ABSTRACT
Objective:
The aim of this study was to determine the effects of teriparatide treatment on bone mineral density (BMD), back pain, and biochemical parameters in patients with severe postmenopausal osteoporosis.
Materials and Methods:
The study included 13 patients with severe postmenopausal osteoporosis who were followed up at our osteoporosis outpatient clinic and completed treatment or currently undergoing treatment with subcutaneous 20 μq/day teriparatide. Patients were retrospectively evaluated before and after treatment with regards to BMD, biochemical parameters, and severity of back pain.
Results:
When the pre and post treatment values of the patients included in the study were compared, there was a statistically significant improvement in the BMD and severity of back pain after treatment (p<0.05), while the biochemical parameters did not differ significantly (p>0.05).
Conclusion:
In patients with severe postmenopausal osteoporosis, teriparatide therapy is seemed to be an effective treatment choice by improving the BMD values and reducing the back pain.
Keywords:
Back pain, severe osteoporosis, teriparatide
References
1Rizzoli R. Postmenopausal Osteoporosis: assessment and management. Best Pract Res Clin Endocrinol Metab 2018;32:739-57.
2Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 2012;23:949-55.
3Yıldızgören MT, Öziş TN, Baki AE, Tutkun E, Yılmaz H, Tiftik T, et al. Evaluation of bone mineral density and 25-hydroxyvitamin D levels in subjects with silica exposure. Environ Health Prev Med 2016;21:149-53.
4Hodsman AB, Bauer DC, Dempster DW, Dian L, Hanley DA, Harris ST, et al. Parathyroid hormone and teriparatide for the treatment of osteoporosis: A review of the evidence and suggested guidelines for its use. Endocr Rev 2005;26:688-703.
5Chen P, Miller PD, Rocker R, Resch H, Ranan A, Pavo I, et al. Increase in BMD correlate with improvements in bone microarchitecture with Teriparatide treatment in post-menopausal women with osteoporosis. J Bone Miner Res 2007;22:1173-80.
6Ma YL, Zeng Q, Donley DW, Ste-Marie LG, Gallagher JC, Dalsky GP, et al. Teriparatide increases bone formation in modeling and remodeling osteons and enhances IGF-II immunoreactivity in postmenopausal women with osteoporosis. J Bone Miner Res 2006;21:855-64.
7Bodenner D, Redman C, Riggs A. Teriparatide in the management of osteoporosis. Clin Interv Aging 2007;2:499-507.
8Çevikol A, Karaahmet ÖZ, Gürçay E, Karataş G, Karaca Umay E, Çakcı A. Şiddetli Osteoporozlu Hastalarda Teriparatid Tedavisi: Kemik Mineral Yoğunluğu, Biyokimyasal Parametreler, Sırt Ağrısı ve Yaşam Kalitesi Üzerine Etkiler. Turk J Osteoporos 2014;20:51-5.
9The WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Geneva. World Health Organ Tech Rep Ser. 1994;843:1-129.
10Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semi quantitative technique. J Bone Miner Res 1993;8:1137-48.
11Akarırmak Ü, Özkul İ. Osteoporoz tedavisinde paratiroid hormon (PTH). Turk J Osteoporos 2002;8:40-6.
12Rubin MR, Comsan F, Lindsay R, Bilezikian JP. The anabolic effects of parathroid hormone. Osteoporos Int 2002;13:267-77.
13Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001;344:1434-41.
14Özşahin M, Büyükkaya R, Kaya E, Baki AE, Aydın Y, Çelebi E, ve ark. Postmenopozal Osteoporoz Tedavisinde Teriparatid ve Alendronat Sodyumun Etkinliğinin Karşılaştırılması. Duzce Medical Journal 2013;15:30-3.
15Berry SD, Dufour AB, Travison TG, Zhu H, Yehoshua A, Barron R, et al. Changes in bone mineral density (BMD): a longitudinal study of osteoporosis patients in the real-world setting. Arch Osteoporos 2018;12;13:124.
16Akyol Y, Atmaca A, Durmuş D, Ulus Y, Tander B, Alaylı G. Şiddetli Postmenopozal Osteoporozlu Hastalarda Teriparatid Tedavisinin Ağrı, Yaşam Kalitesi, Depresyon ve Biyokimyasal Parametreler Üzerine Etkisi: Erken Dönem Sonuçlar. Turk J Phys Med Rehab 2011;57:134-8.
17Orwoll ES, Scheele WH, Paul S, Adami S, Syversen U, Diez-Perez A, et al. The effect of teriparatide [human parathyroid hormone (1-34)] therapy on bone density in men with osteoporosis. J Bone Miner Res 2003;18:9-17.
18Langdahl BL, Gerald R, Jakop F, Karras D, Ljunggren O, Lems WF, et al. Reduction in fracture rate and back pain and increased quality of life in postmenopausal women treated with teriparatide: 18-month data from the European Forsteo Observational Study (EFOS). Calcif Tissue Int 2009;85:484-93.
19Nevitt MC, Chen P, Dore RK, Reginster JY, Kiel DP, Zanchetta JR, et al. Reduced risk of back pain following teriparatide treatment:a meta analysis Osteoporos Int 2006;17:273-80.
20Nakajima A, Shimoji N, Shiomi K, Shimizu S, Moriya H, Einhorn TA, et al. Mechanisms for the enhancement of fracture healing in rats treated with intermittent low-dose human parathyroid hormone (1-34). J Bone Miner Res 2002;17:2038-47.
21Shi Z, Zhou H, Pan B, Lu L, Liu J, Kang Y, et al. Effectiveness of Teriparatide on Fracture Healing: A Systematic Review and Meta-Analysis. PLoS One 2016;11:e0168691.
