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Parathyroid Hormone as a Therapy for Osteoporosis

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Osteoporosis

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Parathyroid hormone (PTH) classically causes bone resorption and bone loss. However, since 1929 (1), it has been known that PTH can also have an anabolic effect on the skeleton. This salutary effect of PTH is the basis for the idea that PTH has the potential to become a therapy for osteoporosis. This chapter will review the effects of endogenous PTH, including lessons learned from primary hyperparathyroidism and the rationale for PTH therapy in osteoporosis. Clinical trials of PTH in osteoporosis, both alone and in combination with other drugs, will also be reviewed.

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References

  1. Bauer W, Aub JC, Albright F. Studies of calcium and phosphorous metabolism. V. A study of the bone trabeculae as a readily reversible supply of calcium. J Exp Med 1929; 49: 145–161.

    Article  PubMed  CAS  Google Scholar 

  2. Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, et al. Skeletal disease in primary hyperparathyroidism. J Bone Miner Res 1989; 4 (3): 283–291.

    Article  PubMed  CAS  Google Scholar 

  3. Halloran BP, Lonergan ET, Portale AA. Aging and renal responsiveness to parathyroid hormone in healthy men. J Clin Endocrinol Metab 1996; 81 (6): 2192–2197.

    Article  PubMed  CAS  Google Scholar 

  4. Bilezikian JP, Silverberg SJ. Parathyroid Hormone. Does it have a role in the pathogenesis of osteoporosis? Clin Lab Med 2000; 20 (3): 559–567.

    PubMed  CAS  Google Scholar 

  5. Ledger GA, Burritt MF, Kao PC, O’ Fallon WM, Riggs BL, Khosla S. Role of parathyroid hormone in mediating nocturnal and age-related increases in bone resorption. J Clin Endocrinol Metab 1995; 80 (11): 3304–3310.

    Article  PubMed  CAS  Google Scholar 

  6. Kotowicz MA, Klee GG, Kao PC, O’Fallon WM, Hodgson SF, Cedel SL, et al, Relationship between serum intact parathyroid hormone concentrations and bone remodeling in type I osteoporosis: evidence that skeletal sensitivity is increased. Osteoporos Int 1990; 1 (1): 14–22.

    Article  PubMed  CAS  Google Scholar 

  7. Marcus R, Madvig P, Crim M, Pont A, Kosek J. Conjugated estrogens in the treatment of postmenopausal women with hyperparathyroidism. Ann Intern Med 1984; 100 (5): 633–640.

    PubMed  CAS  Google Scholar 

  8. Selby PL, Peacock M. Ethinyl estradiol and norethindrone in the treatment of primary hyperparathyroidism in postmenopausal women. N Engl J Med 1986; 314 (23): 1481–1485.

    Article  PubMed  CAS  Google Scholar 

  9. Cosman F, Shen V, Xie F, Seibel M, Ratcliffe A, Lindsay R. Estrogen protection against bone resorbing effects of parathyroid hormone infusion. Assessment by use of biochemical markers (published erratum appears in Ann Intern Med 1994;120(8):698). Ann Intern Med 1993; 118 (5): 337–343.

    CAS  Google Scholar 

  10. Tsai KS, Ebeling PR, Riggs BL. Bone responsiveness to parathyroid hormone in normal and osteoporotic postmenopausal women. J Clin Endocrinol Metab 1989; 69 (5): 1024–1027.

    Article  PubMed  CAS  Google Scholar 

  11. Ebeling PR, Jones JD, Burritt MF, Duerson CR, Lane AW, Hassager C, et al. Skeletal responsiveness to endogenous parathyroid hormone in postmenopausal osteoporosis. J Clin Endocrinol Metab 1992; 75 (4): 1033–1038.

    Article  PubMed  CAS  Google Scholar 

  12. Eastell R, Calvo MS, Burritt MF, Offord KP, Russell RG, Riggs BL. Abnormalities in circadian patterns of bone resorption and renal calcium conservation in type I osteoporosis. J Clin Endocrinol Metab 1992; 74 (3): 487–494.

