Abstract
The aim of this study was to investigate the characteristics of postmenopausal women prescribed with teriparatide in Slovenia, during the first decade after its approval, and the predictors of bone mineral density (BMD) improvement with treatment. We retrospectively studied postmenopausal osteoporotic patients prescribed with teriparatide at tertiary center from 2006 to 2015. BMD was measured at standard sites by DXA at baseline, after 12 and 24 months. 25-hydroxyvitamin D and procollagen type I N-terminal propeptide (PINP) were measured at the same time-points. The inclusion criteria were met by 188 women (aged 71 years on average), 151 (80.3%) with postmenopausal and 37 (19.7%) with glucocorticoid-induced osteoporosis. Everyone had at least one fracture, 159 (84.6%) had ≥2 fractures, with vertebral fractures in 172 patients (91.5%). All patients had been previously on antiresorptives for 8.6 years on average. The average BMD change at lumbar spine, total hip, and femoral neck was +5.0%, −1.1%, and +0.3% after 24 months of treatment, respectively. Higher baseline PINP was associated with higher BMD increase at all sites after the first 12 months. Teriparatide was prescribed mostly to elderly women with severe osteoporosis who had sustained two or more fractures despite long-term antiresorptive therapy. Baseline PINP might predict initial BMD increase with teriparatide.
Highlights
Osteoporosis is a systemic skeletal disease characterized by increased bone fragility, which affects mainly postmenopausal women and represents a substantial public health problem [1]
16,000 osteoporotic fractures were sustained in Slovenia in 2010 with the ensuing economic burden estimated at €56 million
Bone mineral density (BMD), a major surrogate endpoint for fractures, was shown to improve with teriparatide [5]. Another option for monitoring the treatment is with a bone formation marker such as procollagen type I N-terminal propeptide (PINP), which increases few months after teriparatide initiation [6]
Summary
Osteoporosis is a systemic skeletal disease characterized by increased bone fragility, which affects mainly postmenopausal women and represents a substantial public health problem [1]. 16,000 osteoporotic fractures were sustained in Slovenia in 2010 with the ensuing economic burden estimated at €56 million Further increase in both the number of fractures and costs was projected for 2025 due to aging and considerable treatment gap in high-risk population [2]. Bone mineral density (BMD), a major surrogate endpoint for fractures, was shown to improve with teriparatide [5]. Another option for monitoring the treatment is with a bone formation marker such as procollagen type I N-terminal propeptide (PINP), which increases few months after teriparatide initiation [6]
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