Effect of prior and ongoing raloxifene therapy on response to PTH and maintenance of BMD after PTH therapy

• Published in: Osteoporosis international 2008-04, Vol.19 (4), p.529-535
• Main Authors: Cosman, F., Nieves, J. W., Zion, M., Barbuto, N., Lindsay, R.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Bone density; Bone Density - drug effects; Bone Density - physiology; Bone Density Conservation Agents - metabolism; Bone Density Conservation Agents - therapeutic use; Bone Resorption - drug therapy; Bone Resorption - physiopathology; Clinical outcomes; Diseases of the osteoarticular system; Drug therapy; Endocrinology; Female; Follow-Up Studies; Humans; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Parathyroid Hormone - metabolism; Parathyroid Hormone - secretion; Parathyroid Hormone - therapeutic use; Raloxifene Hydrochloride - metabolism; Raloxifene Hydrochloride - therapeutic use; Rheumatology; Treatment Outcome; Women
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-007-0475-0

Summary Women with osteoporosis on raloxifene were randomized to 1-34hPTH + raloxifene or raloxifene alone for one year. In the PTH + raloxifene group, bone turnover increased 125–584%, spine BMD increased 9.6%, hip BMD increased 1.2–3.6% and radius BMD declined 4.3%. During the follow-up year, on continued raloxifene, BMD declined slightly at all sites except the femoral neck. Introduction The influence of prior antiresorptives on response to 1–34PTH and the ability to maintain BMD gains might differ for antiresorptive agents with different potencies. The objectives were to evaluate biochemical and bone density responses to 1–34PTH in patients on prior and ongoing raloxifene and to determine whether raloxifene maintains bone gains. Methods Forty-two postmenopausal women with osteoporosis on raloxifene were randomized to raloxifene alone or 1–34PTH daily for 12 months (continuing raloxifene). Women were then followed for 12 months on raloxifene alone. Bone turnover markers and BMD were measured at baseline and at 3, 6, 12, 18 and 24 months. Results Biochemical indices increased rapidly during PTH treatment with peak increments of 125–584% for the three markers (p