Document Detail

Biomechanical effects of teriparatide in women with osteoporosis treated previously with alendronate and risedronate: results from quantitative computed tomography-based finite element analysis of the vertebral body.
MedLine Citation:
PMID:  19800436     Owner:  NLM     Status:  MEDLINE    
Previous antiresorptive treatment may influence the anabolic response to teriparatide. The OPTAMISE (Open-label Study to Determine How Prior Therapy with Alendronate or Risedronate in Postmenopausal Women with Osteoporosis Influences the Clinical Effectiveness of Teriparatide) study reported greater increases in biochemical markers of bone turnover and volumetric bone mineral density (BMD) when 12 months of teriparatide treatment was preceded by 2 years or more of risedronate versus alendronate treatment. The objective of this study was to use quantitative computed tomography (CT)-based nonlinear finite element modeling to evaluate how prior therapy with alendronate or risedronate in postmenopausal women with osteoporosis influences the biomechanical effectiveness of teriparatide. Finite element models of the L1 vertebra were created from quantitative CT scans, acquired before and after 12 months of therapy with teriparatide, from 171 patients from the OPTAMISE study. These models were subjected to uniaxial compression. Total BMD-derived bone volume fraction (BV/TV(d), i.e., bone volume [BV]/total volume [TV]), estimated from quantitative CT-based volumetric BMD, vertebral stiffness, and failure load (strength) were calculated for each time measurement point. The results of this study demonstrated that 12 months of treatment with teriparatide following prior treatment with either risedronate or alendronate increased BMD-derived BV/TV(d), the predicted vertebral stiffness, and failure load. However, the effects of teriparatide were more pronounced in patients treated previously with risedronate, which is consistent with the findings of the OPTAMISE study. The mean (+/-standard error) increase in stiffness was greater in the prior risedronate group than the prior alendronate group (24.6+/-3.2% versus 14.4+/-2.8%, respectively; p=0.0073). Similarly, vertebral failure load increased by 27.2+/-3.5% in the prior risedronate group versus 15.3+/-3.1% in the prior alendronate group (p=0.0042). The mechanical variables increased in greater proportion than BV/TV(d), which increased by 6.9+/-0.9% versus 4.6+/-0.8% in the prior-risedronate and prior-alendronate groups, respectively (p=0.0290). Our finding indicated that while teriparatide can be used with success on patients who have previously undergone treatment with risedronate and alendronate, it demonstrated greater anabolic effect on biomechanical properties in prior-risedronate patients in the first year of teriparatide treatment.
Yan Chevalier; Evelyn Quek; Babul Borah; Gary Gross; John Stewart; Thomas Lang; Philippe Zysset
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-01
Journal Detail:
Title:  Bone     Volume:  46     ISSN:  1873-2763     ISO Abbreviation:  Bone     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8504048     Medline TA:  Bone     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Inc. All rights reserved.
Institute of Lightweight Design and Structural Biomechanics, Vienna, Austria.
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MeSH Terms
Alendronate / pharmacology,  therapeutic use*
Biomechanics / drug effects
Bone Density Conservation Agents / pharmacology,  therapeutic use*
Etidronic Acid / analogs & derivatives*,  pharmacology,  therapeutic use
Finite Element Analysis*
Middle Aged
Osteoporosis / drug therapy*,  physiopathology
Teriparatide / pharmacology,  therapeutic use*
Tomography, X-Ray Computed
Reg. No./Substance:
0/Bone Density Conservation Agents; 105462-24-6/risedronic acid; 2809-21-4/Etidronic Acid; 52232-67-4/Teriparatide; 66376-36-1/Alendronate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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