[Efficacy of teriparatide in treatment of glucocorticoid-induced osteoporosis]. [Article in Japanese]
Author(s): Soen S.
Affiliation(s): Department of Orthopaedic Surgery and Rheumatology, Kinki University School of
Medicine, Japan.
Publication date & source: 2012, Clin Calcium. , 22(3):315-20
The skeletal effects of glucocorticoids include both direct and indirect actions
on bone that result early, transient in bone resorption accompanied by a decrease
in bone formation, which is maintained for the duration of glucocorticoid
therapy. Teriparatide exerts anabolic effects on bone, so it is understandable
why teriparatide is thought to be a rational treatment option. The effects of 36
months' treatment with teriparatide and alendronate in women and men with
glucocorticoid-induced osteoporosis were examined in an active-comparator
randomized, double-blind, controlled trial. This study confirmed the superiority
of teriparatide over alendronate with respect BMD changes in the spine and hip
and significantly reduced risk of vertebral fractures in teriparatide-treated
patients. However, because teriparatide is significantly more expensive than
bisphosphonates and has not been demonstrated in adequately powered studies to be
superior in reducing fractures, bisphosphonates remain the first-line treatment
option for the majority of glucocorticoid-treated patients at increased risk of
fracture.
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