M A Paggiosi1, L Yang2, D Blackwell2, J S Walsh2,3, E McCloskey2,3, N Peel4, R Eastell2,3. 1. The Mellanby Centre for Bone Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK. m.a.paggiosi@sheffield.ac.uk. 2. The Mellanby Centre for Bone Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK. 3. The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), University of Liverpool, Liverpool, UK. 4. Metabolic Bone Centre (Sorby Wing), Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Abstract
The central and peripheral skeleton was characterised using imaging techniques during 104 weeks of teriparatide treatment. Teriparatide exerts differential effects on the central and the peripheral skeleton. Overall, we did not observe a change in total body bone mineral. Our conclusions are constrained by the study limitations. INTRODUCTION: Teriparatide stimulates bone formation and resorption and therefore can cause bone gain and loss. We simultaneously characterised the central and peripheral skeleton using imaging techniques to better understand the mechanism of action of teriparatide. METHODS: Postmenopausal, osteoporotic women (n = 20, 65.4 ± 5.5 years) were recruited into a 104-week study of teriparatide. Imaging techniques included DXA, quantitative computed tomography (QCT), and high-resolution peripheral quantitative computed tomography (HR-pQCT). RESULTS: Total lumbar spine areal bone mineral content (aBMC) (+ 11.2%), total lumbar spine areal bone mineral density (aBMD) (+ 8.1%), subregional thoracic spine aBMD (+ 7.5%), lumbar spine aBMC (+ 23.5%), lumbar spine aBMD (+ 11.9%), pelvis aBMC (+ 9.3%), and pelvis aBMD (+ 4.3%) increased. However, skull aBMC (- 5.0%), arms aBMC (- 5.1%), legs aBMC (- 2.9%), and legs aBMD (- 2.5%) decreased. Overall, we did not observe a change in total body bone mineral. Increases in L1-L3 volumetric BMD (vBMD) (+ 28.5%) occurred but there was no change in total proximal femur vBMD. Radius and tibia cortical vBMD (- 3.3 and - 3.4%) and tissue mineral density (- 3.2 and - 3.8%) decreased and there was an increase in porosity (+ 21.2 and + 10.3%). Tibia, but not radius, trabecular inhomogeneity (+ 3.2%), and failure load (+ 0.2%) increased, but cortical thickness (- 3.1%), area (- 2.9%), and pore volume (- 1.6%) decreased. CONCLUSIONS: Teriparatide exerts differential effects on the central and the peripheral skeleton. Central trabecular vBMD (L1-L3) is improved, but there is a concomitant decrease in peripheral cortical vBMD and an increase in porosity. Overall, we did not observe a change in total body bone mineral. We acknowledge that our conclusions may be speculative and are constrained by the technical limitations of the imaging techniques used, the lack of a control group, and the small sample size studied.
The central and peripheral skeleton was characterised using imaging techniques during 104 weeks of teriparatide treatment. Teriparatide exerts differential effects on the central and the peripheral skeleton. Overall, we did not observe a change in total body bone mineral. Our conclusions are constrained by the study limitations. INTRODUCTION:Teriparatide stimulates bone formation and resorption and therefore can cause bone gain and loss. We simultaneously characterised the central and peripheral skeleton using imaging techniques to better understand the mechanism of action of teriparatide. METHODS: Postmenopausal, osteoporoticwomen (n = 20, 65.4 ± 5.5 years) were recruited into a 104-week study of teriparatide. Imaging techniques included DXA, quantitative computed tomography (QCT), and high-resolution peripheral quantitative computed tomography (HR-pQCT). RESULTS: Total lumbar spine areal bone mineral content (aBMC) (+ 11.2%), total lumbar spine areal bone mineral density (aBMD) (+ 8.1%), subregional thoracic spine aBMD (+ 7.5%), lumbar spine aBMC (+ 23.5%), lumbar spine aBMD (+ 11.9%), pelvis aBMC (+ 9.3%), and pelvis aBMD (+ 4.3%) increased. However, skull aBMC (- 5.0%), arms aBMC (- 5.1%), legs aBMC (- 2.9%), and legs aBMD (- 2.5%) decreased. Overall, we did not observe a change in total body bone mineral. Increases in L1-L3 volumetric BMD (vBMD) (+ 28.5%) occurred but there was no change in total proximal femur vBMD. Radius and tibia cortical vBMD (- 3.3 and - 3.4%) and tissue mineral density (- 3.2 and - 3.8%) decreased and there was an increase in porosity (+ 21.2 and + 10.3%). Tibia, but not radius, trabecular inhomogeneity (+ 3.2%), and failure load (+ 0.2%) increased, but cortical thickness (- 3.1%), area (- 2.9%), and pore volume (- 1.6%) decreased. CONCLUSIONS:Teriparatide exerts differential effects on the central and the peripheral skeleton. Central trabecular vBMD (L1-L3) is improved, but there is a concomitant decrease in peripheral cortical vBMD and an increase in porosity. Overall, we did not observe a change in total body bone mineral. We acknowledge that our conclusions may be speculative and are constrained by the technical limitations of the imaging techniques used, the lack of a control group, and the small sample size studied.
Entities:
Keywords:
Densitometry; Mechanism of action; Osteoporosis; Teriparatide; Treatment response
Authors: Yanfei L Ma; Qingqiang Zeng; David W Donley; Louis-Georges Ste-Marie; J Christopher Gallagher; Gail P Dalsky; Robert Marcus; Erik Fink Eriksen Journal: J Bone Miner Res Date: 2006-06 Impact factor: 6.741
Authors: Kirsti Uusi-Rasi; Lisa M Semanick; Jose R Zanchetta; Cesar E Bogado; Erik F Eriksen; Masahiko Sato; Thomas J Beck Journal: Bone Date: 2005-06 Impact factor: 4.398
Authors: E S Orwoll; W H Scheele; S Paul; S Adami; U Syversen; A Diez-Perez; J M Kaufman; A D Clancy; G A Gaich Journal: J Bone Miner Res Date: 2003-01 Impact factor: 6.741
Authors: Barbara M Obermayer-Pietsch; Fernando Marin; Eugene V McCloskey; Peyman Hadji; Jordi Farrerons; Steven Boonen; Maurice Audran; Clare Barker; Athanasios D Anastasilakis; William D Fraser; Thomas Nickelsen Journal: J Bone Miner Res Date: 2008-10 Impact factor: 6.741
Authors: Christian Graeff; Wolfram Timm; Thomas N Nickelsen; Jordi Farrerons; Fernando Marín; Clare Barker; Claus C Glüer Journal: J Bone Miner Res Date: 2007-09 Impact factor: 6.741
Authors: Melissa S Putman; Logan B Greenblatt; Michael Bruce; Taisha Joseph; Hang Lee; Gregory Sawicki; Ahmet Uluer; Leonard Sicilian; Isabel Neuringer; Catherine M Gordon; Mary L Bouxsein; Joel S Finkelstein Journal: J Clin Endocrinol Metab Date: 2021-03-08 Impact factor: 5.958
Authors: Nina Lenherr-Taube; Carol Kl Lam; Reza Vali; Amer Shammas; Paolo Campisi; Faisal Zawawi; Gino R Somers; Jennifer Stimec; Ozgur Mete; Andy Ko Wong; Etienne Sochett Journal: JBMR Plus Date: 2020-01-02