Journal of Bone and Mineral Metabolism

, Volume 35, Issue 1, pp 91–98 | Cite as

The effects of switching daily teriparatide to oral bisphosphonates or denosumab in patients with primary osteoporosis

  • Kosuke Ebina
  • Jun Hashimoto
  • Masafumi Kashii
  • Makoto Hirao
  • Shoichi Kaneshiro
  • Takaaki Noguchi
  • Yasunori Tsukamoto
  • Hideki Yoshikawa
Original Article


The aim of this 12-month, observational study was to compare the effects of switching daily teriparatide (TPTD) to oral bisphosphonates (BP) therapy or denosumab (DMAb) therapy in patients with primary osteoporosis. Patients [n = 78; 71 postmenopausal women and seven men; mean age 76.3 (64–94) years; mean duration of prior daily TPTD therapy 20.1 (6–24) months] were allocated to either the (1) “switch-to-BP” group [n = 36; weekly alendronate 35 mg (n = 19), weekly risedronate 17.5 mg (n = 12), monthly minodronate 50 mg (n = 5)]; or (2) “switch-to-DMAb” group (n = 42; 60 mg sc every 6 months) based on each physicians’ decision. Changes in bone mineral density (BMD) and serum bone turnover markers were monitored every 6 months. No significant difference was observed in baseline clinical characteristics between the groups. After 12 months, the increase in BMD was significantly greater in the switch-to-DMAb group compared to the switch-to-BP group: lumbar spine (6.2 vs. 2.6 %; P < 0.01), total hip (4.2 vs. 1.1 %; P < 0.05), and femoral neck (3.5 vs. 1.4 %; P < 0.05). In addition, the patients in the switch-to-DMAb group showed a significant decrease compared to those in the switch-to-BP group in TRACP-5b (−55.8 vs. −32.8 %; P < 0.01) and ucOC (−85.5 vs. −65.0 %; P < 0.001), while no significant difference was observed in PINP (−67.5 vs. −62.1 %). Switching daily TPTD to DMAb significantly increased BMD and decreased bone resorption marker compared to switching to oral BP at 12 months, and thus may provide an effective sequential treatment option after daily TPTD treatment.


Primary osteoporosis Daily teriparatide Oral bisphosphonates Denosumab 



The authors thank Dr. Eiji Sogo, Dr. Hirokazu Iwata, and Dr. Hirotaka Tsuji for their excellent cooperation in conducting the study.

Compliance with ethical standards

Conflict of interest

K Ebina has received payments for lectures from Daiichi Sankyo. J Hashimoto, M Kashii, M Hirao, S Kaneshiro, T Noguchi, Y Tsukamoto, and H Yoshikawa declare that they have no conflicts of interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2016

Authors and Affiliations

  • Kosuke Ebina
    • 1
  • Jun Hashimoto
    • 2
  • Masafumi Kashii
    • 1
  • Makoto Hirao
    • 1
  • Shoichi Kaneshiro
    • 3
  • Takaaki Noguchi
    • 1
  • Yasunori Tsukamoto
    • 4
  • Hideki Yoshikawa
    • 1
  1. 1.Department of Orthopaedic Surgery, Graduate School of MedicineOsaka UniversitySuitaJapan
  2. 2.Department of Rheumatology, National Hospital OrganizationOsaka Minami Medical CenterKawachinaganoJapan
  3. 3.Department of Orthopaedic Surgery, Japan Community Health Care OrganizationOsaka HospitalOsakaJapan
  4. 4.Department of Orthopaedic SurgeryNorth Osaka Police HospitalIbarakiJapan

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