after adjustment for age and baseline LSBMD. During follow-up, serum levels of osteocalcin (OCN) and C-telopeptide of type I collagen (CTX) increased significantly in the TPTD group. In multivariate linear regression models, TPTD treatment (adjusted β = 7.92, P = .032) and younger age (adjusted β = 1.06, P = .046), but not baseline LSBMD, body mass index, serum OCN level and CTX level, were independently associated with greater increases in LSBMD. CONCLUSIONS: In patients with PLO, LSBMD at 12 months increased in both the TPTD-treated and control groups. TPTD treatment and younger age were associated with greater increases in LSMBD irrespective of baseline LSBMD.
CONTEXT: Teriparatide (TPTD) therapy has been proposed as a potential treatment strategy in severe cases of pregnancy- and lactation-associated osteoporosis (PLO) characterized by the occurrence of fragility fractures in the third trimester or early postpartum. OBJECTIVE: To investigate the changes in bone mineral density (BMD) and bone turnover markers in patients with PLO with and without TPTD treatment. DESIGN: Retrospective cohort study. PATIENTS: Thirty-two patients with PLO who presented with multiple vertebral fractures to a tertiary institution between 2007 and 2015 were included. MEASUREMENTS: Changes in BMD at the lumbar spine (LSBMD) and proximal femur after 12 months of daily subcutaneous injections of 20 μg TPTD (n = 27) were assessed. Subjects who rejected the TPTD treatment were used as controls (n = 5). RESULTS: LSBMD increased in both subjects treated with TPTD and controls, with greater increases in the TPTD group (15.5 ± 6.6% vs 7.5 ± 7.1%, P = .020) after adjustment for age and baseline LSBMD. During follow-up, serum levels of osteocalcin (OCN) and C-telopeptide of type I collagen (CTX) increased significantly in the TPTD group. In multivariate linear regression models, TPTD treatment (adjusted β = 7.92, P = .032) and younger age (adjusted β = 1.06, P = .046), but not baseline LSBMD, body mass index, serum OCN level and CTX level, were independently associated with greater increases in LSBMD. CONCLUSIONS: In patients with PLO, LSBMD at 12 months increased in both the TPTD-treated and control groups. TPTD treatment and younger age were associated with greater increases in LSMBD irrespective of baseline LSBMD.
Authors: Adi Cohen; Mafo Kamanda-Kosseh; David W Dempster; Hua Zhou; Ralph Müller; Elliott Goff; Ivelisse Colon; Mariana Bucovsky; Julie Stubby; Thomas L Nickolas; Emily M Stein; Robert R Recker; Joan M Lappe; Elizabeth Shane Journal: J Bone Miner Res Date: 2019-07-26 Impact factor: 6.741
Authors: Adi Cohen; Stephanie Shiau; Nandini Nair; Robert R Recker; Joan M Lappe; David W Dempster; Thomas L Nickolas; Hua Zhou; Sanchita Agarwal; Mafo Kamanda-Kosseh; Mariana Bucovsky; John M Williams; Donald J McMahon; Julie Stubby; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2020-10-01 Impact factor: 5.958