    Article  PubMed  CAS  Google Scholar 

  13. Silverberg SJ, Shane E, de la Cruz L, Segre GV, Clemens TL, Bilezikian JP. Abnormalities in parathyroid hormone secretion and 1,25- dihydroxyvitamin D3 formation in women with osteoporosis. N Engl J Med 1989; 320 (5): 277–281.

    Article  PubMed  CAS  Google Scholar 

  14. Cosman F, Shen V, Herrington B, Lindsay R. Response of the parathyroid gland to infusion of human parathyroid hormone-(1–34) (PTH-[1–341): demonstration of suppression of endogenous secretion using immunoradiometric intact PTH-(1–84) assay. J Clin Endocrinol Metab 1991; 73 (6): 1345–1351.

    Article  PubMed  CAS  Google Scholar 

  15. Dempster DW, Cosman F, Parisien M, Shen V, Lindsay R. Anabolic actions of parathyroid hormone on bone. Endocr Rev 1993; 14 (6): 690–709.

    PubMed  CAS  Google Scholar 

  16. Parisien M, Silverberg SJ, Shane E, de la Cruz L, Lindsay R, Bilezikian JP, et al. The histomorphometry of bone in primary hyperparathyroidism: preservation of cancellous bone structure. J Clin Endocrinol Metab 1990; 70 (4): 930–938.

    Article  PubMed  CAS  Google Scholar 

  17. Parisien M, Mellish RW, Silverberg SJ, Shane E, Lindsay R, Bilezikian JP, et al. Maintenance of cancellous bone connectivity in primary hyperparathyroidism: trabecular strut analysis. J Bone Miner Res 1992; 7 (8): 913–919.

    Article  PubMed  CAS  Google Scholar 

  18. Parisien M, Cosman F, Mellish RW, Schnitzer M, Nieves J, Silverberg SJ, et al. Bone structure in postmenopausal hyperparathyroid, osteoporotic, and normal women. J Bone Miner Res 1995; 10 (9): 1393–1399.

    Article  PubMed  CAS  Google Scholar 

  19. Parisien M, Schnitzer M, Nieves J Mellish RW, Silverberg SJ, Shane E, et al. A comparison of bone structure and turnover in postmenopausal women with osteoporosis or primary hyperparathyroidism, in Proceedings of the Fourth International Symposium on Osteoporosis, Hong Kong 1993, pp. 162, 163.

    Google Scholar 

  20. Dempster DW, Parisien M, Silverberg SJ, Liang XG, Schnitzer M, Shen V, et al. On the mechanism of cancellous bone preservation in postmenopausal women with mild primary hyperparathyroidism. J Clin Endocrinol Metab 1999; 84 (5): 1562–1566.

    Article  PubMed  CAS  Google Scholar 

  21. Wilson RJ, Rao S, Ellis B, Kleerekoper M, Parfitt AM. Mild asymptomatic primary hyperparathyroidism is not a risk factor for vertebral fractures. Ann Intern Med 1988; 109 (12): 959–962.

    PubMed  CAS  Google Scholar 

  22. Melton Lid, Atkinson EJ, O’Fallon WM, Heath Hd. Risk of age-related fractures in patients with primary hyperparathyroidism. Arch Intern Med 1992; 152 (11): 2269–2273.

    Article  Google Scholar 

  23. Khosla S, Melton 3rd LJ, Wermers RA, Crowson CS, O’Fallon W, Riggs B. Primary hyperparathyroidism and the risk of fracture: a population-based study. J Bone Miner Res 1999; 14 (10): 1700–1707.

    Article  PubMed  CAS  Google Scholar 

  24. Lindsay R, Cosman F. The pharmacology of estrogens in osteoporosis. In: Bilezikian JP, Raisz LG, Rodan GA, eds., Principles of Bone Biology, Academic Press, San Diego, CA, 1996, pp. 1063–1068.

    Google Scholar 

  25. Fleisch H. Bisphosphonates: mechanisms of action and clinical use. In: Bilezikian JP, Raisz LG, Rodan GA, eds,. Principles of Bone Biology, Academic Press, San Diego, CA, 1996, pp. 1037–1052.

