Skip to main content

Advertisement

Log in

The effect of teriparatide to alleviate pain and to prevent vertebral collapse after fresh osteoporotic vertebral fracture

  • Original Article
  • Published:
Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Vertebral fracture is often seen in osteoporotic patients. Teriparatide is expected to promote bone union. Therefore, we evaluated the action of vertebral collapse prevention by administering teriparatide to vertebral fracture patients. Thirty-four patients with fresh vertebral fracture (48 vertebrae) participated in this study. They were administered either teriparatide (daily 20 µg/day or weekly 56.5 µg/week) or risedronate (17.5 mg/week): ten patients (20 vertebrae) received teriparatide daily (Daily group), 11 patients (15 vertebrae) received teriparatide weekly (Weekly group), and 13 patients (14 vertebrae) received risedronate (RIS group). We compared some laboratory examination items, visual analogue scale (VAS) of low back pain, vertebral collapse rate and local kyphotic angle, and the cleft frequency. In addition, we evaluated 22 vertebral fracture patients (24 vertebrae) who did not take any osteoporotic medicines (Control group). There was no significant difference in any of the scores at the start of treatment. At 8 and 12 weeks after the initial visit, VAS scores in the Daily and Weekly groups were significantly lower than in the RIS group (p < 0.05). At 8 and 12 weeks, the vertebral collapse rate and local kyphotic angle in the Daily group were significantly lower than in the RIS and Control groups (p < 0.01 and p < 0.05, respectively), and those in the Weekly group were significantly lower than in the Control group (p < 0.05). The cleft frequency in the Daily group was significantly lower than in the RIS group (p < 0.05). Teriparatide is promising for the prevention of vertebral collapse progression after vertebral fracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Lemke DM (2005) Vertebroplasty and kyphoplasty for treatment of painful osteoporotic compression fractures. J Am Acad Nurse Pract 17:268–276

    Article  PubMed  Google Scholar 

  2. Hasegawa K, Homma T, Uchiyama S, Takahashi H (1998) Vertebral pseudarthrosis in the osteoporotic spine. Spine 23:2201–2206

    Article  PubMed  CAS  Google Scholar 

  3. Mochida J, Toh E, Chiba M, Nishimura K (2001) Treatment of osteoporotic late collapse of a vertebral body of thoracic and lumbar spine. J Spinal Disord 14:393–398

    Article  PubMed  CAS  Google Scholar 

  4. Tsuchida T, Sato K, Miyakoshi N, Abe T, Kudo T, Tamura Y, Kasukawa Y, Suzuki K (2000) Histomorphometric evaluation of the recovering effects of human parathyroid hormone (1–34) on bone structure and turnover in streptozotocin-induced diabetic rats. Calcif Tissue Int 66:229–233

    Article  PubMed  CAS  Google Scholar 

  5. Miyakoshi N (2004) Effects of parathyroid hormone on cancellous bone mass and structure in osteoporosis. Curr Pharm Des 10:2615–2627

    Article  PubMed  CAS  Google Scholar 

  6. Tsujimoto M, Uenaka K, Iwata A, Higashiuchi Y, Sowa H (2012) Effects of teriparatide in Japanese and non-Japanese populations: bridging findings on pharmacokinetics and efficacy. J Bone Miner Metab 30:326–337

    Article  PubMed  CAS  Google Scholar 

  7. Andreassen TT, Ejersted C, Oxlund H (1999) Intermittent parathyroid hormone (1–34) treatment increases callus formation and mechanical strength of healing rat fractures. J Bone Miner Res 14:960–968

    Article  PubMed  CAS  Google Scholar 

  8. Nozaka K, Miyakoshi N, Kasukawa Y, Maekawa S, Noguchi H, Shimada Y (2008) Intermittent administration of human parathyroid hormone enhances bone formation and union at the site of cancellous bone osteotomy in normal and ovariectomized rats. Bone 42:90–97

    Article  PubMed  CAS  Google Scholar 

  9. Peichl P, Holzer LA, Maier R, Holzer G (2011) Parathyroid hormone 1–84 accelerates fracture-healing in pubic bones of elderly osteoporotic women. J Bone Joint Surg Am 93:1583–1587

    Article  PubMed  Google Scholar 

  10. Fahrleitner-Pammer A, Langdahl BL, Marin F, Jakob F, Karras D, Barrett A, Ljunggren Ö, Walsh JB, Rajzbaum G, Barker C, Lems WF (2011) Fracture rate and back pain during and after discontinuation of teriparatide: 36-month data from the European Forsteo Observational Study (EFOS). Osteoporos Int 22:2709–2719

