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Abaloparatide effect on forearm bone mineral density and wrist fracture risk in postmenopausal women with osteoporosis.
Osteoporos Int. 2019 Jun; 30(6):1187-1194.OI

Abstract

PURPOSE

Wrist fractures are common, contribute significantly to morbidity in women with postmenopausal osteoporosis, and occur predominantly at the ultradistal radius, a site rich in trabecular bone. This exploratory analysis of the phase 3 ACTIVE study evaluated effects of abaloparatide versus placebo and teriparatide on forearm bone mineral density (BMD) and risk of wrist fracture.

METHODS

Forearm BMD was measured by dual energy X-ray absorptiometry in a subset of 982 women from ACTIVE, evenly distributed across the three treatment groups. Wrist fractures were ascertained in the total cohort (N = 2463).

RESULTS

After 18 months, ultradistal radius BMD changes from baseline were 2.25 percentage points greater for abaloparatide compared with placebo (95% confidence interval (CI) 1.38, 3.12, p < 0.001) and 1.54 percentage points greater for abaloparatide compared with teriparatide (95% CI 0.64, 2.45, p < 0.001). At 18 months, 1/3 radius BMD losses (versus baseline) were similar for abaloparatide compared with placebo (-0.42; 95% CI -1.03, 0.20; p = 0.19) but losses with teriparatide exceeded those of placebo (-1.66%; 95% CI -2.27, -1.06; p < 0.001). The decline with abaloparatide was less than that seen with teriparatide (group difference 1.22%; 95% CI 0.57, 1.87; p < 0.001). The radius BMD findings, at both ultradistal and 1/3 sites, are consistent with the numerically lower incidence of wrist fractures observed in women treated with abaloparatide compared with teriparatide (HR = 0.43; 95% CI 0.18, 1.03; p = 0.052) and placebo (HR = 0.49, 95% CI 0.20, 1.19, p = 0.11).

CONCLUSIONS

Compared with teriparatide, abaloparatide increased BMD at the ultradistal radius (primarily trabecular bone) and decreased BMD to a lesser extent at the 1/3 radius (primarily cortical bone), likely contributing to the numerically lower wrist fracture incidence observed with abaloparatide.

Authors+Show Affiliations

Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA. nelson.watts@hotmail.com.Radius Health, Inc., Waltham, MA, USA.Radius Health, Inc., Waltham, MA, USA.Radius Health, Inc., Waltham, MA, USA.Radius Health, Inc., Waltham, MA, USA.Colorado Center for Bone Research, Lakewood, CO, USA.Columbia University College of Physicians and Surgeons, New York, NY, USA.

Pub Type(s)

Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

30899994

Citation

Watts, N B., et al. "Abaloparatide Effect On Forearm Bone Mineral Density and Wrist Fracture Risk in Postmenopausal Women With Osteoporosis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 30, no. 6, 2019, pp. 1187-1194.
Watts NB, Hattersley G, Fitzpatrick LA, et al. Abaloparatide effect on forearm bone mineral density and wrist fracture risk in postmenopausal women with osteoporosis. Osteoporos Int. 2019;30(6):1187-1194.
Watts, N. B., Hattersley, G., Fitzpatrick, L. A., Wang, Y., Williams, G. C., Miller, P. D., & Cosman, F. (2019). Abaloparatide effect on forearm bone mineral density and wrist fracture risk in postmenopausal women with osteoporosis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 30(6), 1187-1194. https://doi.org/10.1007/s00198-019-04890-2
Watts NB, et al. Abaloparatide Effect On Forearm Bone Mineral Density and Wrist Fracture Risk in Postmenopausal Women With Osteoporosis. Osteoporos Int. 2019;30(6):1187-1194. PubMed PMID: 30899994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abaloparatide effect on forearm bone mineral density and wrist fracture risk in postmenopausal women with osteoporosis. AU - Watts,N B, AU - Hattersley,G, AU - Fitzpatrick,L A, AU - Wang,Y, AU - Williams,G C, AU - Miller,P D, AU - Cosman,F, Y1 - 2019/03/21/ PY - 2018/09/28/received PY - 2019/01/31/accepted PY - 2019/3/23/pubmed PY - 2020/1/7/medline PY - 2019/3/23/entrez KW - Abaloparatide KW - Bone mineral density KW - Osteoporosis KW - Teriparatide KW - Wrist fracture SP - 1187 EP - 1194 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 30 IS - 6 N2 - PURPOSE: Wrist fractures are common, contribute significantly to morbidity in women with postmenopausal osteoporosis, and occur predominantly at the ultradistal radius, a site rich in trabecular bone. This exploratory analysis of the phase 3 ACTIVE study evaluated effects of abaloparatide versus placebo and teriparatide on forearm bone mineral density (BMD) and risk of wrist fracture. METHODS: Forearm BMD was measured by dual energy X-ray absorptiometry in a subset of 982 women from ACTIVE, evenly distributed across the three treatment groups. Wrist fractures were ascertained in the total cohort (N = 2463). RESULTS: After 18 months, ultradistal radius BMD changes from baseline were 2.25 percentage points greater for abaloparatide compared with placebo (95% confidence interval (CI) 1.38, 3.12, p < 0.001) and 1.54 percentage points greater for abaloparatide compared with teriparatide (95% CI 0.64, 2.45, p < 0.001). At 18 months, 1/3 radius BMD losses (versus baseline) were similar for abaloparatide compared with placebo (-0.42; 95% CI -1.03, 0.20; p = 0.19) but losses with teriparatide exceeded those of placebo (-1.66%; 95% CI -2.27, -1.06; p < 0.001). The decline with abaloparatide was less than that seen with teriparatide (group difference 1.22%; 95% CI 0.57, 1.87; p < 0.001). The radius BMD findings, at both ultradistal and 1/3 sites, are consistent with the numerically lower incidence of wrist fractures observed in women treated with abaloparatide compared with teriparatide (HR = 0.43; 95% CI 0.18, 1.03; p = 0.052) and placebo (HR = 0.49, 95% CI 0.20, 1.19, p = 0.11). CONCLUSIONS: Compared with teriparatide, abaloparatide increased BMD at the ultradistal radius (primarily trabecular bone) and decreased BMD to a lesser extent at the 1/3 radius (primarily cortical bone), likely contributing to the numerically lower wrist fracture incidence observed with abaloparatide. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/30899994/Abaloparatide_effect_on_forearm_bone_mineral_density_and_wrist_fracture_risk_in_postmenopausal_women_with_osteoporosis_ L2 - https://doi.org/10.1007/s00198-019-04890-2 DB - PRIME DP - Unbound Medicine ER -