Journal of Bone and Mineral Metabolism

, Volume 28, Issue 2, pp 233–239

Teriparatide is safe and effectively increases bone biomarkers in institutionalized individuals with osteoporosis

  • Kathryn M. Ryder
  • S. Bobo Tanner
  • Laura Carbone
  • John E. Williams
  • Henry M. Taylor
  • Andrew Bush
  • Victorina Pintea
  • Mitchell A. Watsky
Short Communication

DOI: 10.1007/s00774-009-0123-1

Cite this article as:
Ryder, K.M., Bobo Tanner, S., Carbone, L. et al. J Bone Miner Metab (2010) 28: 233. doi:10.1007/s00774-009-0123-1

Abstract

Institutionalized adults with severe developmental disabilities have a high rate of minimal trauma and appendicular fracture. There is little information about osteoporosis treatment in this population. In this efficacy and safety study, men and women with severe developmental disabilities and osteoporosis received 20 mcg teriparatide subcutaneously daily for 18–24 months. Markers of bone formation [procollagen type 1 intact N-terminal propeptide (P1NP)] and resorption [C-telopeptide (CTx)] were measured at three-month intervals. Serum calcium was measured at two-week intervals for 12 weeks and thereafter at three-month intervals. Twenty-seven individuals received at least one injection. The incidence of hypercalcemia was 11.1% but was persistent and led to medication discontinuation in only one participant. Biomarkers of bone formation increased rapidly, doubling by three months. At 12 months, P1NP and CTx remained elevated from baseline; P1NP had risen from 66.95 ± 83.71 μg/l (mean ± SD) to 142.42 ± 113.85 μg/l (P = 0.05), and CTx had increased from 0.377 ± 0.253 to 1.016 ± 1.048 ng/ml (P = 0.01). The majority of participants had an increase in P1NP of over 10 μg/l. In conclusion, teriparatide is safe and effective in developmentally disabled institutionalized adults. Serial calcium measurements are warranted, particularly during the first three months of therapy.

Keywords

TeriparatideDisuse osteoporosisDevelopmental disabilitiesInstitutionalizedBiomarkers

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer 2009

Authors and Affiliations

  • Kathryn M. Ryder
    • 1
    • 2
    • 3
    • 8
  • S. Bobo Tanner
    • 4
  • Laura Carbone
    • 1
    • 3
  • John E. Williams
    • 5
  • Henry M. Taylor
    • 6
  • Andrew Bush
    • 2
  • Victorina Pintea
    • 7
  • Mitchell A. Watsky
    • 7
  1. 1.Department of MedicineThe University of Tennessee Health Science CenterMemphisUSA
  2. 2.Department of Preventive MedicineThe University of Tennessee Health Science CenterMemphisUSA
  3. 3.Veterans Affairs Medical CenterMemphisUSA
  4. 4.Vanderbilt University School of MedicineNashvilleUSA
  5. 5.Gardner Center for Developing MindsGreenville Hospital SystemGreenvilleUSA
  6. 6.State of Tennessee Division of Mental Retardation ServicesNashvilleUSA
  7. 7.The Department of PhysiologyThe University of Tennessee Health Science CenterMemphisUSA
  8. 8.Division of General Internal Medicine, Department of MedicineThe University of Tennessee Health Science CenterMemphisUSA