    Google Scholar 

  26. Azria M, Avioli L. Calcitonin. In: Bilezikian JP, Raisz LG, Rodan GA, eds,. Principles of Bone Biology, Academic Press, San Diego, CA, 1996, pp. 1083–1098.

    Google Scholar 

  27. Rosen CJ, Chesnut 3rd CH, Mallinak NJ. The predictive value of biochemical markers of bone turnover for bone mineral density in early postmenopausal women treated with hormone replacement or calcium supplementation (see comments). J Clin Endocrinol Metab 1997; 82 (6): 1904–1910.

    Article  PubMed  CAS  Google Scholar 

  28. Greenspan SL, Parker RA, Ferguson L, Rosen HN, Maitland-Ramsey L, Karpf DB. Early changes in biochemical markers of bone turnover predict the long-term response to alendronate therapy in representative elderly women: a randomized clinical trial. J Bone Miner Res 1998; 13 (9): 1431–1438.

    Article  PubMed  CAS  Google Scholar 

  29. Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin interventions (PEPI) trial. The Writing Group for the PEPI. JAMA 1996;276(17):1389–1396.

    Google Scholar 

  30. Liberman UA, Weiss SR, Broll J, Minne HW, Quan H, Bell NH, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 1995; 333 (22): 1437–1443.

    Article  PubMed  CAS  Google Scholar 

  31. Riggs BL, Hodgson SF, O’Fallon WM, Chao EY, Wahner HW, Muhs JM, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med 1990; 322 (12): 802–809.

    Article  PubMed  CAS  Google Scholar 

  32. Kleerekoper M, Peterson EL, Nelson DA, Phillips E, Schork MA, Tilley BC, et al. A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporos Int 1991; 1 (3): 155–161.

    Article  PubMed  CAS  Google Scholar 

  33. Meunier PJ, Sebert JL, Reginster JY, Briancon D, Appelboom T, Netter P, et al. Fluoride salts are no better at preventing new vertebral fractures than calcium-vitamin D in postmenopausal osteoporosis: the FAVOStudy. Osteoporos Int 1998; 8 (1): 4–12.

    Article  PubMed  CAS  Google Scholar 

  34. Pak CY, Sakhaee K, Zerwekh JE, Parcel C, Peterson R, Johnson K. Safe and effective treatment of osteoporosis with intermittent slow release sodium fluoride: augmentation of vertebral bone mass and inhibition of fractures. J Clin Endocrinol Metab 1989; 68 (1): 150–159.

    Article  PubMed  CAS  Google Scholar 

  35. Pak CY, Sakhaee K, Adams-Huet B, Piziak V, Peterson RD, Poindexter JR, Treatment of postmenopausal osteoporosis with slow-release sodium fluoride. Final report of a randomized controlled trial. Ann Intern Med 1995; 123 (6): 401–408.

    PubMed  CAS  Google Scholar 

  36. Pak CY, Zerwekh JE, Antich PP, Bell NH, Singer FR. Slow-release sodium fluoride in osteoporosis. J Bone Miner Res 1996; 11 (5): 561–564.

    Article  PubMed  CAS  Google Scholar 

  37. Ringe JD, Kipshoven C, Coster A, Umbach R. Therapy of established postmenopausal osteoporosis with monofluorophosphate plus calcium: dose-related effects on bone density and fracture rate. Osteoporos Int 1999; 9 (2): 171–178.

    Article  PubMed  CAS  Google Scholar 

  38. Reginster JY, Meurmans L, Zegels B, Rovati LC, Minne HW, Giacovelli G, et al. The effect of sodium monofluorophosphate plus calcium on vertebral fracture rate in postmenopausal women with moderate osteoporosis. A randomized, controlled trial (see comments). Ann Intern Med 1998; 129 (1): 1–8.

    PubMed  CAS  Google Scholar 

  39. Ringe JD, Dorst A, Kipshoven C, Rovati LC, Setnikar I. Avoidance of vertebral fractures in men with idiopathic osteoporosis by a three year therapy with calcium and low-dose intermittent monofluorophosphate. Osteoporos Int 1998; 8 (1): 47–52.