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Lyritis G, Marin F, Barker C, Pfeifer M, Farrerons J, Brixen K, del Pino J, Keen R, Nickelsen TN, EUROFORS Study Group (2010) Back pain during different sequential treatment regimens of teriparatide: results from EUROFORS. Curr Med Res Opin 26:1799–1807

    Article  PubMed  CAS  Google Scholar 

  12. Hadji P, Zanchetta JR, Russo L, Recknor CP, Saaq KG, McKiernan FE, Silverman SL, Alam J, Burqe RT, Lakshmanan MC, Kreqe JH, Masica DN, Mitlak BH, Stock JL (2012) The effect of teriparatide compared with risedoronate on reduction of back pain in postmenopausal women with osteoporotic vertebral fractures. Osteoporosis Int 23:2141–2150

    Article  CAS  Google Scholar 

  13. Park JH, Kanq KC, Shin DE, Koh YG, Son JS, Kim BH (2014) Preventive effects of conservative treatment with short-term teriparatide on the progression of vertebral body collapse after osteoporotic vertebral compression fracture. Osteoporosis Int 25:613–618

    Article  Google Scholar 

  14. Fukushima M, Kunogi J, Miyoshi K (2012) Balloon kyphoplasty at the extension position for severe collapsed vertebral fractures (in Japanese). Jpn J Occup Med Traumatol 60:235–239

    Google Scholar 

  15. Ohtori S, Akazawa T, Murata Y, Kinoshita T, Yamashita M, Nakagawa K, Inoue G, Nakamura J, Orita S, Ochiai N, Kishida S, Takaso M, Eguchi Y, Yamauchi K, Suzuki M, Aoki Y, Takahashi K (2010) Risedronate decreases bone resorption and improves low back pain in postmenopausal osteoporosis patients without vertebral fractures. J Clin Neurosci 17:209–213

    Article  PubMed  CAS  Google Scholar 

  16. Orita S, Ohtori S, Koshi T, Yamashita M, Yamauchi K, Inoue G, Suzuki M, Eguchi Y, Kamoda H, Arai G, Ishikawa T, Miyagi M, Ochiai N, Kishida S, Takaso M, Aoki Y, Toyone T, Takahashi K (2010) The effects of risedronate and exercise on osteoporotic lumbar rat vertebrae and their sensory innervation. Spine 35:1974–1982

    Article  PubMed  Google Scholar 

  17. Nakazawa T, Nakajima A, Shiomi K, Moriya H, Einhorn TA, Yamazaki M (2005) Effects of low-dose, intermittent treatment with recombinant human parathyroid hormone (1–34) on chondrogenesis in a model of experimental fracture healing. Bone 37:711–719

    Article  PubMed  CAS  Google Scholar 

  18. Kakar S, Einhorn TA, Vora S, Miara LJ, Hon G, Wigner NA, Toben D, Jacobsen KA, AI-Sebaei MO, Song M, Trackman PC, Morgan EF, Gerstenfeld LC, Bames GL (2007) Enhanced chondrogenesis and Wnt signaling in PTH-treated fractures. J Bone Miner Res 22:1903–1912

    Article  PubMed  CAS  Google Scholar 

  19. Tsuchie H, Miyakoshi N, Kasukawa Y, Aonuma H, Shimada Y (2013) Intermittent administration of human parathyroid hormone before osteosynthesis stimulates cancellous bone union in ovariectomized rats. Tohoku J Exp Med 229:19–28

    Article  PubMed  CAS  Google Scholar 

  20. Ma YL, Zeng Q, Donley DW, Ste-Marie LG, Gallagher JC, Dalsky GP, Marcus R, Eriksen EF (2006) Teriparatide increases bone formation in modeling and remodeling osteons and enhances IGF-II immunoreactivity in postmenopausal women with osteoporosis. J Bone Miner Res 21:855–864

    Article  PubMed  CAS  Google Scholar 

  21. Miki T, Nakatsuka K, Naka H, Masaki H, Imanishi Y, Ito M, Inaba M, Morii H, Nishizawa Y (2004) Effect and safety of intermittent weekly administration of human parathyroid hormone 1–34 in patients with primary osteoporosis evaluated by histomorphometry and microstructural analysis of iliac trabecular bone before and after 1 year of treatment. J Bone Miner Metab 22:569–576

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

All authors have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hiroyuki Tsuchie.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsuchie, H., Miyakoshi, N., Kasukawa, Y. et al. The effect of teriparatide to alleviate pain and to prevent vertebral collapse after fresh osteoporotic vertebral fracture. J Bone Miner Metab 34, 86–91 (2016). https://doi.org/10.1007/s00774-014-0646-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00774-014-0646-y

Keywords

Navigation