Efficacy of Daily Teriparatide Treatment in Low Levels of Walking State Patients.

Abstract

Little is known about the efficacy of osteoporosis medication in patients with low levels of walking state, namely, influence by immobilization levels. We retrospectively compared the efficacy of the daily teriparatide therapy in patients with low and high levels of walking state to detect possible immobilization-related differences. We analyzed 661 patients treated with 20μg/day of teriparatide for 24months. We measured the changes in the bone mineral density (BMD) of the lumbar spine (LS) and of the femoral neck (FN), the changes in serum procollagen type I N-terminal propeptide (PINP) levels and urinary N-telopeptide (uNTX) excretion. To compare the results of BMD and bone turnover marker, the patients were divided into two subgroups, low levels of walking state and high levels of walking state. Compared with baseline, in the low levels of walking state subgroup, the percent LS BMD and FN BMD increased significantly by 12.8±8.9% and 5.0±13.8% at 24months, respectively (p<0.01 vs baseline for LS and FN, respectively); the mean absolute LS BMD and FN BMD change was 0.101±0.067g/cm2 and 0.017±0.063g/cm2 at 24months, respectively. In the high levels of walking state subgroup, the percent LS BMD and FN BMD increased significantly by 13.4±9.5% and 3.1±7.8% at 24months, respectively; the mean absolute LS BMD and FN BMD change was 0.104±0.068g/cm2 and 0.017±0.042g/cm2 at 24months, respectively. The increases in percent and absolute BMD in LS and FN, and the changes in PINP and uNTX were similar between the subgroups. The efficacy of the daily teriparatide treatment is similar between low levels of walking state patients and high levels of walking state patients and was not influenced by immobilization levels.