| Treatment with parathyroid peptides and estrogen replacement for severe postmenopausal vertebral osteoporosis: prediction of long-term responses in spine and femur. | |
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MedLine Citation:
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PMID: 11281158 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J Reeve; A Mitchell; M Tellez; P Hulme; J R Green; B Wardley-Smith; R Mitchell |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of bone and mineral metabolism Volume: 19 ISSN: 0914-8779 ISO Abbreviation: J. Bone Miner. Metab. Publication Date: 2001 |
Date Detail:
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Created Date: 2001-04-02 Completed Date: 2001-08-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9436705 Medline TA: J Bone Miner Metab Country: Japan |
Other Details:
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Languages: eng Pagination: 102-14 Citation Subset: IM |
Affiliation:
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University Department of Medicine, Addenbrooke's Hospital, Cambridge, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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