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.
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Acknowledgments
This study was supported by Eli Lilly and Company. The authors acknowledge the study investigators [20] and also acknowledge JoNita Cogburn, Ph.D., i3 Statprobe for editorial assistance.
Conflicts of interest
BL Langdahl is a lecturer for Eli Lilly and Company, Novartis, Amgen, Servier, Roche, and Merck Sharp & Dohme and serves on advisory boards for Eli Lilly and Company, Novartis, and Amgen.
E Shane receives research support from Novartis and Eli Lilly and Company.
H Dobnig is a lecturer at symposia organized by Eli Lilly and Company.
JR Zanchetta has received consultant fees and/or research grants from Sanofi-Aventis, GlaxoSmithKline, MSD, Eli Lilly and Company, Wyeth, Amgen, Pfizer, Roche, and Servier.
M Maricic is a lecturer for and has received research grant support from Eli Lilly and Company.
F Marin, K Krohn, K See, and MR Warner are employees and stockholders of Eli Lilly and Company.
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Langdahl, B.L., Marin, F., Shane, E. et al. Teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: an analysis by gender and menopausal status. Osteoporos Int 20, 2095–2104 (2009). https://doi.org/10.1007/s00198-009-0917-y
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DOI: https://doi.org/10.1007/s00198-009-0917-y