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Effects of Teriparatide, Denosumab, or Both on Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial.
J Clin Densitom. 2017 Oct - Dec; 20(4):507-512.JC

Abstract

In postmenopausal women, 2 yr of combined teriparatide and denosumab increases bone mineral density more than either drug alone, and switching from either combination or teriparatide to denosumab for an additional 2 yr further increases bone mineral density. Conversely, switching from denosumab to teriparatide results in transient bone loss. The effects of these interventions on spine microarchitecture are unknown. In the DATA and DATA-Switch studies, 94 postmenopausal osteoporotic women were randomized to receive 24 mo of teriparatide (20 µg daily), denosumab (60 mg every 6 mo), or both. Then, women originally assigned to 24 mo of teriparatide received 24 mo of denosumab, whereas subjects originally randomized to 24 mo of denosumab received 24 mo of teriparatide. Subjects who received both drugs received an additional 24 mo of denosumab alone. Spine trabecular bone score (TBS, a gray-level textural assessment of bone microarchitecture) was measured blinded from treatment groups using images from 2-dimensional dual-energy X-ray absorptiometry spine scans at 0, 12, 24, 30, 36, and 48 mo in 65 women who had posterior-anterior spine dual-energy X-ray absorptiometry images suitable for TBS analysis. After 24 mo, TBS increased by 2.7 ± 4.7% in the teriparatide group (p = 0.009 vs baseline), by 1.8 ± 5.0% in the denosumab group (p = 0.118 vs baseline), and by 4.5 ± 6.7% in the combination group (p = 0.017 vs baseline), with no significant between-group differences. In the 6 mo after the treatments were switched (months 24-30), TBS continued to increase in the combination-to-denosumab and teriparatide-to-denosumab groups but decreased by -1.1 ± 4.0% in the denosumab-to-teriparatide group (p < 0.05 vs other groups). After 48 mo, compared to month 0, TBS increased by 5.1 ± 5.8% in the teriparatide-to-denosumab group, by 3.6 ± 4.2% in the denosumab-to-teriparatide group, and by 6.1 ± 4.7% in the combination-to-denosumab group (p < 0.001 vs baseline for all groups, p = not significant for between-group differences). Switching from teriparatide to denosumab also increased spine TBS. Conversely, switching from denosumab to teriparatide transiently degraded spine trabecular microarchitecture, the clinical consequences of which require further study.

Authors+Show Affiliations

Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA. Electronic address: jntsai@mgh.harvard.edu.Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.Center of Bone Disease, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28624340

Citation

Tsai, Joy N., et al. "Effects of Teriparatide, Denosumab, or Both On Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial." Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry, vol. 20, no. 4, 2017, pp. 507-512.
Tsai JN, Jiang LA, Lee H, et al. Effects of Teriparatide, Denosumab, or Both on Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial. J Clin Densitom. 2017;20(4):507-512.
Tsai, J. N., Jiang, L. A., Lee, H., Hans, D., & Leder, B. Z. (2017). Effects of Teriparatide, Denosumab, or Both on Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial. Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry, 20(4), 507-512. https://doi.org/10.1016/j.jocd.2017.05.007
Tsai JN, et al. Effects of Teriparatide, Denosumab, or Both On Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial. J Clin Densitom. 2017 Oct - Dec;20(4):507-512. PubMed PMID: 28624340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Teriparatide, Denosumab, or Both on Spine Trabecular Microarchitecture in DATA-Switch: a Randomized Controlled Trial. AU - Tsai,Joy N, AU - Jiang,Linda A, AU - Lee,Hang, AU - Hans,Didier, AU - Leder,Benjamin Z, Y1 - 2017/06/16/ PY - 2017/03/29/received PY - 2017/04/20/revised PY - 2017/05/15/accepted PY - 2017/6/19/pubmed PY - 2018/7/7/medline PY - 2017/6/19/entrez KW - Denosumab KW - osteoporosis KW - teriparatide SP - 507 EP - 512 JF - Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry JO - J Clin Densitom VL - 20 IS - 4 N2 - In postmenopausal women, 2 yr of combined teriparatide and denosumab increases bone mineral density more than either drug alone, and switching from either combination or teriparatide to denosumab for an additional 2 yr further increases bone mineral density. Conversely, switching from denosumab to teriparatide results in transient bone loss. The effects of these interventions on spine microarchitecture are unknown. In the DATA and DATA-Switch studies, 94 postmenopausal osteoporotic women were randomized to receive 24 mo of teriparatide (20 µg daily), denosumab (60 mg every 6 mo), or both. Then, women originally assigned to 24 mo of teriparatide received 24 mo of denosumab, whereas subjects originally randomized to 24 mo of denosumab received 24 mo of teriparatide. Subjects who received both drugs received an additional 24 mo of denosumab alone. Spine trabecular bone score (TBS, a gray-level textural assessment of bone microarchitecture) was measured blinded from treatment groups using images from 2-dimensional dual-energy X-ray absorptiometry spine scans at 0, 12, 24, 30, 36, and 48 mo in 65 women who had posterior-anterior spine dual-energy X-ray absorptiometry images suitable for TBS analysis. After 24 mo, TBS increased by 2.7 ± 4.7% in the teriparatide group (p = 0.009 vs baseline), by 1.8 ± 5.0% in the denosumab group (p = 0.118 vs baseline), and by 4.5 ± 6.7% in the combination group (p = 0.017 vs baseline), with no significant between-group differences. In the 6 mo after the treatments were switched (months 24-30), TBS continued to increase in the combination-to-denosumab and teriparatide-to-denosumab groups but decreased by -1.1 ± 4.0% in the denosumab-to-teriparatide group (p < 0.05 vs other groups). After 48 mo, compared to month 0, TBS increased by 5.1 ± 5.8% in the teriparatide-to-denosumab group, by 3.6 ± 4.2% in the denosumab-to-teriparatide group, and by 6.1 ± 4.7% in the combination-to-denosumab group (p < 0.001 vs baseline for all groups, p = not significant for between-group differences). Switching from teriparatide to denosumab also increased spine TBS. Conversely, switching from denosumab to teriparatide transiently degraded spine trabecular microarchitecture, the clinical consequences of which require further study. SN - 1094-6950 UR - https://www.unboundmedicine.com/medline/citation/28624340/Effects_of_Teriparatide_Denosumab_or_Both_on_Spine_Trabecular_Microarchitecture_in_DATA_Switch:_a_Randomized_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1094-6950(17)30034-3 DB - PRIME DP - Unbound Medicine ER -