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Clinical Orthopaedics and Related Research®

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01-03-2012 | Clinical Research

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

Authors: Aasis Unnanuntana, MD, Quang V. Ton, MD, John P. Kleimeyer, BA, Joseph T. Nguyen, MPH, Joseph M. Lane, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2012

Abstract

Background

Fracture leads to local and systemic catabolic physiologic changes. As teriparatide is an agent used to treat osteoporosis in patients with fragility fractures, it is unclear whether teriparatide treatment alters bone mineral density (BMD) and bone markers when given to patients with fractures.

Questions/purposes

We asked whether BMD and bone marker responses would be blunted in patients with fractures placed on teriparatide after fracture compared with patients without fractures on teriparatide.

Patients and Methods

We retrospectively collected data from 141 patients treated with teriparatide for osteoporosis. Seventy-seven patients received teriparatide after fractures (fracture group), whereas 64 were treated for other indications (nonfracture group). We determined BMD at the lumbar spine and at the proximal femur before and 12 and 24 months posttreatment. Bone markers (urine N-telopeptide [urine NTX], bone-specific alkaline phosphatase [BALP]) were measured at baseline and 3, 12, and 24 months posttreatment.

Results

Mean lumbar spine and hip BMDs at last followup increased from baseline with no differences between groups to approximately 9% and 4% at 24 months, respectively. Both bone markers increased from baseline in the nonfracture group, peaking at 12 months. For the fracture group, only urine NTX increased at 3 and 12 months posttreatment. Although the peak levels of both bone markers in the nonfracture group were greater, there was no difference between the two groups.

Conclusions

Fracture does not have a negative effect on the BMD and bone marker responses to teriparatide treatment. Clinicians should anticipate comparable BMD responses when treating patients with teriparatide for osteoporotic fractures and for other indications.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment
Authors: Aasis Unnanuntana, MD
Quang V. Ton, MD
John P. Kleimeyer, BA
Joseph T. Nguyen, MPH
Joseph M. Lane, MD
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 3/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-2029-1

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Springer Medicine

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

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