Comparative effects of teriparatide and risedronate in glucocorticoid-induced osteoporosis in men: 18-month results of the EuroGIOPs trial

Επιστημονική δημοσίευση - Άρθρο Περιοδικού uoadl:3157754 22 Αναγνώσεις

Μονάδα:
Ερευνητικό υλικό ΕΚΠΑ
Τίτλος:
Comparative effects of teriparatide and risedronate in
glucocorticoid-induced osteoporosis in men: 18-month results of the
EuroGIOPs trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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 (0.005between 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.
Έτος δημοσίευσης:
2013
Συγγραφείς:
Glueer, Claus-C
Marin, Fernando
Ringe, Johann D.
Hawkins,
Federico
Moericke, Ruediger
Papaioannu, Nikolaos
Farahmand,
Parvis
Minisola, Salvatore
Martinez, Guillermo
Nolla, Joan
M.
Niedhart, Christopher
Guanabens, Nuria
Nuti, Ranuccio and
Martin-Mola, Emilio
Thomasius, Friederike
Kapetanos, Georgios
and Pena, Jaime
Graeff, Christian
Petto, Helmut
Sanz,
Beatriz
Reisinger, Andreas
Zysset, Philippe K.
Περιοδικό:
JOURNAL OF BONE AND MINERAL RESEARCH
Εκδότης:
Wiley
Τόμος:
28
Αριθμός / τεύχος:
6
Σελίδες:
1355-1368
Λέξεις-κλειδιά:
BONE MINERAL DENSITY; BONE MICROSTRUCTURE; FINITE ELEMENT ANALYSIS;
GLUCOCORTICOID-INDUCED OSTEOPOROSIS; HIGH RESOLUTION QUANTITATIVE
COMPUTED TOMOGRAPHY; MALE OSTEOPOROSIS; VERTEBRAL FRACTURE
Επίσημο URL (Εκδότης):
DOI:
10.1002/jbmr.1870
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