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Distribution of Prevalent and Incident Vertebral Fractures and Their Association with Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial.
Calcif Tissue Int. 2020 06; 106(6):646-654.CT

Abstract

Vertebral fractures (VFx) occur most frequently in the mid-thoracic and thoraco-lumbar regions, which experience the highest mechanical loading along the spine. The prevalence and incidence of VFx by their location and severity, and their relationship with bone mineral density (BMD), are seldom reported in randomized clinical trial cohorts. The VERO trial randomized 1360 postmenopausal women with at least two moderate or one severe VFx to receive either teriparatide or risedronate for up to 24 months. In this post hoc analysis, we describe the centrally read distribution and severity of prevalent and incident VFx, and the association of their location with the baseline BMD. At baseline, 21.4% of all evaluable vertebral bodies had a prevalent VFx; most commonly at L1, T12, L2 and T11 (38.5%, 37.4%, 25.3% and 23.5% of patients, respectively). Patients with prevalent VFx only at T12/L1 showed a higher baseline BMD compared to patients with VFx at other levels. At month 24, 100 patients had 126 incident VFx (teriparatide: 35; risedronate: 91). The most frequent incident VFx occurred at T12 (n = 17, 1.6% of patients), followed by L1 and T11 (n = 14, 1.3% both). The frequency of incident VFx was lower at all vertebral levels in patients given teriparatide. These results confirm prior reports that VFx occurs more frequently at mid-thoracic and thoraco-lumbar regions of the spine. Patients with these VFx locations have higher BMD than those who fracture at other sites, suggesting a role for mechanical stress in the etiology of VFx. Teriparatide is superior to risedronate in the prevention of VFx at these common fracture locations.Trial registration ClinicalTrials.gov Identifier: NCT01709110.

Authors+Show Affiliations

Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. piet.geusens@scarlet.be.Department of Medicine (Endocrinology), University of British Columbia, Vancouver, BC, V5Z 4E1, Canada.Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.Department of Medical Research, Eli Lilly and Company, Avda. de la Industria 30, 28108, Alcobendas (Madrid), Spain.Department of Medical Research, Eli Lilly and Company, Avda. de la Industria 30, 28108, Alcobendas (Madrid), Spain.

Pub Type(s)

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

Language

eng

PubMed ID

32157334

Citation

Geusens, Piet, et al. "Distribution of Prevalent and Incident Vertebral Fractures and Their Association With Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial." Calcified Tissue International, vol. 106, no. 6, 2020, pp. 646-654.
Geusens P, Kendler DL, Fahrleitner-Pammer A, et al. Distribution of Prevalent and Incident Vertebral Fractures and Their Association with Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial. Calcif Tissue Int. 2020;106(6):646-654.
Geusens, P., Kendler, D. L., Fahrleitner-Pammer, A., López-Romero, P., & Marin, F. (2020). Distribution of Prevalent and Incident Vertebral Fractures and Their Association with Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial. Calcified Tissue International, 106(6), 646-654. https://doi.org/10.1007/s00223-020-00683-6
Geusens P, et al. Distribution of Prevalent and Incident Vertebral Fractures and Their Association With Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial. Calcif Tissue Int. 2020;106(6):646-654. PubMed PMID: 32157334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distribution of Prevalent and Incident Vertebral Fractures and Their Association with Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial. AU - Geusens,Piet, AU - Kendler,David L, AU - Fahrleitner-Pammer,Astrid, AU - López-Romero,Pedro, AU - Marin,Fernando, Y1 - 2020/03/10/ PY - 2019/11/26/received PY - 2020/01/17/accepted PY - 2020/3/12/pubmed PY - 2021/7/15/medline PY - 2020/3/12/entrez KW - Bisphosphonates KW - Osteoporosis KW - Risedronate KW - Spine KW - Teriparatide KW - Vertebral fractures SP - 646 EP - 654 JF - Calcified tissue international JO - Calcif Tissue Int VL - 106 IS - 6 N2 - Vertebral fractures (VFx) occur most frequently in the mid-thoracic and thoraco-lumbar regions, which experience the highest mechanical loading along the spine. The prevalence and incidence of VFx by their location and severity, and their relationship with bone mineral density (BMD), are seldom reported in randomized clinical trial cohorts. The VERO trial randomized 1360 postmenopausal women with at least two moderate or one severe VFx to receive either teriparatide or risedronate for up to 24 months. In this post hoc analysis, we describe the centrally read distribution and severity of prevalent and incident VFx, and the association of their location with the baseline BMD. At baseline, 21.4% of all evaluable vertebral bodies had a prevalent VFx; most commonly at L1, T12, L2 and T11 (38.5%, 37.4%, 25.3% and 23.5% of patients, respectively). Patients with prevalent VFx only at T12/L1 showed a higher baseline BMD compared to patients with VFx at other levels. At month 24, 100 patients had 126 incident VFx (teriparatide: 35; risedronate: 91). The most frequent incident VFx occurred at T12 (n = 17, 1.6% of patients), followed by L1 and T11 (n = 14, 1.3% both). The frequency of incident VFx was lower at all vertebral levels in patients given teriparatide. These results confirm prior reports that VFx occurs more frequently at mid-thoracic and thoraco-lumbar regions of the spine. Patients with these VFx locations have higher BMD than those who fracture at other sites, suggesting a role for mechanical stress in the etiology of VFx. Teriparatide is superior to risedronate in the prevention of VFx at these common fracture locations.Trial registration ClinicalTrials.gov Identifier: NCT01709110. SN - 1432-0827 UR - https://www.unboundmedicine.com/medline/citation/32157334/Distribution_of_Prevalent_and_Incident_Vertebral_Fractures_and_Their_Association_with_Bone_Mineral_Density_in_Postmenopausal_Women_in_the_Teriparatide_Versus_Risedronate_VERO_Clinical_Trial_ L2 - https://dx.doi.org/10.1007/s00223-020-00683-6 DB - PRIME DP - Unbound Medicine ER -