Document Detail


Effects of teriparatide retreatment in osteoporotic men and women.
MedLine Citation:
PMID:  19401368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: The stimulatory effect of teriparatide on bone mineral density (BMD) and bone turnover is initially exuberant, but then diminishes. OBJECTIVE: Our objective was to determine whether retreating with teriparatide after a drug-free period can restore the initial exuberant response to teriparatide. DESIGN AND SETTING: This was a planned extension of a randomized controlled trial conducted in a single university hospital. PATIENTS AND INTERVENTION: Subjects previously participated in a 30-month randomized trial comparing the effects of alendronate (group 1), teriparatide (group 2), or both (group 3) on BMD and bone turnover in men and women with low BMD (phase 1). Subjects who completed phase 1 on their assigned therapy entered phase 2 (months 30-42), during which teriparatide was stopped in groups 2 and 3. Teriparatide was administered to all subjects during months 42 to 54 (phase 3). MAIN OUTCOME MEASURES: We compared changes in BMD and markers of bone turnover (serum osteocalcin, N-terminal propeptide of type 1 collagen, and N-telopeptide) between phase 1 and 3 in subjects receiving teriparatide alone. RESULTS: Posterior-anterior and lateral spine BMD increased 12.5 +/- 1.5 and 16.9 +/- 1.7%, respectively, during the first 12 months of teriparatide administration and 5.2 +/- 0.8 and 6.2 +/- 1.8%, respectively, during teriparatide retreatment (P < 0.001 and P = 0.001). Increases in osteocalcin (P < 0.001), N-terminal propeptide of type 1 collagen (P < 0.001), and N-telopeptide (P < 0.001) were greater during the first period of teriparatide administration. CONCLUSION: The response to teriparatide is attenuated when readministered after a 12-month hiatus.
Authors:
Joel S Finkelstein; Jason J Wyland; Benjamin Z Leder; Sherri-Ann M Burnett-Bowie; Hang Lee; Harald Jüppner; Robert M Neer
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Publication Detail:
Type:  Clinical Trial, Phase I; Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2009-04-28
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  94     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-08     Completed Date:  2009-08-06     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2495-501     Citation Subset:  AIM; IM    
Affiliation:
Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. jfinkelstein@partners.org
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00000400
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alendronate / administration & dosage,  adverse effects
Algorithms
Bone Density / drug effects
Bone Density Conservation Agents / administration & dosage,  adverse effects,  therapeutic use
Dose-Response Relationship, Drug
Drug Combinations
Female
Humans
Male
Medication Adherence
Middle Aged
Osteoporosis / drug therapy*
Retreatment
Teriparatide / administration & dosage,  adverse effects,  therapeutic use*
Grant Support
ID/Acronym/Agency:
5 P50 AR44855/AR/NIAMS NIH HHS; K24 DK02759/DK/NIDDK NIH HHS; RR-1066/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Drug Combinations; 52232-67-4/Teriparatide; 66376-36-1/Alendronate
Comments/Corrections

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


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