Teriparatide reduces bone microdamage accumulation in postmenopausal women previously treated with alendronate

Harald Dobnig, Jan J. Stepan, David Burr, Jiliang Li, Dana Michalská, Adrien Sipos, Helmut Petto, Astrid Fahrleitner-Pammer, Imre Pavo

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Suppression of bone turnover by bisphosphonates is associated with increased bone microdamage accumulation in animal models. Our objective was to study the effects of teriparatide treatment on changes in microdamage accumulation at the iliac crest in previously treatment-naïve patients or in those switched from alendronate to teriparatide. Sixty-six postmenopausal women with osteoporosis (mean age, 68.0 yr; and mean BMD T-score of -2.8 at lumbar spine and -1.7 at total hip; 62% with prevalent fractures) entered this prospective, nonrandomized study and started with 24-mo 20 μg/d subcutaneous teriparatide treatment in monotherapy: 38 patients stopped previous alendronate treatment (10 mg/d or 70 mg/wk for a mean duration of 63.6 mo) and switched to teriparatide, whereas 28 were previously treatment naïve. Thirty-one paired biopsies with two intact cortices were collected and analyzed for microstructure and microdamage accumulation at baseline and after 24 mo of teriparatide administration. After 24 mo of teriparatide treatment, crack density (Cr.Dn), crack surface density (Cr.S.Dn), and crack length (Cr.Le) were decreased in previously alendronate-treated patients, whereas only Cr.Le was reduced in former treatment naïve patients. Patients with lower initial femoral neck BMD also showed a higher reduction of microdamage accumulation. Better bone microarchitecture correlated positively, whereas bone turnover markers and age did not correlate with reduced microdamage accumulation on teriparatide. In conclusion, teriparatide reduces microdamage accumulation in the iliac crest of patients previously treated with alendronate. There is insufficient evidence to suggest that age or bone turnover would be associated with this change.

Original languageEnglish
Pages (from-to)1998-2006
Number of pages9
JournalJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Volume24
Issue number12
DOIs
StatePublished - Dec 2009

Fingerprint

Teriparatide
Alendronate
Bone and Bones
Bone Remodeling
Therapeutics
Femur Neck
Diphosphonates
Osteoporosis
Hip
Spine
Animal Models
Prospective Studies
Biopsy

Keywords

  • Alendronate
  • Bone microdamage
  • Histomorphometry
  • Osteoporosis
  • Teriparatide

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Teriparatide reduces bone microdamage accumulation in postmenopausal women previously treated with alendronate. / Dobnig, Harald; Stepan, Jan J.; Burr, David; Li, Jiliang; Michalská, Dana; Sipos, Adrien; Petto, Helmut; Fahrleitner-Pammer, Astrid; Pavo, Imre.

In: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, Vol. 24, No. 12, 12.2009, p. 1998-2006.

Research output: Contribution to journalArticle

Dobnig, Harald ; Stepan, Jan J. ; Burr, David ; Li, Jiliang ; Michalská, Dana ; Sipos, Adrien ; Petto, Helmut ; Fahrleitner-Pammer, Astrid ; Pavo, Imre. / Teriparatide reduces bone microdamage accumulation in postmenopausal women previously treated with alendronate. In: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 2009 ; Vol. 24, No. 12. pp. 1998-2006.
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