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Comparative Effect of rhPTH(1-84) on Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis.
J Bone Miner Res. 2018 12; 33(12):2132-2139.JB

Abstract

Parathyroid hormone (PTH) (1-84) improves lumbar spine (LS) areal bone mineral density (aBMD) and trabecular bone score (TBS) in hypoparathyroidism over a 2-year treatment period. Studies in osteoporosis have shown that with PTH(1-34) there is a significant increase in LS aBMD and TBS. In this article, we provide new data comparing the effects of the same form of PTH, namely recombinant human PTH, rhPTH(1-84), on aBMD and TBS in hypoparathyroid and osteoporotic patients over an 18-month treatment period. We studied 19 premenopausal (mean age 45.8 ± 11.8 years) and 16 postmenopausal (71 ± 8.4 years) hypoparathyroid women and 38 women with postmenopausal osteoporosis (71 ± 8.3 years). DXA (hologic) at LS, femoral neck, total hip, and distal one-third radius was assessed. Site-matched LS TBS data were extracted from deidentified spine DXA scans using the TBS iNsight software (version 2.1; Medimaps, Geneva, Switzerland). We observed a significant increase in LS aBMD in premenopausal and postmenopausal hypoparathyroid (3 ± 1.1%, p < 0.02 and 3.1 ± 1.4%, p < 0.05, respectively) and osteoporosis (6.2 ± 1.1%, p < 0.0001) patients after 18 months. There was a significant increase (3 ± 1.5%, p = 0.05) in TBS in premenopausal hypoparathyroid patients. A change in TBS was not observed in either postmenopausal group. One-third radius aBMD significantly declined in postmenopausal hypoparathyroid (-3.6 ± 1.1%, p < 0.01) and osteoporosis (-8 ± 1.4%, p < 0.0001) patients. Overall, there was a significantly greater increase in TBS in premenopausal hypoparathyroid than in osteoporosis patients (p < 0.0001) after adjusting for baseline values, age, BMI, and average daily dose of rhPTH(1-84). Comparing only postmenopausal women, the LS aBMD increase was greater in osteoporotic than hypoparathyroid subjects (p < 0.01). Our results demonstrate that rhPTH(1-84) administered for 18 months increases trabecular aBMD in hypoparathyroidism and postmenopausal osteoporosis with greater gains observed in the subjects with osteoporosis. The data suggest different effects of PTH on bone depending on the baseline skeletal structure, skeletal dynamics, compartments, and menopausal status. © 2018 American Society for Bone and Mineral Research.

Authors+Show Affiliations

Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.Department of Medicine, Division of Endocrinology, Santa Casa de Belo Horizonte, and Felicio Rocho Hospital, Belo Horizonte, Brazil.Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physician and Surgeons, Columbia University, New York, NY, USA.Division of Endocrinology, Department of Medicine, Lenox Hill Hospital, New York, NY, USA.Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physician and Surgeons, Columbia University, New York, NY, USA.Faculty of Economics, UNINT University, Rome, Italy.Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.Department of Radiology, Sapienza University of Rome, Rome, Italy.Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physician and Surgeons, Columbia University, New York, NY, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30088838

