Document Detail


Treatment with parathyroid peptides and estrogen replacement for severe postmenopausal vertebral osteoporosis: prediction of long-term responses in spine and femur.
MedLine Citation:
PMID:  11281158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fifteen women with severe vertebral osteoporosis were treated with daily parathyroid peptide (hPTH) plus hormone-replacement co-therapy (HRT) for 1 year. Eight other patients were randomized to HRT alone. Co-therapy with hPTH and HRT resulted in an impressive mean treatment response at the spine (dual-energy X-ray absorptiometry DXA) 15% above baseline; P < 0.015 compared with the HRT group) at 2 years, while at the proximal femur and radius there were smaller increases. hPTH co-therapy led to a significantly positive metabolic calcium balance at 1 year (by 2.13 mmol Ca/day, equivalent to a 5% annual increment in total body calcium; P = 0.015). The magnitude of the lumbar spine DXA response at 2 years depended statistically on the increase in bone formation rate, measured with 85Sr (r2 adjusted 0.48; P < 0.005) and patients with a large spine DXA response had larger calcium balance improvements (P < 0.03). Plasma osteocalcin changes tracked closely with increases in bone formation rate (r2 = 0.87). In seven patients treated throughout with HRT alone, and in eight hPTH-treated patients (three of whom switched to bisphosphonate therapy at year 4). DXA spine changes seen in years 3-5 were minimal, with no evidence of a statistically significant difference between groups. It is concluded that hPTH or comparable PTH receptor activators remain the most promising anabolic treatment for osteoporosis currently under clinical evaluation and a 6- or 12-month measurement of bone formation or a marker predicts the 2-5 year bone density outcome. Post-hPTH treatment, loss of bone appeared preventable with anti-resorptive therapy.
Authors:
J Reeve; A Mitchell; M Tellez; P Hulme; J R Green; B Wardley-Smith; R Mitchell
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of bone and mineral metabolism     Volume:  19     ISSN:  0914-8779     ISO Abbreviation:  J. Bone Miner. Metab.     Publication Date:  2001  
Date Detail:
Created Date:  2001-04-02     Completed Date:  2001-08-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9436705     Medline TA:  J Bone Miner Metab     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  102-14     Citation Subset:  IM    
Affiliation:
University Department of Medicine, Addenbrooke's Hospital, Cambridge, UK.
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MeSH Terms
Descriptor/Qualifier:
Bone Density
Bone and Bones / metabolism
Calcium / metabolism
Estrogen Replacement Therapy*
Female
Femur / radiography
Humans
Male
Osteocalcin / blood
Osteoporosis, Postmenopausal / drug therapy*,  metabolism,  physiopathology,  radiography
Parathyroid Hormone / therapeutic use*
Peptide Fragments / therapeutic use
Predictive Value of Tests
Spine / radiography
Teriparatide / therapeutic use
Time Factors
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 0/Peptide Fragments; 0/parathyroid hormone (1-38); 104982-03-8/Osteocalcin; 52232-67-4/Teriparatide; 7440-70-2/Calcium

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


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