Efficacy of switching from teriparatide to zoledronic acid or denosumab on bone mineral density and biochemical markers of bone turnover in older patients with severe osteoporosis: a real-life study

• Published in: Endocrine 2023-10, Vol.82 (1), p.181-189
• Main Authors: Dito, Giorgia, Lugaresi, Marina, Degradi, Chiara, Guabello, Gregorio, Longhi, Matteo, Corbetta, Sabrina
• Format: Article
• Language: English
• Subjects: Biochemical markers; Bisphosphonates; Bone density; Bone mass; Bone mineral density; Bone turnover; Diabetes; Endocrinology; Fractures; Hip; Humanities and Social Sciences; Internal Medicine; Medicine; Medicine & Public Health; Mineralization; multidisciplinary; Original; Original Article; Osteoporosis; Parathyroid hormone; Science; Zoledronic acid
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-023-03431-6

Purpose Osteoporosis is characterized by loss of bone mass and susceptibility to fracture. Skeletal effects of teriparatide (TPT) are not persistent after drug withdrawal and sequential therapy with bisphosphonates or denosumab (Dmab) after TPT discontinuation represents a valid option. Here, the two sequential strategies were evaluated in severe osteoporotic patients. Methods The study retrospectively enrolled 56 severe osteoporotic patients who received TPT for 24 months followed by 24 months of zoledronic acid (ZOL) (TPT + ZOL) or Dmab (TPT+Dmab). Clinical features, incident fractures, bone mineral density (BMD) measurements, and bone marker profiles were collected. One-way ANOVA analyzed the difference between mean T-scores at baseline, after 24 months of TPT, and after 2 doses of ZOL or after at least 3 doses of Dmab. Results Twenty-three patients received TPT + ZOL (19 females, 4 males; median [IR] age, 74.3 [66.9, 78.6] years) and 33 patients received TPT+Dmab (31 females, 2 males; mean [IR] age, 66.6 ± 11.3 years). Mean lumbar and hip T-scores were increased after both TPT + ZOL and TPT+Dmab (all p