2 years of teriparatide restores bone quality to premenopausal levels
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Teriparatide restores bone mineral quality to premenopausal levels for women with postmenopausal osteoporosis if taken for 24 months, but not if taken at shorter intervals, according to study findings published in Bone.
“The study confirms that the full benefits of teriparatide treatment on forming bone quality are realized only with a full-course treatment,” Eleftherios P. Paschalis, PhD, faculty member at Ludwig Boltzmann Institute of Osteology, Hanusch Hospital in Vienna, told Healio. “Moreover, the results strongly suggest that teriparatide treatment is very effective, as at the end of 2 years of therapy, forming bone quality similar to that of healthy premenopausal women.”
Paschalis and colleagues conducted an observation study analyzing the effects of 6 months of teriparatide (Forteo, Eli Lilly; Bonsity, Alvogen) on 28 postmenopausal women who participated in the SHOTZ trial (mean age, 65 years) and 24 months of teriparatide on 32 postmenopausal women who participated in SHOTZ or the teriparatide fracture prevention trials (mean age, 67.4 years). Bone quality in the two postmenopausal groups was compared with a group of 62 healthy premenopausal women who participated in various studies (mean age, 40.5 years) as well as a group of 94 postmenopausal women who received placebo in the Horizon and the teriparatide fracture prevention trials (mean age, 70.6 years). Raman microspectroscopic analysis was used to compare bone quality indices pertaining to mineral and organic matrix at actively forming trabecular bone surfaces in iliac crest bone biopsies at three distinct tissue ages. Mineral-to-matrix ratio, mineral maturity/crystallinity, tissue water, glycosaminoglycan and pyridinoline were compared between the groups.
Both teriparatide groups had increased mineral-to-matrix ratio compared with the postmenopausal group taking placebo. Mineral-to-matrix ratio was similar between the 6-month teriparatide group and the premenopausal group, whereas the 24-month teriparatide group had higher values compared with all other groups. Both teriparatide groups had lower mineral maturity/crystallinity compared with the postmenopausal placebo cohort and similar levels to the premenopausal group.
Tissue water was higher in the 6-month teriparatide group compared with the premenopausal cohort. The 24-month teriparatide group had similar tissue water to premenopausal women and lower levels than the postmenopausal placebo or the 6-month teriparatide groups. Both teriparatide groups had lower levels of glycosaminoglycan than either of the control groups and lower pyridinoline compared with the postmenopausal placebo group. The 24-month teriparatide group had lower levels of pyridinoline compared with the 6-month group and similar levels to those observed in premenopausal women.
“We were surprised by the fact that teriparatide reversed the effects of postmenopausal osteoporosis on forming bone quality to a healthy premenopausal state and that it rejuvenates bone quality,” Paschalis said.
Paschalis said future studies should analyze whether other osteoporosis treatments have similar effects on bone quality when compared with healthy premenopausal women.
For more information:
Eleftherios P. Paschalis, PhD, can be reached at eleftherios.paschalis@osteologie.lbg.ac.at.
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