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Factors associated with bone response to teriparatide in young postmenopausal women with osteoporosis

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Abstract

Introduction

To investigate the factors associated with changes in vertebral bone mineral density during teriparatide treatment.

Materials and methods

Single centre, longitudinal study involving 145 osteoporotic postmenopausal women treated with teriparatide. Clinical evaluation, bone mineral density (BMD) measurements assessment and laboratory analyses were performed at baseline then after 12 and 18 months of treatment. Bone non-response to treatment was defined as no significant increase in BMD at 18 months as compared to baseline.

Results

Of the 145 women initially included, 109 completed the 18-month course of the treatment. 75% of them had a history of prior osteoporotic treatment. Baseline mean age was 60 ± 8 years. Mean baseline vertebral T-score was − 3.7 ± 0.7 and 83 (76%) women had suffered at least one vertebral fracture. At the end of treatment, 18 women (17%) were classified as non-responders. In the responder group (n = 91), vertebral BMD increased by 0.091 ± 0.04 g/cm2 (12.2 ± 5.3%). Clinical characteristics, baseline BMDs and the percentage of women previously treated with bisphosphonates as well as the duration of prior treatment did not significantly differ between the two groups of responders and non-responders. At baseline, non-responders had significant mean lower C-terminal fragment of type 1 collagen (CTX) values than responders (p < 0.01). Only baseline CTX values (r = 0.30 p < 0.01) were independently correlated to vertebral BMD changes during teriparatide treatment.

Conclusion

A minority of treated women had no vertebral densitometric gain after 18 months of teriparatide therapy. Low levels of baseline bone remodeling were the main factor associated with poor response to treatment.

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References

  1. Thomas T (2006) Intermittent parathyroid hormone therapy to increase bone formation. Jt Bone Spine 73:262–269

    Article  CAS  Google Scholar 

  2. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA et al (2001) Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441

    Article  CAS  PubMed  Google Scholar 

  3. Chen P, Miller PD, Delmas PD, Misurski DA, Krege JH et al (2006) Change in lumbar spine BMD and vertebral fracture risk reduction in teriparatide-treated postmenopausal women with osteoporosis. J Bone Miner Res 21:1785–1790

    Article  CAS  PubMed  Google Scholar 

  4. Chen P, Miller PD, Recker R, Resch H, Rana A et al (2007) Increases in BMD correlate with improvements in bone microarchitecture with teriparatide treatment in postmenopausal women with osteoporosis. J Bone Miner Res 22:1173–1180

    Article  CAS  PubMed  Google Scholar 

  5. Krege JH, Lane NE, Harris JM, Miller PD (2014) PINP as a biological response marker during teriparatide treatment for osteoporosis. Osteoporos Int 25:2159–2171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Eastell R, Krege JH, Chen P, Glass EV, Reginster J-Y et al (2006) Development of an algorithm for using PINP to monitor treatment of patients with teriparatide. Curr Med Res Opin 22:61–66

    Article  CAS  PubMed  Google Scholar 

  7. Glover SJ, Eastell R, McCloskey EV, Rogers A, Garnero P et al (2009) Rapid and robust response of biochemical markers of bone formation to teriparatide therapy. Bone 45:1053–1058

    Article  CAS  PubMed  Google Scholar 

  8. Eastell R, Mitlak BH, Wang Y, Hu M, Fitzpatrick LA et al (2019) Bone turnover markers to explain changes in lumbar spine BMD with abaloparatide and teriparatide: results from ACTIVE. Osteoporos Int 30:667–673

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Blumsohn A, Marin F, Nickelsen T, Brixen K, Sigurdsson G et al (2011) Early changes in biochemical markers of bone turnover and their relationship with bone mineral density changes after 24 months of treatment with teriparatide. Osteoporos Int 22:1935–1946

    Article  CAS  PubMed  Google Scholar 

  10. Chen P, Satterwhite JH, Licata AA, Lewiecki EM, Sipos AA et al (2005) Early changes in biochemical markers of bone formation predict BMD response to teriparatide in postmenopausal women with osteoporosis. J Bone Miner Res 20:962–970

    Article  CAS  PubMed  Google Scholar 

  11. Niimi R, Kono T, Nishihara A, Hasegawa M, Matsumine A et al (2014) An algorithm using the early changes in PINP to predict the future BMD response for patients treated with daily teriparatide. Osteoporos Int 25:377–384

    Article  CAS  PubMed  Google Scholar 

  12. Lu C, Chen Y, Zhang B, Chen Y, Bai F et al (2017) Response to teriparatide in Chinese patients with established osteoporosis: osteocalcin and lumbar spine bone-mineral density changes from teriparatide phase III study. Clin Interv Aging 12:1717–1723

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Tsujimoto M, Chen P, Miyauchi A, Sowa H, Krege JH et al (2011) PINP as an aid for monitoring patients treated with teriparatide. Bone 48:798–803

