@article{3157754,
    title = "Comparative effects of teriparatide and risedronate in
glucocorticoid-induced osteoporosis in men: 18-month results of the
EuroGIOPs trial",
    author = "Glueer, Claus-C and Marin, Fernando and Ringe, Johann D. and Hawkins, and Federico and Moericke, Ruediger and Papaioannu, Nikolaos and Farahmand, and Parvis and Minisola, Salvatore and Martinez, Guillermo and Nolla, Joan and M. and Niedhart, Christopher and Guanabens, Nuria and Nuti, Ranuccio and and Martin-Mola, Emilio and Thomasius, Friederike and Kapetanos, Georgios and and Pena, Jaime and Graeff, Christian and Petto, Helmut and Sanz, and Beatriz and Reisinger, Andreas and Zysset, Philippe K.",
    journal = "JOURNAL OF BONE AND MINERAL RESEARCH",
    year = "2013",
    volume = "28",
    number = "6",
    pages = "1355-1368",
    publisher = "Wiley",
    issn = "0884-0431",
    doi = "10.1002/jbmr.1870",
    keywords = "BONE MINERAL DENSITY; BONE MICROSTRUCTURE; FINITE ELEMENT ANALYSIS;
GLUCOCORTICOID-INDUCED OSTEOPOROSIS; HIGH RESOLUTION QUANTITATIVE
COMPUTED TOMOGRAPHY; MALE OSTEOPOROSIS; VERTEBRAL FRACTURE",
    abstract = "Data on treatment of glucocorticoid-induced osteoporosis (GIO) in men
are scarce. We performed a randomized, open-label trial in men who have
taken glucocorticoids (GC) for 3 months, and had an areal bone mineral
density (aBMD) T-score 1.5 standard deviations. Subjects received 20g/d
teriparatide (n=45) or 35mg/week risedronate (n=47) for 18 months.
Primary objective was to compare lumbar spine (L1L3) BMD measured by
quantitative computed tomography (QCT). Secondary outcomes included BMD
and microstructure measured by high-resolution QCT (HRQCT) at the 12th
thoracic vertebra, biomechanical effects for axial compression, anterior
bending, and axial torsion evaluated by finite element (FE) analysis
from HRQCT data, aBMD by dual X-ray absorptiometry, biochemical markers,
and safety. Computed tomography scans were performed at 0, 6, and 18
months. A mixed model repeated measures analysis was performed to
compare changes from baseline between groups. Mean age was 56.3 years.
Median GC dose and duration were 8.8mg/d and 6.4 years, respectively;
39.1% of subjects had a prevalent fracture, and 32.6% received prior
bisphosphonate treatment. At 18 months, trabecular BMD had significantly
increased for both treatments, with significantly greater increases with
teriparatide (16.3% versus 3.8%; p=0.004). HRQCT trabecular and
cortical variables significantly increased for both treatments with
significantly larger improvements for teriparatide for integral and
trabecular BMD and bone surface to volume ratio (BS/BV) as a
microstructural measure. Vertebral strength increases at 18 months were
significant in both groups (teriparatide: 26.0% to 34.0%; risedronate:
4.2% to 6.7%), with significantly higher increases in the teriparatide
group for all loading modes (0.005<p<0.015). Adverse events were similar
between groups. None of the patients on teriparatide but five (10.6%)
on risedronate developed new clinical fractures (p=0.056). In
conclusion, in this 18-month trial in men with GIO, teriparatide showed
larger improvements in spinal BMD, microstructure, and FE-derived
strength than risedronate."
}