Calcified Tissue International

, Volume 101, Issue 4, pp 396–403 | Cite as

Effects of Teriparatide and Sequential Minodronate on Lumbar Spine Bone Mineral Density and Microarchitecture in Osteoporosis

  • Daichi Miyaoka
  • Yasuo Imanishi
  • Masaya Ohara
  • Noriyuki Hayashi
  • Yuki Nagata
  • Shinsuke Yamada
  • Katsuhito Mori
  • Masanori Emoto
  • Masaaki Inaba
Original Research


The trabecular bone score (TBS) is a new surrogate for trabecular bone microarchitecture assessment, independent of bone mineral density (BMD), calculated from pixel gray-level variations in the lumbar spine (LS) dual-energy X-ray absorptiometry (DXA) image. Although Teriparatide (TPTD) increased LS-BMD as well as TBS in 2 years, the precise time-course of these parameters was not well known. The aim of this study was to determine the changes in LS-BMD and the TBS in osteoporotic patients treated with TPTD, followed by minodronate (MINO). Primary osteoporotic patients with a low LS-BMD (T-score < −2.5) and/or at least one vertebral fracture were treated with TPTD subcutaneously at 20 µg/day for 12–24 months, followed by MINO (orally at 50 mg/once monthly) for 12 months. LS-BMD and the TBS were measured at 0, 3, 6, 12, and 24 months after the initiation of TPTD treatment, and 12 months after the initiation of MINO. The increments of LS-BMD, significant at 6 months, increased until 12 months, whereas the increments of TBS, significant at 3 months (0.035 ± 0.011; p = 0.045 vs. the baseline), stabilized until 12 months. TPTD treatment, followed by 12 months of MINO, maintained both BMD and the TBS. Comparing the increments of the TBS to those of LS-BMD, our results indicate that TPTD treatment improved trabecular microarchitecture faster than mineralization. TPTD treatment, followed by MINO, can maintain both BMD and the TBS.


Osteoporosis Teriparatide Minodronate Bone mineral density Trabecular bone score 



DM contributed to the acquisition, analysis, and interpretation of the data. YI, ME, and MI contributed to the conception and design of the study. MO, NH, YN, SY, and KM contributed to the acquisition of the data. DM took responsibility for the integrity of the data analysis. All authors participated in drafting or revising the manuscript and approved the final version of the manuscript for submission.


MI received grant support and lecture fees from Eli Lilly Japan K.K. and Ono Pharmaceutical Co., LTD. YI and KM received lecture fees from Eli Lilly Japan K.K. and Ono Pharmaceutical Co., LTD.

Compliance with Ethical Standards

Conflicts of interest

Daichi Miyaoka, Masaya Ohara, Noriyuki Hayashi, Yuki Nagata, Shinsuke Yamada, and Masanori Emoto have no conflicts of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study, which received institutional ethics committee approval (Osaka City University Graduate School of Medicine, registration number 1775).


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Metabolism, Endocrinology and Molecular MedicineOsaka City University Graduate School of MedicineAbeno-kuJapan

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