Improvement of cancellous bone microstructure in patients on teriparatide following alendronate pretreatment
Language English Country United States Media print-electronic
Document type Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
PubMed
27185100
DOI
10.1016/j.bone.2016.05.004
PII: S8756-3282(16)30131-4
Knihovny.cz E-resources
- Keywords
- Alendronate pretreatment, Cancellous bone microstructure, PINP, Teriparatide, Turnover markers,
- MeSH
- Alendronate therapeutic use MeSH
- Bone Density Conservation Agents therapeutic use MeSH
- Collagen Type I blood MeSH
- Bone Density drug effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Peptide Fragments blood MeSH
- Peptides blood MeSH
- Osteoporosis, Postmenopausal drug therapy MeSH
- Procollagen blood MeSH
- Bone Remodeling drug effects MeSH
- Aged MeSH
- Teriparatide therapeutic use MeSH
- Cancellous Bone drug effects MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Alendronate MeSH
- collagen type I trimeric cross-linked peptide MeSH Browser
- Bone Density Conservation Agents MeSH
- Collagen Type I MeSH
- Peptide Fragments MeSH
- Peptides MeSH
- procollagen Type I N-terminal peptide MeSH Browser
- Procollagen MeSH
- Teriparatide MeSH
An increase in procollagen type I amino-terminal propeptide (PINP) early after teriparatide initiation was shown to correlate with increased lumbar spine areal BMD and is a good predictor of the anabolic response to teriparatide. Few data exist correlating PINP and bone microstructure, and no data exist in patients on teriparatide following prior potent antiresorptive treatment. This exploratory analysis aimed to investigate the effects of teriparatide on cancellous bone microstructure and correlations of bone markers with microstructure in alendronate-pretreated patients. This was a post hoc analysis of changes in bone markers and three-dimensional indices of bone microstructure in paired iliac crest biopsies from a prospective teriparatide treatment study in postmenopausal women with osteoporosis who were either treatment-naïve (TN, n=16) or alendronate-pretreated (ALN, n=29) at teriparatide initiation. Teriparatide (20μg/day) was given for 24months; biopsies were taken at baseline and endpoint, and serum concentrations of PINP and type 1 collagen cross-linked C-telopeptide (βCTX) were measured at intervals up to 24months. In the TN and ALN groups, respectively, mean (SD) increases in three-dimensional bone volume/tissue volume were 105 (356)% (P=0.039) and 55 (139)% (P<0.005) and trabecular thickness 30.4 (30)% (P<0.001) and 30.8 (53)% (P<0.001). No significant changes were observed in trabecular number or separation. In the ALN patients, 3-month change of neither PINP nor βCTX correlated with indices of cancellous bone microstructure. However, 12-month changes in biochemical bone markers correlated significantly with improvements in bone volume/tissue volume, r=0.502 (P<0.01) and r=0.378 (P<0.05), trabecular number, r=0.559 (P<0.01) and r=0.515 (P<0.01), and reduction of trabecular separation, r=-0.432 (P<0.05) and r=-0.530 (P<0.01), for PINP and βCTX, respectively. We conclude that cancellous bone microstructure improved with teriparatide therapy irrespective of prior antiresorptive use.
Department of Anatomy and Cell Biology Indiana University School of Medicine Indianapolis IN USA
Department of Biology Indiana University Purdue University Indianapolis IN USA
Eli Lilly and Company Lilly Corporate Center Indianapolis IN USA
Institute of Rheumatology and Faculty of Medicine 1 Charles University Prague Czech Republic
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