    Article  PubMed  CAS  Google Scholar 

  40. Rosen CJ, Bilezikian J. Hot topic: anabolic therapy for osteoporosis. J Clin Endocrinol Metab 2001; 86: 957–964.

    Article  PubMed  CAS  Google Scholar 

  41. Tam CS, Heersche JN, Murray TM, Parsons JA. Parathyroid hormone stimulates the bone apposition rate independently of its resorptive action: differential effects of intermittent and continuous administration. Endocrinology 1982; 110 (2): 506–512.

    Article  PubMed  CAS  Google Scholar 

  42. Hodsman AB, Fraher Li, Ostbye T, Adachi JD, Steer BM. An evaluation of several biochemical markers for bone formation and resorption in a protocol utilizing cyclical parathyroid hormone and calcitonin therapy for osteoporosis. J Clin Invest 1993; 91 (3): 1138–1148.

    Article  PubMed  CAS  Google Scholar 

  43. Calvo MS, Eastell R, Offord KP, Bergstralh EJ, Burritt MF. Circadian variation in ionized calcium and intact parathyroid hormone: evidence for sex differences in calcium homeostasis. J Clin Endocrinol Metab 1991; 72 (1): 69–76.

    Article  PubMed  CAS  Google Scholar 

  44. Hock IM, Gera I. Effects of continuous and intermittent administration and inhibition of resorption on the anabolic response of bone to parathyroid hormone. J Bone Miner Res 1992; 7 (1): 65–72.

    Article  PubMed  CAS  Google Scholar 

  45. Abou-Samra AB, Juppner H, Force T, Freeman MW, Kong XF, Schipani E, et al. Expression cloning of a common receptor for parathyroid hormone and parathyroid hormone-related peptide from rat osteoblast-like cells: a single receptor stimulates intracellular accumulation of both cAMP and inositol trisphosphates and increases intracellular free calcium. Proc Natl Acad Sci USA 1992; 89 (7): 2732–2736.

    Article  PubMed  CAS  Google Scholar 

  46. Juppner H, Abou-Samra AB, Freeman M, Kong XF, Schipani E, Richards J, et al. A G protein-linked receptor for parathyroid hormone and parathyroid hormone-related peptide. Science 1991; 254 (5034): 1024–1026.

    Article  PubMed  CAS  Google Scholar 

  47. Usdin TB, Gruber C, Bonner TI. Identification and functional expression of a receptor selectively recognizing parathyroid hormone, the PTH2 receptor. J Biol Chem 1995;270(26):15,455–15,458.

    Google Scholar 

  48. Finkelstein JS. Pharmacological mechanisms of therapeutics: parathyroid hormone. In: Bilezikian JP, Raisz LG, Rodan GA, eds., Principles of Bone Biology, Academic Press, San Diego, CA, 1996, pp. 993–1006.

    Google Scholar 

  49. Fujimori A, Cheng SL, Avioli LV, Civitelli R. Dissociation of second messenger activation by parathyroid hormone fragments in osteosarcoma cells. Endocrinology 1991; 128 (6): 3032–3049.

    Article  PubMed  CAS  Google Scholar 

  50. Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP. A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med 1999; 341 (17): 1249–1255.

    Article  PubMed  CAS  Google Scholar 

  51. Nakaoka D, Sugimoto T, Kobayashi T, Yamaguchi T, Kobayashi A, Chihara K. Prediction of bone mass change after parathyroidectomy in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 2000; 85 (5): 1901–1907.

    Article  PubMed  CAS  Google Scholar 

  52. Seibel MJ, Gartenberg F, Silverberg SJ, Ratcliffe A, Robins SP, BilezikianJP. Urinary hydroxypyridinum cross-links of collagen in primary hyperparathyroidism. J Clin Endocrinol Metab 1992; 74 (3): 481–486.

    Article  PubMed  CAS  Google Scholar 

  53. Christiansen P, Steiniche T, Mosekilde L, Hessov I, Melsen F. Primary hyperparathyroidism: changes in trabecular bone remodeling following surgical treatment-evaluated by histomorphometric methods. Bone 1990; 11 (2): 75–79.

