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Osteoporosis International

Open Access 01-12-2013 | Original Article

Early changes in biochemical markers of bone formation during teriparatide therapy correlate with improvements in vertebral strength in men with glucocorticoid-induced osteoporosis

Authors: P. Farahmand, F. Marin, F. Hawkins, R. Möricke, J. D. Ringe, C.-C. Glüer, N. Papaioannou, S. Minisola, G. Martínez, J. M. Nolla, C. Niedhart, N. Guañabens, R. Nuti, E. Martín-Mola, F. Thomasius, J. Peña, C. Graeff, G. Kapetanos, H. Petto, A. Gentzel, A. Reisinger, P. K. Zysset

Published in: Osteoporosis International | Issue 12/2013

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Abstract

Summary

Changes of the bone formation marker PINP correlated positively with improvements in vertebral strength in men with glucocorticoid-induced osteoporosis (GIO) who received 18-month treatment with teriparatide, but not with risedronate. These results support the use of PINP as a surrogate marker of bone strength in GIO patients treated with teriparatide.

Introduction

To investigate the correlations between biochemical markers of bone turnover and vertebral strength estimated by finite element analysis (FEA) in men with GIO.

Methods

A total of 92 men with GIO were included in an 18-month, randomized, open-label trial of teriparatide (20 μg/day, n = 45) and risedronate (35 mg/week, n = 47). High-resolution quantitative computed tomography images of the 12th thoracic vertebra obtained at baseline, 6 and 18 months were converted into digital nonlinear FE models and subjected to anterior bending, axial compression and torsion. Stiffness and strength were computed for each model and loading mode. Serum biochemical markers of bone formation (amino-terminal-propeptide of type I collagen [PINP]) and bone resorption (type I collagen cross-linked C-telopeptide degradation fragments [CTx]) were measured at baseline, 3 months, 6 months and 18 months. A mixed-model of repeated measures analysed changes from baseline and between-group differences. Spearman correlations assessed the relationship between changes from baseline of bone markers with FEA variables.

Results

PINP and CTx levels increased in the teriparatide group and decreased in the risedronate group. FEA-derived parameters increased in both groups, but were significantly higher at 18 months in the teriparatide group. Significant positive correlations were found between changes from baseline of PINP at 3, 6 and 18 months with changes in FE strength in the teriparatide-treated group, but not in the risedronate group.

Conclusions

Positive correlations between changes in a biochemical marker of bone formation and improvement of biomechanical properties support the use of PINP as a surrogate marker of bone strength in teriparatide-treated GIO patients.
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Metadata
Title
Early changes in biochemical markers of bone formation during teriparatide therapy correlate with improvements in vertebral strength in men with glucocorticoid-induced osteoporosis
Authors
P. Farahmand
F. Marin
F. Hawkins
R. Möricke
J. D. Ringe
C.-C. Glüer
N. Papaioannou
S. Minisola
G. Martínez
J. M. Nolla
C. Niedhart
N. Guañabens
R. Nuti
E. Martín-Mola
F. Thomasius
J. Peña
C. Graeff
G. Kapetanos
H. Petto
A. Gentzel
A. Reisinger
P. K. Zysset
Publication date
01-12-2013
Publisher
Springer London
Published in
Osteoporosis International / Issue 12/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-013-2379-5