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Osteoporosis International

Baseline serum PINP is associated with early lumbar spine bone mineral density gains during twice-weekly teriparatide treatment: the OASIS cohort study

Authors
Rui Niimi
Tomonori Kobayakawa
Yuki Etani
Takaaki Noguchi
Atsushi Sugimoto
Ken Nakata
Seiji Okada
Masahiro Hasegawa
Kosuke Ebina
Published in
Osteoporosis International

Abstract

Summary

Baseline serum PINP was significantly and independently associated with achieving a ≥ 8% increase in lumbar spine (LS) bone mineral density (BMD) after 12 months of twice-weekly teriparatide therapy.

Purpose

Early predictors of the BMD response to twice-weekly teriparatide remain poorly defined. This study aimed to identify clinical and biochemical determinants of early LS BMD improvement under this regimen.

Method

In this retrospective multicenter cohort study, 242 osteoporosis patients at high fracture risk completed 12 months of twice-weekly teriparatide (28.2 μg). At baseline, 88.0% were female, mean age was 80.0 years, 83.5% had a history of osteoporotic fracture, and 72.3% were treatment-naïve. Multivariate regression was performed to identify independent predictors of LS BMD change, and receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff value for predicting an LS BMD increase ≥ 8% at 12 months.

Results

The percent change (mean ± standard deviation) in LS BMD was 7.0 ± 8.6%, and 41.3% of patients achieved an LS BMD increase ≥ 8% at 12 months. In the multivariate model, baseline total procollagen type I N-terminal propeptide (PINP) was significantly and independently associated with percent LS BMD change (standardized coefficient = 2.73, p < 0.001). ROC analysis identified a baseline PINP cutoff of 53.1 μg/L for predicting ≥ 8% LS BMD increase (sensitivity 74.4%, specificity 60.5%, area under the curve = 0.67).

Conclusion

Baseline serum PINP represents one of the clinically relevant independent predictors of early LS BMD response to twice-weekly teriparatide.
Title
Baseline serum PINP is associated with early lumbar spine bone mineral density gains during twice-weekly teriparatide treatment: the OASIS cohort study
Authors
Rui Niimi
Tomonori Kobayakawa
Yuki Etani
Takaaki Noguchi
Atsushi Sugimoto
Ken Nakata
Seiji Okada
Masahiro Hasegawa
Kosuke Ebina
Publication date
06-04-2026
Publisher
Springer London
Published in
Osteoporosis International
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-026-07985-9
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