Differential effects of teriparatide, denosumab and zoledronate on hip structural and mechanical parameters in osteoporosis; a real-life study

• Published in: Journal of endocrinological investigation 2024-07, Vol.47 (7), p.1667-1677
• Main Authors: Jaarah, N., Lam, C. F. J., Lodhia, N., Dulnoan, D., Moore, A. E., Hampson, G.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Aged; Aged, 80 and over; Bone Density - drug effects; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - therapeutic use; Bone mineral density; Denosumab - administration & dosage; Denosumab - therapeutic use; Diphosphonates - administration & dosage; Diphosphonates - therapeutic use; Dual energy X-ray absorptiometry; Endocrinology; Female; Femur; Follow-Up Studies; Geometry; Hip; Humans; Internal Medicine; Male; Mechanical properties; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original; Original Article; Osteoporosis; Osteoporosis - drug therapy; Osteoporosis - pathology; Parathyroid hormone; Retrospective Studies; Spine (lumbar); Teriparatide - administration & dosage; Teriparatide - pharmacology; Teriparatide - therapeutic use; Zoledronic acid; Zoledronic Acid - administration & dosage; Zoledronic Acid - pharmacology; Zoledronic Acid - therapeutic use
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-023-02280-4

Purpose The aim of this study was to evaluate changes in hip geometry parameters following treatment with teriparatide (TPD), denosumab (Dmab) and zoledronate (ZOL) in real-life setting. Methods We studied 249 patients with osteoporosis (OP) with mean [SD] age of 71.5 [11.1] years divided into 3 treatment groups; Group A received TPD; n  = 55, Group B (Dmab); n  = 116 and Group C (ZOL); n  = 78 attending a routine metabolic bone clinic. Bone mineral density (BMD) was measured by DXA at the lumbar spine (LS), total hip (TH) and femoral neck (FN) prior to treatment and after 2 years (Group A), after a mean treatment duration of 3.3 [1.3] years (Group B) and after 1, 2 and 3 doses of ZOL (Group C) to assess treatment response. Hip structural analysis (HSA) was carried out retrospectively from DXA-acquired femur images at the narrow neck (NN), the intertrochanter (IT) and femoral shaft (FS). Results Changes in p arameters of hip geometry and mechanical strength were seen in the following treatment. Percentage change in cross-sectional area (CSA): 3.56[1.6] % p  = 0.01 and cross-sectional moment of inertia (CSMI): 4.1[1.8] % p  = 0.029 increased at the NN only in Group A. Improvement in HSA parameters at the IT were seen in group B: CSA: 3.3[0.67]% p