Histomorphometric changes by teriparatide in alendronate-pretreated women with osteoporosis

• Published in: Osteoporosis international 2010-12, Vol.21 (12), p.2027-2036
• Main Authors: Stepan, J. J, Burr, D. B, Li, J, Ma, Y. L, Petto, H, Sipos, A, Dobnig, H, Fahrleitner-Pammer, A, Michalská, D, Pavo, I
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alendronate; Alendronate - therapeutic use; Biological and medical sciences; Biomarkers; Biomarkers - blood; Biopsy; Bone Density - drug effects; Bone Density Conservation Agents - therapeutic use; Bone Remodeling - drug effects; Bone turnover; Bones, joints and connective tissue. Antiinflammatory agents; Diseases of the osteoarticular system; Drug Substitution; Drug therapy; Effects; Endocrinology; Female; Femur Neck - physiopathology; Fundamental and applied biological sciences. Psychology; Histomorphometry; Humans; Lumbar Vertebrae - physiopathology; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteogenesis - drug effects; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - pathology; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Pharmacology. Drug treatments; Rheumatology; Skeleton and joints; Teriparatide; Teriparatide - therapeutic use; Treatment Outcome; Vertebrates: osteoarticular system, musculoskeletal system; Women
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-009-1168-7

Summary The level of increased bone formation after 24 months of treatment with teriparatide (rhPTH (1-34), TPTD) is similar in patients who were either treatment-naïve (TN) or had lower bone turnover initially due to previous alendronate (ALN) therapy. Introduction Bone anabolic effects of TPTD in postmenopausal women with osteoporosis may be blunted during the initial phase after switching from ALN to TPTD. To explore the long-term implications, we examined histomorphometric and biochemical markers of bone turnover of patients on TPTD therapy after long-term ALN treatment. Methods Paired biopsies were obtained after tetracycline double labeling at baseline and after 24 months of TPTD treatment from 29 ALN-pretreated (64.5 ± 16.4 months) and 16 TN patients. Biochemical markers were measured at baseline, during the treatment, or at study end. Results Compared with the baseline, after 24-month TPTD, activation frequency (Ac.F.) and osteoid surface (OS) increased in both groups: 0.11-0.34 cycles per year, 3.96-9.8% in the ALN-pretreated group and 0.19-0.33 cycles per year, 6.2-11.3% (p