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Effects of 1 year of daily teriparatide treatment on iliacal bone mineralization density distribution (BMDD) in postmenopausal osteoporotic women previously treated with alendronate or risedronate
Author(s) -
Misof Barbara M,
Paschalis Eleftherios P,
Blouin Stéphane,
FratzlZelman Nadja,
Klaushofer Klaus,
Roschger Paul
Publication year - 2010
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.198
Subject(s) - teriparatide , medicine , osteoporosis , alendronic acid , mineralization (soil science) , endocrinology , bisphosphonate , bone mineral , chemistry , organic chemistry , nitrogen
Anabolic treatment with teriparatide of postmenopausal osteoporotic patients previously treated with bisphosphonates is a new therapeutic approach. However, its effects on the bone mineralization density distribution (BMDD) are unknown. We studied paired transiliac bone biopsy samples taken before and after 1 year of treatment with recombinant human parathyroid hormone peptide 1‐34 (teriparatide) from 16 osteoporotic women treated with either alendronate (priorALN) or risedronate (priorRIS) for at least 2 years and subsequently treated for 12 months with teriparatide. Cancellous (Cn.) and cortical (Ct.) BMDD values were measured using quantitative backscattered electron imaging. At baseline, BMDD values of priorALN and priorRIS women were similar and within the normal range. One year of teriparatide treatment caused significant effects on the BMDD. Analyzing changes from baseline for each bisphosphonate group separately, priorALN patients revealed increases in the portion of low mineralized bone areas (Cn.Ca Low +25.9%, Ct.Ca Low +62.0%, both p < .05) and Ct. heterogeneity of mineralization (Ct.Ca Width +22.8%, p < .001). PriorRIS patients showed increased mineralization heterogeneity (Cn.Ca Width +14.8%, p < .05, and Ct.Ca Width +15.8%, p < .001). Analysis of the influence of the prior bisphosphonate treatment showed that the BMDD response to 1 year of teriparatide treatment did not depend on the type of prior bisphosphonate. In consequence, priorALN and priorRIS groups were combined. The pooled groups revealed increased Cn.Ca Width and Ct.Ca Width (+10.7%, p < .01, and +19.6%, p < .001, respectively) as well as increased Cn.Ca Low and Ct.Ca Low (+18.2%, p < .05, and +36.6%, p < .01, respectively). In summary, our findings indicate a significant effect of teriparatide on BMDD when administered subsequent to a bisphosphonate in agreement with teriparatide's anabolic action. © 2010 American Society for Bone and Mineral Research.