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

• Published in: Journal of bone and mineral research Vol. 25; no. 11; pp. 2297 - 2303
• Main Authors: Misof, Barbara M, Paschalis, Eleftherios P, Blouin, Stéphane, Fratzl‐Zelman, Nadja, Klaushofer, Klaus, Roschger, Paul
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.11.2010; Wiley; Oxford University Press
• Subjects: Alendronate - therapeutic use; Biological and medical sciences; bisphosphonates; Bone Density - drug effects; Bone Density Conservation Agents - pharmacology; Bone Density Conservation Agents - therapeutic use; bone mineralization density; Calcification, Physiologic - drug effects; Drug Administration Schedule; Etidronic Acid - analogs & derivatives; Etidronic Acid - therapeutic use; Female; Fundamental and applied biological sciences. Psychology; Humans; Ilium - drug effects; Ilium - pathology; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; postmenopausal osteoporosis; quantitative backscattered electron imaging (QBEI); Risedronate Sodium; Skeleton and joints; teriparatide; Teriparatide - pharmacology; Teriparatide - therapeutic use; Treatment Outcome; Vertebrates: osteoarticular system, musculoskeletal system; BONE MINERALIZATION DENSITY; Diseases of the osteoarticular system; Antiresorptive agent; Diphosphonic acid derivatives; Bisphosphonates; Density; Osteoarticular system; Alendronic acid; Osteoporosis; Osteoforming; Vertebrata; Mammalia; Treatment; POSTMENOPAUSAL OSTEOPOROSIS; Risedronic acid; Mineralization; Imaging; Distribution; Postmenopause; Female; Bone; Teriparatide; QUANTITATIVE BACKSCATTERED ELECTRON IMAGING (QBEI)
• ISSN: 0884-0431; 1523-4681; 1523-4681
• DOI: 10.1002/jbmr.198

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.CaLow +25.9%, Ct.CaLow +62.0%, both p < .05) and Ct. heterogeneity of mineralization (Ct.CaWidth +22.8%, p < .001). PriorRIS patients showed increased mineralization heterogeneity (Cn.CaWidth +14.8%, p < .05, and Ct.CaWidth +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.CaWidth and Ct.CaWidth (+10.7%, p < .01, and +19.6%, p < .001, respectively) as well as increased Cn.CaLow and Ct.CaLow (+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.