    Article  PubMed  CAS  Google Scholar 

  54. Kronenberg HM. PTH: Mechanism of action. In: Favus M, ed., Primer on Metabolic Bone Diseases, ASBMR, 1996, pp. 68–70.

    Google Scholar 

  55. Morley P, Whitfield JF, Willick GE. Anabolic effects of PTH on bone. Trends Endocrinol Metab 1997; 8: 225–231.

    Article  PubMed  CAS  Google Scholar 

  56. Grinspoon S, Baum H, Lee K, Anderson E, Herzog D, Klibanski A. Effects of short-term recombinant human insulin-like growth factor I administration on bone turnover in osteopenic women with anorexia nervosa. J Clin Endocrinol Metab 1996; 81 (11): 3864–3870.

    Article  PubMed  CAS  Google Scholar 

  57. Abou-Samra AB, Jueppner H, Westerberg D, Potts Jr. JT, Segre GV. Parathyroid hormone causes translocation of protein kinase-C from cytosol to membranes in rat osteosarcoma cells. Endocrinology 1989; 124 (3): 1107–1113.

    Article  PubMed  CAS  Google Scholar 

  58. Goltzman D. Interactions of PTH and PTHrP with the PTH/PTHrP receptor and with downstream signaling pathways: exceptions that provide the rules (editorial; comment) (see comments). J Bone Miner Res 1999; 14 (2): 173–177.

    Article  PubMed  CAS  Google Scholar 

  59. Canalis E, Centrella M, Burch W, McCarthy TL. Insulin-like growth factor I mediates selective anabolic effects of parathyroid hormone in bone cultures. J Clin Invest 1989; 83 (1): 60–65.

    Article  PubMed  Google Scholar 

  60. Hock JM, Gera I, Fonseca J, Raisz LG. Human parathyroid hormone-(1–34) increases bone mass in ovariectomized and orchidectomized rats. Endocrinology 1988; 122 (6): 2899–2904.

    Article  PubMed  CAS  Google Scholar 

  61. Hodsman AB, Fraher LJ, Watson PH. Parathyroid hormone. In: Rosen CJ, Glowacki J, Bilezikian JP, eds., The Aging Skeleton, Academic Press, San Diego, CA 1999, pp. 563–578.

    Chapter  Google Scholar 

  62. Linkhart TA, Mohan S. Parathyroid hormone stimulates release of insulin-like growth factor-I (IGFI) and IGF-II from neonatal mouse calvaria in organ culture. Endocrinology 1989; 125 (3): 1484–1491.

    Article  PubMed  CAS  Google Scholar 

  63. Watson PH, Lazowski DA, Han V, Fraher LJ, Steer BM, Hodsman AB. PTH restores bone mass and enhances osteoblast IGF-1 gene expression in ovarectomized rats. Bone 1995; 16: 1–9.

    Article  Google Scholar 

  64. Jilka RL, Weinstein RS, Bellido T, Roberson P, Parfitt AM, Manolagas SC. Increased bone formation by prevention of osteoblast apoptosis with parathyroid hormone (see comments). J Clin Invest 1999; 104 (4): 439–446.

    Article  PubMed  CAS  Google Scholar 

  65. Hilliker S, Wergedal JE, Gruber HE, Bettica P, Baylink DJ. Truncation of the amino terminus of PTH alters its anabolic activity on bone in vivo. Bone 1996; 19 (5): 469–477.

    Article  PubMed  CAS  Google Scholar 

  66. Armamento-Villareal R, Ziambaras K, Abbasi-Jarhomi SH, Dimarogonas A, Halstead L, Fausto A, et al. An intact N terminus is required for the anabolic action of parathyroid hormone on adult female rats. J Bone Miner Res 1997; 12 (3): 384–392.

    CAS  Google Scholar 

  67. Hesch RD, Heck J, Auf’mKolk B, Schettler T, Atkinson MJ. First clinical observations with hPTH(138), a more potent human parathyroid hormone peptide. Horm Metab Res 1984;16(10):559,560.

