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Sustained nonvertebral fragility fracture risk reduction after discontinuation of teriparatide treatment.
J Bone Miner Res. 2005 Sep; 20(9):1507-13.JB

Abstract

A follow-up in 1262 women was conducted after the discontinuation of teriparatide. The hazard ratio for combined teriparatide group (20 and 40 microg) for the 50-month period after baseline was 0.57 (p = 0.002), suggesting a sustained effect in reducing the risk of nonvertebral fragility fracture.

INTRODUCTION

Treatment with teriparatide [rhPTH(1-34)] 20 and 40 microg once-daily subcutaneous dosing significantly reduced the risk of nonvertebral fragility fractures over a median exposure of 19 months.

MATERIALS AND METHODS

All participants in the Fracture Prevention Trial were invited to participate in a follow-up study. Prior treatment assignments were revealed, and patients were able to receive osteoporosis treatments without restriction.

RESULTS

Approximately 60% of the 1262 patients received an osteoporosis treatment at some time during follow-up, with greater use in the former placebo group than in the combined former teriparatide group (p < 0.05). The hazard ratios for nonvertebral fragility fractures in each teriparatide group relative to placebo were statistically significant for the 50-month period including treatment and follow-up (p < 0.03). In the follow-up period, the hazard ratio was significantly different between the 40 mug and combined groups versus placebo but not for the 20 microg group versus placebo. However, the 20 and 40 microg groups were not different from each other. Kaplan-Meier analysis of time to fracture showed that the fracture incidence in the former placebo and teriparatide groups diverged during the 50-month period including teriparatide treatment and follow-up (p = 0.009). Total hip and femoral neck BMD decreased in teriparatide-treated patients who had no follow-up treatment; BMD remained stable or further increased in patients who received a bisphosphonate after teriparatide treatment.

CONCLUSIONS

While the study design is observational, the results support a sustained effect of teriparatide in reducing the risk of nonvertebral fragility fractures up to 30 months after discontinuation of treatment.

Authors+Show Affiliations

Department of Endocrinology and Diabetes and University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16059622

Citation

Prince, Richard, et al. "Sustained Nonvertebral Fragility Fracture Risk Reduction After Discontinuation of Teriparatide Treatment." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 9, 2005, pp. 1507-13.
Prince R, Sipos A, Hossain A, et al. Sustained nonvertebral fragility fracture risk reduction after discontinuation of teriparatide treatment. J Bone Miner Res. 2005;20(9):1507-13.
Prince, R., Sipos, A., Hossain, A., Syversen, U., Ish-Shalom, S., Marcinowska, E., Halse, J., Lindsay, R., Dalsky, G. P., & Mitlak, B. H. (2005). Sustained nonvertebral fragility fracture risk reduction after discontinuation of teriparatide treatment. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(9), 1507-13.
Prince R, et al. Sustained Nonvertebral Fragility Fracture Risk Reduction After Discontinuation of Teriparatide Treatment. J Bone Miner Res. 2005;20(9):1507-13. PubMed PMID: 16059622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained nonvertebral fragility fracture risk reduction after discontinuation of teriparatide treatment. AU - Prince,Richard, AU - Sipos,Adrien, AU - Hossain,Anwar, AU - Syversen,Unni, AU - Ish-Shalom,Sophia, AU - Marcinowska,Ewa, AU - Halse,Johan, AU - Lindsay,Robert, AU - Dalsky,Gail P, AU - Mitlak,Bruce H, Y1 - 2005/05/02/ PY - 2004/12/06/received PY - 2005/04/06/revised PY - 2005/04/27/accepted PY - 2005/8/2/pubmed PY - 2006/1/5/medline PY - 2005/8/2/entrez SP - 1507 EP - 13 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 20 IS - 9 N2 - UNLABELLED: A follow-up in 1262 women was conducted after the discontinuation of teriparatide. The hazard ratio for combined teriparatide group (20 and 40 microg) for the 50-month period after baseline was 0.57 (p = 0.002), suggesting a sustained effect in reducing the risk of nonvertebral fragility fracture. INTRODUCTION: Treatment with teriparatide [rhPTH(1-34)] 20 and 40 microg once-daily subcutaneous dosing significantly reduced the risk of nonvertebral fragility fractures over a median exposure of 19 months. MATERIALS AND METHODS: All participants in the Fracture Prevention Trial were invited to participate in a follow-up study. Prior treatment assignments were revealed, and patients were able to receive osteoporosis treatments without restriction. RESULTS: Approximately 60% of the 1262 patients received an osteoporosis treatment at some time during follow-up, with greater use in the former placebo group than in the combined former teriparatide group (p < 0.05). The hazard ratios for nonvertebral fragility fractures in each teriparatide group relative to placebo were statistically significant for the 50-month period including treatment and follow-up (p < 0.03). In the follow-up period, the hazard ratio was significantly different between the 40 mug and combined groups versus placebo but not for the 20 microg group versus placebo. However, the 20 and 40 microg groups were not different from each other. Kaplan-Meier analysis of time to fracture showed that the fracture incidence in the former placebo and teriparatide groups diverged during the 50-month period including teriparatide treatment and follow-up (p = 0.009). Total hip and femoral neck BMD decreased in teriparatide-treated patients who had no follow-up treatment; BMD remained stable or further increased in patients who received a bisphosphonate after teriparatide treatment. CONCLUSIONS: While the study design is observational, the results support a sustained effect of teriparatide in reducing the risk of nonvertebral fragility fractures up to 30 months after discontinuation of treatment. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/16059622/Sustained_nonvertebral_fragility_fracture_risk_reduction_after_discontinuation_of_teriparatide_treatment_ L2 - https://doi.org/10.1359/JBMR.050501 DB - PRIME DP - Unbound Medicine ER -