Osteoporosis International

, Volume 20, Issue 12, pp 2095–2104

Teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: an analysis by gender and menopausal status

Authors

    • Åarhus University Hospital, Åarhus Sygehus
  • F. Marin
    • Lilly Research LaboratoriesEli Lilly and Company
  • E. Shane
    • Columbia University
  • H. Dobnig
    • Medical University of Graz
  • J. R. Zanchetta
    • Instituto de Investigaciones Metabólicas, School of MedicineUSAL University
  • M. Maricic
    • Catalina Pointe Arthritis and Rheumatology Specialists
  • K. Krohn
    • Lilly Research LaboratoriesEli Lilly and Company
  • K. See
    • Lilly Research LaboratoriesEli Lilly and Company
  • M. R. Warner
    • Lilly Research LaboratoriesEli Lilly and Company
Original Article

DOI: 10.1007/s00198-009-0917-y

Cite this article as:
Langdahl, B.L., Marin, F., Shane, E. et al. Osteoporos Int (2009) 20: 2095. doi:10.1007/s00198-009-0917-y

Abstract

Summary

The effects of teriparatide versus alendronate were compared by gender and menopausal status in patients with glucocorticoid-induced osteoporosis. At 18 months, increases in lumbar spine BMD were significantly greater in the teriparatide versus alendronate group in postmenopausal women (7.8% versus 3.7%, p < 0.001), premenopausal women (7.0% versus 0.7%, p < 0.001), and men (7.3% versus 3.7%, p = 0.03).

Introduction

In patients with glucocorticoid-induced osteoporosis (GIO), teriparatide significantly increased bone mineral density (BMD) and decreased vertebral fractures compared with alendronate. We examined effects of teriparatide versus alendronate by gender and menopausal status.

Methods

This was a multicenter, randomized, double-blind study of teriparatide 20 µg/day versus alendronate 10 mg/day in patients with GIO (277 postmenopausal women, 67 premenopausal women, 83 men). Primary outcome was change in lumbar spine BMD. Secondary outcomes included change in hip BMD, change in bone biomarkers, fracture incidence, and safety.

Results

At 18 months, mean percent increases from baseline in lumbar spine BMD were significantly greater in the teriparatide versus alendronate group in postmenopausal women (7.8% versus 3.7%, p < 0.001), premenopausal women (7.0% versus 0.7%, p < 0.001), and men (7.3% versus 3.7%, p = 0.03). Radiographic vertebral fractures occurred in one teriparatide (one postmenopausal) and ten alendronate patients (six postmenopausal, four men), and nonvertebral fractures occurred in 12 teriparatide (nine postmenopausal, two premenopausal, one man) and eight alendronate patients (six postmenopausal, two men). The proportion of patients reporting adverse events in teriparatide versus alendronate groups was consistent across subgroups.

Conclusion

Among men and pre- and postmenopausal women with GIO, lumbar spine BMD increased more in patients receiving teriparatide compared with alendronate.

Keywords

Alendronate Bone biomarkers Glucocorticoid-induced osteoporosis PINP Premenopausal Teriparatide

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009