    Google Scholar 

  68. Reeve J, Hesp R, Williams D, Hulme P, Klenerman L, Zanelli JM, et al. Anabolic effect of low doses of a fragment of human parathyroid hormone on the skeleton in postmenopausal osteoporosis. Lancet 1976; 1 (7968): 1035–1038.

    Article  PubMed  CAS  Google Scholar 

  69. Slovik DM, Neer RM, Potts Jr. JT. Short-term effects of synthetic human parathyroid hormone-(1–34) administration on bone mineral metabolism in osteoporotic patients. J Clin Invest 1981; 68 (5): 1261–1271.

    Article  PubMed  CAS  Google Scholar 

  70. Reeve J, Meunier PJ, Parsons JA, Bernat M, Bijvoet OL, Courpron P, et al. Anabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: a multicentre trial. Br Med J 1980; 280 (6228): 1340–1344.

    Article  PubMed  CAS  Google Scholar 

  71. Hesp R, Hulme P, Williams D, Reeve J. The relationship between changes in femoral bone density and calcium balance in patients with involutional osteoporosis treated with human PTH fragment 1–34. Metab Bone Dis Relat Res 1981; 2: 331–334.

    Article  Google Scholar 

  72. Slovik DM, Adams JS, Neer RM, Holick MF, Potts Jr. JT. Deficient production of 1,25dihydroxyvitamin D in elderly osteoporotic patients. N Engl J Med 1981; 305 (7): 372–374.

    Article  PubMed  CAS  Google Scholar 

  73. Slovik DM, Rosenthal DI, Doppelt SH, Potts Jr. JT, Daly MA, Campbell JA, et al. Restoration of spinal bone in osteoporotic men by treatment with human parathyroid hormone (1–34) and 1,25dihydroxyvitamin D. J Bone Miner Res 1986; 1 (4): 377–381.

    Article  PubMed  CAS  Google Scholar 

  74. Neer M, Slovik DM, Daly M, Potts Jr. T, Nussbaum SR. Treatment of postmenopausal osteoporosis with daily parathyroid hormone plus calcitriol. Osteoporos Int 1993;3(Suppl 1): 204, 205.

    Google Scholar 

  75. Reeve J, Davies UM, Hesp R, McNally E, Katz D. Treatment of osteoporosis with human parathyroid peptide and observations on effect of sodium fluoride (published erratum appears in BMJ 1990;301(6750):477). BMJ 1990; 301 (6747): 314–318.

    Article  PubMed  CAS  Google Scholar 

  76. Reeve J, Bradbeer JN, Arlot M, Davies UM, Green JR, Hampton L, et al. hPTH 1–34 treatment of osteoporosis with added hormone replacement therapy: biochemical, kinetic and histological responses. Osteoporos Int 1991; 1 (3): 162–170.

    Article  PubMed  CAS  Google Scholar 

  77. Reeve J, Arlot ME, Bradbeer JN, Hesp R, McAlly E, Meunier PJ, et al. Human parathyroid peptide treatment of vertebral osteoporosis. Osteoporos Int 1993; 3 (Suppl 1): 199–203.

    Article  PubMed  Google Scholar 

  78. Reeve J, Arlot M, Price TR, Edouard C, Hesp R, Hulme P, et al. Periodic courses of human 1–34 parathyroid peptide alternating with calcitriol paradoxically reduce bone remodelling in spinal osteoporosis. Eur J Clin Invest 1987; 17 (5): 421–428.

    Article  PubMed  CAS  Google Scholar 

  79. Hesch RD, Heck J, Delling G, Keck E, Reeve J, Canzler H, et al. Results of a stimulatory therapy of low bone metabolism in osteoporosis with (1–38)hPTH and diphosphonate EHDP. Protocol of study I, osteoporosis trial Hannover. Klin Wochenschr 1988; 66 (19): 976–984.