Citation

Cipriani, Cristiana, et al. "Comparative Effect of rhPTH(1-84) On Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 33, no. 12, 2018, pp. 2132-2139.
Cipriani C, Pepe J, Silva BC, et al. Comparative Effect of rhPTH(1-84) on Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis. J Bone Miner Res. 2018;33(12):2132-2139.
Cipriani, C., Pepe, J., Silva, B. C., Rubin, M. R., Cusano, N. E., McMahon, D. J., Nieddu, L., Angelozzi, M., Biamonte, F., Diacinti, D., Hans, D., Minisola, S., & Bilezikian, J. P. (2018). Comparative Effect of rhPTH(1-84) on Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 33(12), 2132-2139. https://doi.org/10.1002/jbmr.3554
Cipriani C, et al. Comparative Effect of rhPTH(1-84) On Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis. J Bone Miner Res. 2018;33(12):2132-2139. PubMed PMID: 30088838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Effect of rhPTH(1-84) on Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis. AU - Cipriani,Cristiana, AU - Pepe,Jessica, AU - Silva,Barbara C, AU - Rubin,Mishaela R, AU - Cusano,Natalie E, AU - McMahon,Donald J, AU - Nieddu,Luciano, AU - Angelozzi,Maurizio, AU - Biamonte,Federica, AU - Diacinti,Daniele, AU - Hans,Didier, AU - Minisola,Salvatore, AU - Bilezikian,John P, Y1 - 2018/08/08/ PY - 2018/04/24/received PY - 2018/06/25/revised PY - 2018/07/07/accepted PY - 2018/8/9/pubmed PY - 2019/11/2/medline PY - 2018/8/9/entrez KW - BONE MINERAL DENSITY KW - HYPOPARATHYROIDISM KW - MICROARCHITECTURE KW - OSTEOPOROSIS KW - PARATHYROID HORMONE SP - 2132 EP - 2139 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 - 33 IS - 12 N2 - Parathyroid hormone (PTH) (1-84) improves lumbar spine (LS) areal bone mineral density (aBMD) and trabecular bone score (TBS) in hypoparathyroidism over a 2-year treatment period. Studies in osteoporosis have shown that with PTH(1-34) there is a significant increase in LS aBMD and TBS. In this article, we provide new data comparing the effects of the same form of PTH, namely recombinant human PTH, rhPTH(1-84), on aBMD and TBS in hypoparathyroid and osteoporotic patients over an 18-month treatment period. We studied 19 premenopausal (mean age 45.8 ± 11.8 years) and 16 postmenopausal (71 ± 8.4 years) hypoparathyroid women and 38 women with postmenopausal osteoporosis (71 ± 8.3 years). DXA (hologic) at LS, femoral neck, total hip, and distal one-third radius was assessed. Site-matched LS TBS data were extracted from deidentified spine DXA scans using the TBS iNsight software (version 2.1; Medimaps, Geneva, Switzerland). We observed a significant increase in LS aBMD in premenopausal and postmenopausal hypoparathyroid (3 ± 1.1%, p < 0.02 and 3.1 ± 1.4%, p < 0.05, respectively) and osteoporosis (6.2 ± 1.1%, p < 0.0001) patients after 18 months. There was a significant increase (3 ± 1.5%, p = 0.05) in TBS in premenopausal hypoparathyroid patients. A change in TBS was not observed in either postmenopausal group. One-third radius aBMD significantly declined in postmenopausal hypoparathyroid (-3.6 ± 1.1%, p < 0.01) and osteoporosis (-8 ± 1.4%, p < 0.0001) patients. Overall, there was a significantly greater increase in TBS in premenopausal hypoparathyroid than in osteoporosis patients (p < 0.0001) after adjusting for baseline values, age, BMI, and average daily dose of rhPTH(1-84). Comparing only postmenopausal women, the LS aBMD increase was greater in osteoporotic than hypoparathyroid subjects (p < 0.01). Our results demonstrate that rhPTH(1-84) administered for 18 months increases trabecular aBMD in hypoparathyroidism and postmenopausal osteoporosis with greater gains observed in the subjects with osteoporosis. The data suggest different effects of PTH on bone depending on the baseline skeletal structure, skeletal dynamics, compartments, and menopausal status. © 2018 American Society for Bone and Mineral Research. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/30088838/Comparative_Effect_of_rhPTH_1_84__on_Bone_Mineral_Density_and_Trabecular_Bone_Score_in_Hypoparathyroidism_and_Postmenopausal_Osteoporosis_ L2 - https://doi.org/10.1002/jbmr.3554 DB - PRIME DP - Unbound Medicine ER -