| Title | EFFECTS OF TERIPARATIDE TREATMENT AND DISCONTINUATION IN POSTMENOPAUSAL WOMEN AND EUGONADAL MEN WITH OSTEOPOROSIS. | | Author(s) | Leder BZ, Neer RM, Wyland JJ, Lee H, Burnett-Bowie SA, Finkelstein JS | | Institution | Endocrine Unit, Department of Medicine (BZL, RMN, JJW, SMB, JSF), and Biostatistics Center (HWL), Massachusetts General Hospital, Boston, MA 02114. | | Source | J Clin Endocrinol Metab 2009 May 12. | | Abstract | Context: In postmenopausal women, bone mineral density (BMD) declines after teriparatide therapy is stopped. The pattern of BMD loss after teriparatide therapy is stopped in men is less clear.
Objective: To determine if the pattern of teriparatide-induced bone accrual and post-teriparatide bone loss differs between postmenopausal women and eugonadal men.
Design: Prospective cohort sub-study.
Patients: 14 postmenopausal women and 17 eugonadal men, age 46-85 with lumbar spine or femoral neck BMD T-scores < -2. Intervention: Teriparatide (37 mcg SC daily) for 24-months followed by 12-months off-therapy. Main Outcome Measures: BMD at various anatomic sites by dual-energy x-ray absorptiometry (DXA), trabecular spine BMD by quantitative computer tomography (QCT), and bone turnover markers were measured during the treatment and observation periods. The response to teriparatide administration and discontinuation was compared between female and males.
Results: BMD of the spine, femoral neck, total hip and trabecular spine increased similarly during the treatment period in men and women whereas BMD at the radius was stable in men but decreased by 8.1 +/-3.3% in women (P<0.0001). After teriparatide was stopped, BMD at the posterior-anterior spine decreased by 7.1 +/-3.8% in women and by 4.1 +/-3.5% in men (P=0.036). BMD at the total hip and femoral neck decreased by 3.8 +/-3.9 and 3.1 +/- 4.3%, respectively in women but remained stable in men (P<0.05 for both sites). BMD at the distal radius remained stable in men but increased in women by 1.6 +/-3.1% (P=0.069).
Conclusions: Teriparatide appears to increase BMD similarly in postmenopausal women and eugonadal men with osteoporosis. After teriparatide is stopped, the decline in BMD is greater in women than in men. If confirmed in larger cohorts, these findings would suggest that the indication for immediate antiresorptive therapy after teriparatide may not be as urgent in men as in women. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19435827 |
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