    Article  PubMed  CAS  Google Scholar 

  80. Hesch RD, Busch U, Prokop M, Delling G, Rittinghaus EF. Increase of vertebral density by combination therapy with pulsatile 1–38hPTH and sequential addition of calcitonin nasal spray in osteoporotic patients. Calcif Tissue Int 1989; 44 (3): 176–180.

    Article  PubMed  CAS  Google Scholar 

  81. Hodsman AB, Fraher LJ. Biochemical responses to sequential human parathyroid hormone (1–38) and calcitonin in osteoporotic patients. Bone Miner 1990; 9 (2): 137–152.

    Article  PubMed  CAS  Google Scholar 

  82. Hodsman AB, Steer BM, Fraher LJ, Drost DJ. Bone densitometric and histomorphometric responses to sequential human parathyroid hormone (1–38) and salmon calcitonin in osteoporotic patients. Bone Miner 1991; 14 (1): 67–83.

    Article  PubMed  CAS  Google Scholar 

  83. Fujita T, Inoue T, Morii H, Morita R, Norimatsu H, Orimo H, et al. Effect of an intermittent weekly dose of human parathyroid hormone (1–34) on osteoporosis: a randomized double-masked prospective study using three dose levels. Osteoporos Int 1999; 9 (4): 296–306.

    Article  PubMed  CAS  Google Scholar 

  84. Finkelstein JS, Klibanski A, Schaefer EH, Hornstein MD, Schiff I, Neer RM. Parathyroid hormone for the prevention of bone loss induced by estrogen deficiency. N Engl J Med 1994; 331 (24): 1618–1623.

    Article  PubMed  CAS  Google Scholar 

  85. Finkelstein JS, Klibanski A, Arnold AL, Toth TL, Hornstein MD, Neer RM. Prevention of estrogen deficiency-related bone loss with human parathyroid hormone-(1–34): a randomized controlled trial. JAMA 1998; 280 (12): 1067–1073.

    Article  PubMed  CAS  Google Scholar 

  86. Finkelstein JS, Arnold AL. Increases in bone mineral density after discontinuation of daily human parathyroid hormone and gonadotropin-releasing hormone analog administration in women with endometriosis. J Clin Endocrinol Metab 1999; 84 (4): 1214–1219.

    Article  PubMed  CAS  Google Scholar 

  87. Rittmaster RS, Bolognese M, Ettinger MP, Hanley DA, Hodsman AB, Kendler DL, et al. Enhancement of bone mass in osteoporotic women with parathyroid hormone followed by alendronate. J Clin Endocrinol Metab 2000; 85 (6): 2129–2134.

    Article  PubMed  CAS  Google Scholar 

  88. Neer R, Arnaud CD, Zanchetta J, Prince R, Gaich G, Reginster J.Y, et al. Recombinant human PTH (rhPTH[1–341) reduces the risk of spine and non-spine fractures in postmenopausal osteoporosis (abstract). 82nd Annual Meeting of the Endocrine Society, 2000.

    Google Scholar 

  89. Kurland ES, Rosen CJ, Cosman F McMahon D, Chan F, Shane E, et al. Insulin-like growth factorI in men with idiopathic osteoporosis. J Clin Endocrinol Metab 1997; 82 (9): 2799–2805.

    Article  PubMed  CAS  Google Scholar 

  90. Johansson AG, Eriksen EF, Lindh E, Langdahl B, Blum WF, Lindahl A, et al. Reduced serum levels of the growth hormone-dependent insulin-like growth factor binding protein and a negative bone balance at the level of individual remodeling units in idiopathic osteoporosis in men. J Clin Endocrinol Metab 1997; 82 (9): 2795–2798.

    Article  PubMed  CAS  Google Scholar 

  91. Kurland ES, Cosman F, McMahon D, Rosen CJ, Lindsay R, Bilezikian JP. Parathyroid hormone as a therapy for idiopathic osteoporosis in men: effects on bone mineral density and bone markers. J Clin Endocrinol Metab 2000; 85: 3069–3076.

    Article  PubMed  CAS  Google Scholar 

  92. Lindsay R, Nieves J, Formica C, Henneman E, Woelfert L, Shen V, et al. Randomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis. Lancet 1997; 350 (9077): 550–555.