    Article  CAS  PubMed  Google Scholar 

  14. Gallagher JC, Rosen CJ, Chen P, Misurski DA, Marcus R et al (2006) Response rate of bone mineral density to teriparatide in postmenopausal women with osteoporosis. Bone 39:1268–1275

    Article  CAS  PubMed  Google Scholar 

  15. Elraiyah T, Ahmed AH, Wang Z, Farr JN, Murad MH et al (2016) Predictors of teriparatide treatment failure in patients with low bone mass. Bone Rep 4:17–22

    Article  PubMed  Google Scholar 

  16. Heaney RP, Watson P (2011) Variability in the measured response of bone to teriparatide. Osteoporos Int 22:1703–1708

    Article  CAS  PubMed  Google Scholar 

  17. Obermayer-Pietsch BM, Marin F, McCloskey EV, Hadji P, Farrerons J et al (2008) Effects of two years of daily teriparatide treatment on BMD in postmenopausal women with severe osteoporosis with and without prior antiresorptive treatment. J Bone Miner Res 23:1591–1600

    Article  CAS  PubMed  Google Scholar 

  18. Schwarz P, Jorgensen NR, Mosekilde L, Vestergaard P (2012) Effects of increasing age, dosage, and duration of PTH treatment on BMD increase–a meta-analysis. Calcif Tissue Int 90:165–173

    Article  CAS  PubMed  Google Scholar 

  19. Boonen S, Marin F, Obermayer-Pietsch B, Simões ME, Barker C et al (2008) Effects of previous antiresorptive therapy on the bone mineral density response to two years of teriparatide treatment in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 93:852–860

    Article  CAS  PubMed  Google Scholar 

  20. Niimi R, Kono T, Nishihara A, Hasegawa M, Matsumine A et al (2014) Determinants associated with bone mineral density increase in response to daily teriparatide treatment in patients with osteoporosis. Bone 66:26–30

    Article  CAS  PubMed  Google Scholar 

  21. Niimi R, Kono T, Nishihara A, Hasegawa M, Kono T et al (2016) A retrospective analysis of nonresponse to daily teriparatide treatment. Osteoporos Int 27:2845–2853

    Article  CAS  PubMed  Google Scholar 

  22. Middleton ET, Steel SA, Doherty SM (2007) The effect of prior bisphosphonate exposure on the treatment response to teriparatide in clinical practice. Calcif Tissue Int 81:335–340

    Article  CAS  PubMed  Google Scholar 

  23. Geusens P, Marin F, Kendler DL, Russo LA, Zerbini CAF et al (2018) Effects of teriparatide compared with risedronate on the risk of fractures in subgroups of postmenopausal women with severe osteoporosis: the VERO trial. J Bone Miner Res 33:783–794

    Article  CAS  PubMed  Google Scholar 

  24. Ettinger B, San Martin J, Crans G, Pavo I (2004) Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate. J Bone Miner Res 19:745–751

    Article  CAS  PubMed  Google Scholar 

  25. Pouilles JM, Tremollieres F, Todorovsky N, Ribot C (1991) Precision and sensitivity of dual-energy x-ray absorptiometry in spinal osteoporosis. J Bone Miner Res 6:997–1002

    Article  CAS  PubMed  Google Scholar 

  26. Miller PD, Delmas PD, Lindsay R, Watts NB, Luckey M et al (2008) Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate. J Clin Endocrinol Metab 93:3785–3793

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ste-Marie LG, Schwartz SL, Hossain A, Desaiah D, Gaich GA et al (2006) Effect of teriparatide [rhPTH(1–34)] on BMD when given to postmenopausal women receiving hormone replacement therapy. J Bone Miner Res 21:283–291

    Article  CAS  PubMed  Google Scholar 

  28. Delmas PD, Licata AA, Reginster JY, Crans GG, Chen P et al (2006) Fracture risk reduction during treatment with teriparatide is independent of pretreatment bone turnover. Bone 39:237–243

    Article  CAS  PubMed  Google Scholar 

  29. Marcus R, Wang O, Satterwhite J, Mitlak B (2003) The skeletal response to teriparatide is largely independent of age, initial bone mineral density, and prevalent vertebral fractures in postmenopausal women with osteoporosis. J Bone Miner Res 18:18–23

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Menopause Center, Paule de Viguier Hospital, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse Cedex 9, 31059, Toulouse, France

    Gosset Anna, Farcy Anne-Lise, Dufond Clémence, Pouillès Jean-Michel & Trémollieres Florence

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  1. Gosset Anna
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  2. Farcy Anne-Lise
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  3. Dufond Clémence
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  4. Pouillès Jean-Michel
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  5. Trémollieres Florence
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Correspondence to Gosset Anna.

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Anna, G., Anne-Lise, F., Clémence, D. et al. Factors associated with bone response to teriparatide in young postmenopausal women with osteoporosis. J Bone Miner Metab 41, 278–285 (2023). https://doi.org/10.1007/s00774-023-01412-3

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  • DOI: https://doi.org/10.1007/s00774-023-01412-3

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