Osteoporosis International

, Volume 14, Issue 1, pp 77–81

Daily treatment with parathyroid hormone is associated with an increase in vertebral cross-sectional area in postmenopausal women with glucocorticoid-induced osteoporosis

  • Q. Rehman
  • T.F. Lang
  • C.D. Arnaud
  • G.W. Modin
  • N.E. Lane
ORIGINAL ARTICLE

DOI: 10.1007/s00198-002-1312-0

Cite this article as:
Rehman, Q., Lang, T., Arnaud, C. et al. Osteoporos Int (2003) 14: 77. doi:10.1007/s00198-002-1312-0

Abstract

 Daily treatment with hPTH (1–34) is associated with a significant increase in bone formation which results in large gains in lumbar spine bone mass. However, bone formation is known to occur on trabecular, endocortical and periosteal surfaces. The purpose of this study was to determine whether daily treatment with hPTH (1–34) for 1 year was associated with a change in vertebral cross-sectional area, or vertebral size, as measured by serial quantitative computed tomography scans. Fifty-one postmenopausal women treated chronically with both glucocorticoids and hormone replacement therapy (HRT) were randomized to either daily hPTH (1–34) for 1 year and HRT or to a control group treated with only HRT. Measurements of bone density of the spine were obtained every 6 months by dual-energy X-ray absorptiometry (DXA) and annually by QCT of the L1 and L2 vertebrae. Vertebral cross-sectional area (VCSA) was obtained from the QCT scans. In addition, we estimated the vertebral compressive strength (VSFOM, g2/cm4 = trabecular BMD2 × VCSA). After 1 year of hPTH (1–34) treatment, VCSA increased 4.8% (p < 0.001), and 1 year after treatment was discontinued VCSA was still 2.6% higher than the baseline value (p < 0.05). The control group had no change in VCSA. In addition, estimated vertebral compressive strength increased more than 200% over baseline levels in the hPTH (1–34) treatment group and no change was observed in the control group. In summary, daily treatment with hPTH (1–34) for 1 year increased vertebral size as measured by VCSA and this increase was maintained after hPTH (1–34) was discontinued. Since vertebral fracture risk is related to both bone size and bone mass, we cautiously speculate that the increase in vertebral size associated with hPTH (1–34) treatment is at least partially responsible for increased vertebral bone strength and reduction of fracture risk associated with this therapy in postmenopausal osteoporosis.

Keywords Bone sizePTHQCTVertebra

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • Q. Rehman
    • 1
  • T.F. Lang
    • 1
  • C.D. Arnaud
    • 1
  • G.W. Modin
    • 1
  • N.E. Lane
    • 2
  1. 1.Departments of Medicine and Radiology, University of California at San Francisco, San Francisco, CA 94143, USAUS
  2. 2.Division of Rheumatology, Box 0868, UCSF, San Francisco, CA 94143, USA Tel.: +1 (415) 206 6654 Fax: +1 (415) 206 8189 e-mail: nelane@itsa.ucsf.eduUS