Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial
This randomized, open-label, multicenter, parallel study imitating real-world clinical practice assessed the effect of switching to weekly teriparatide in patients with glucocorticoid-induced osteoporosis (GIO) with a lumbar spine/proximal femur bone mineral density (BMD) T-score ≤ −2.0 or ≤−1.0 and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/292 |
| _version_ | 1797625472384761856 |
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| author | Toshihiro Nanki Mai Kawazoe Kiyoko Uno Wataru Hirose Hiroaki Dobashi Hiroshi Kataoka Toshihide Mimura Hiroshi Hagino Hajime Kono |
| author_facet | Toshihiro Nanki Mai Kawazoe Kiyoko Uno Wataru Hirose Hiroaki Dobashi Hiroshi Kataoka Toshihide Mimura Hiroshi Hagino Hajime Kono |
| author_sort | Toshihiro Nanki |
| collection | DOAJ |
| description | This randomized, open-label, multicenter, parallel study imitating real-world clinical practice assessed the effect of switching to weekly teriparatide in patients with glucocorticoid-induced osteoporosis (GIO) with a lumbar spine/proximal femur bone mineral density (BMD) T-score ≤ −2.0 or ≤−1.0 and a fragility fracture. Forty-four patients were randomized. The mean durations of the corticosteroid and bisphosphonate administrations were 90.0 and 51.3 months. The baseline BMD at L1–L4 was 0.828 and 0.826 g/cm<sup>2</sup> in Groups B (bisphosphonate) and T (teriparatide); at the femur (total), these values were 0.689 and 0.661 g/cm<sup>2</sup>. The mean change in BMD was numerically higher with teriparatide vs. bisphosphonate but not statistically significant. The mean percentage changes from baseline in BMD at L1–L4 after a 72-week treatment were 0.5% and 4.1% in Groups B and T. The incidence of new fractures was higher in the patients taking bisphosphonates vs. those receiving once-weekly teriparatide at 72 weeks (18.2% vs. 11.8%) and 144 weeks (22.7% vs. 17.6%). The mean percentage change in femur (trochanter) BMD (0.035 [0.007–0.063]; <i>p</i> = 0.02) was significantly greater with teriparatide vs. bisphosphonates. Adverse events (AEs) were more frequent with teriparatide vs. bisphosphonates. Switching to once-weekly teriparatide tended to increase lumbar spine BMD and reduce the occurrence of new fractures vs. bisphosphonates. |
| first_indexed | 2024-03-11T09:56:58Z |
| format | Article |
| id | doaj.art-805ebd615aa545feae809bb09ded0c45 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:56:58Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-805ebd615aa545feae809bb09ded0c452023-11-16T15:44:06ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112129210.3390/jcm12010292Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label TrialToshihiro Nanki0Mai Kawazoe1Kiyoko Uno2Wataru Hirose3Hiroaki Dobashi4Hiroshi Kataoka5Toshihide Mimura6Hiroshi Hagino7Hajime Kono8Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo 143-8541, JapanDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo 143-8541, JapanTeikyo Academic Research Center, Teikyo University, Tokyo 173-8606, JapanHirose Clinic of Rheumatology, Tokorozawa 359-1111, JapanDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki 761-0793, JapanDepartment of Rheumatology and Clinical Immunology, Sapporo City General Hospital, Sapporo 060-8604, JapanDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Moroyama 350-0495, JapanSchool of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8504, JapanDepartment of Internal Medicine, Teikyo University School of Medicine, Tokyo 173-8606, JapanThis randomized, open-label, multicenter, parallel study imitating real-world clinical practice assessed the effect of switching to weekly teriparatide in patients with glucocorticoid-induced osteoporosis (GIO) with a lumbar spine/proximal femur bone mineral density (BMD) T-score ≤ −2.0 or ≤−1.0 and a fragility fracture. Forty-four patients were randomized. The mean durations of the corticosteroid and bisphosphonate administrations were 90.0 and 51.3 months. The baseline BMD at L1–L4 was 0.828 and 0.826 g/cm<sup>2</sup> in Groups B (bisphosphonate) and T (teriparatide); at the femur (total), these values were 0.689 and 0.661 g/cm<sup>2</sup>. The mean change in BMD was numerically higher with teriparatide vs. bisphosphonate but not statistically significant. The mean percentage changes from baseline in BMD at L1–L4 after a 72-week treatment were 0.5% and 4.1% in Groups B and T. The incidence of new fractures was higher in the patients taking bisphosphonates vs. those receiving once-weekly teriparatide at 72 weeks (18.2% vs. 11.8%) and 144 weeks (22.7% vs. 17.6%). The mean percentage change in femur (trochanter) BMD (0.035 [0.007–0.063]; <i>p</i> = 0.02) was significantly greater with teriparatide vs. bisphosphonates. Adverse events (AEs) were more frequent with teriparatide vs. bisphosphonates. Switching to once-weekly teriparatide tended to increase lumbar spine BMD and reduce the occurrence of new fractures vs. bisphosphonates.https://www.mdpi.com/2077-0383/12/1/292bone mineral densitybisphosphonatesglucocorticoid-induced osteoporosisfracturesteriparatide |
| spellingShingle | Toshihiro Nanki Mai Kawazoe Kiyoko Uno Wataru Hirose Hiroaki Dobashi Hiroshi Kataoka Toshihide Mimura Hiroshi Hagino Hajime Kono Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial Journal of Clinical Medicine bone mineral density bisphosphonates glucocorticoid-induced osteoporosis fractures teriparatide |
| title | Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial |
| title_full | Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial |
| title_fullStr | Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial |
| title_full_unstemmed | Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial |
| title_short | Improvement in Glucocorticoid-Induced Osteoporosis on Switching from Bisphosphonates to Once-Weekly Teriparatide: A Randomized Open-Label Trial |
| title_sort | improvement in glucocorticoid induced osteoporosis on switching from bisphosphonates to once weekly teriparatide a randomized open label trial |
| topic | bone mineral density bisphosphonates glucocorticoid-induced osteoporosis fractures teriparatide |
| url | https://www.mdpi.com/2077-0383/12/1/292 |
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