    Article  PubMed  CAS  Google Scholar 

  93. Cosman F, Nieves J, Woelfert L, Gordon S, Shen V, Lindsay R. Parathyroid responsivity in postmenopausal women with osteoporosis during treatment with parathyroid hormone. J Clin Endocrinol Metab 1998; 83 (3): 788–790.

    Article  PubMed  CAS  Google Scholar 

  94. Roe E, Sanchez S, del Puerto G, Pierini E, Bacchetti P, Cann C, et al. Parathyroid hormone 1–34 (hPTH 1–34) and estrogen produce dramatic bone density increases in postmenopausal osteoporosis-results from a placebo-controlled randomized trial. J Bone Miner Res 1999; 14 (suppl 1):S 137.

    Google Scholar 

  95. Lukert BP, Raisz LG. Glucocorticoid-induced osteoporosis: pathogenesis and management (see comments). Ann Intern Med 1990; 112 (5): 352–364.

    PubMed  CAS  Google Scholar 

  96. Lane NE, Sanchez S, Modin GW, Genant HK, ini E, Arnaud CD. Parathyroid hormone treatment can reverse corticosteroid-induced osteoporosis. Results of a randomized controlled clinical trial.J Clin Invest 1998; 102 (8): 1627–1633.

    CAS  Google Scholar 

  97. Lane NE, Sanchez S, Modin GW, Genant HK, Pierini E, Arnaud CD. Bone mass continues to increase at the hip after parathyroid hormone treatment is discontinued in glucocorticoid-induced osteoporosis: results of a randomized controlled clinical trial. J Bone Miner Res 2000; 15 (5): 944–951.

    Article  PubMed  CAS  Google Scholar 

  98. Hodsman AB, Fraher LJ, Watson PH, Ostbye T, Stitt LW, Adachi JD, et al. A randomized controlled trial to compare the efficacy of cyclical parathyroid hormone versus cyclical parathyroid hormone and sequential calcitonin to improve bone mass in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 1997; 82 (2): 620–628.

    Article  PubMed  CAS  Google Scholar 

  99. Hodsman AB, Fraher LJ, Adachi JD. A clinical trial of cyclical clodronate as maintenance therapy following withdrawal of parathyroid hormone, in treatment of postmenopausal osteoporosis (abstract). J Bone Miner Res 1995; 10 (suppl 1): S200.

    Google Scholar 

  100. Cosman F, Nieves J, Woelfert L, Shen V, Lindsay R. Alendronate does not block the anabolic effect of PTH in postmenopausal osteoporotic women. J Bone Miner Res 1998; 13 (6): 1051–1055.

    Article  PubMed  CAS  Google Scholar 

  101. Horwitz M, Stewart A, Greenspan SL. Sequential parathyroid hormone/alendronate therapy for osteoporosis-robbing Peter to pay Paul?. J Clin Endocrinol Metab 2000;85(6): 2127, 2128.

    Google Scholar 

  102. Lindsay R, Hodsman AB, Genant HK, Bolognese M, Ettinger MP. A randomized controlled multicenter study of 1–84hPTH for treatment of postmenopasual osteoporosis (abstract). Bone 1998; 23 (suppl 1): S175.

    Google Scholar 

  103. Zhou H, et al. Effects of daily treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: a paired biopsy study. J Bone Miner Res 2001; 16 (10): 1846–1853.

    Article  PubMed  Google Scholar 

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Authors
  1. Mishaela R. Rubin MD
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  2. John P. Bilezikian MD
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Editors and Affiliations

  1. Oregon Health & Science University, Portland, OR, USA

    Eric S. Orwoll MD  & Michael Bliziotes MD  & 

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Rubin, M.R., Bilezikian, J.P. (2003). Parathyroid Hormone as a Therapy for Osteoporosis. In: Orwoll, E.S., Bliziotes, M. (eds) Osteoporosis. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-278-4_25

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  • DOI: https://doi.org/10.1007/978-1-59259-278-4_25

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-260-5

  • Online ISBN: 978-1-59259-278-4

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