Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone
Background: Teriparatide (TPTD) should be followed by an antiresorptive to maximize bone mineral density gain and anti-fracture protection. Infrequent zoledronic acid (ZOL) administration has demonstrated effectiveness. The duration of ZOL effect following TPTD is unknown. Objective: To evaluate the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-11-01
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| Series: | Therapeutic Advances in Endocrinology and Metabolism |
| Online Access: | https://doi.org/10.1177/20420188231213639 |
| _version_ | 1797499783234977792 |
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| author | Sharon Giveon Galia Zacay Iris Vered A. Joseph Foldes Liana Tripto-Shkolnik |
| author_facet | Sharon Giveon Galia Zacay Iris Vered A. Joseph Foldes Liana Tripto-Shkolnik |
| author_sort | Sharon Giveon |
| collection | DOAJ |
| description | Background: Teriparatide (TPTD) should be followed by an antiresorptive to maximize bone mineral density gain and anti-fracture protection. Infrequent zoledronic acid (ZOL) administration has demonstrated effectiveness. The duration of ZOL effect following TPTD is unknown. Objective: To evaluate the effect of ZOL on bone resorption marker in a post-TPTD versus ZOL-alone scenario in osteoporotic patients. Design: Retrospective cohort study. Methods: Patients treated with TPTD followed by ZOL (TPTD–ZOL) or with a single ZOL infusion were identified in the database of a tertiary referral center. Clinical and laboratory data, including C-terminal telopeptide of type I collagen (CTX) following ZOL treatment, were compared. Results: Twenty-six patients (93% women) treated with TPTD–ZOL and 41 with ZOL were comparable in age (median 70.1 versus 69.6 years, p = 0.6) and sex. Timing of CTX measurement post-ZOL was the same, median 1.0 year. CTX was lower following TPTD–ZOL (median 142.1 versus 184.2 pg/mL, p = 0.005). In a multivariable regression model (controlled for baseline characteristics), pretreatment with TPTD strongly predicted CTX <150 pg/mL, 1 year following ZOL (odds ratio = 7.5, 95% CI 1.3–58.1, p = 0.03). In a subgroup with sequential CTX measurements following one ZOL, significantly lower levels persisted in the TPTD–ZOL group for a median of 4.4 years follow-up. Conclusion: ZOL-administered sequential to TPTD yielded deeper and more prolonged bone resorption suppression than ZOL alone. Prospective data are needed to confirm whether in a sequential treatment scenario, subsequent ZOL dosing interval should be less frequent. |
| first_indexed | 2024-03-10T03:52:22Z |
| format | Article |
| id | doaj.art-9a46193f976a4cbdb1f70b2ab4d89d7d |
| institution | Directory Open Access Journal |
| issn | 2042-0196 |
| language | English |
| last_indexed | 2024-03-10T03:52:22Z |
| publishDate | 2023-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Endocrinology and Metabolism |
| spelling | doaj.art-9a46193f976a4cbdb1f70b2ab4d89d7d2023-11-23T11:03:25ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01962023-11-011410.1177/20420188231213639Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid aloneSharon GiveonGalia ZacayIris VeredA. Joseph FoldesLiana Tripto-ShkolnikBackground: Teriparatide (TPTD) should be followed by an antiresorptive to maximize bone mineral density gain and anti-fracture protection. Infrequent zoledronic acid (ZOL) administration has demonstrated effectiveness. The duration of ZOL effect following TPTD is unknown. Objective: To evaluate the effect of ZOL on bone resorption marker in a post-TPTD versus ZOL-alone scenario in osteoporotic patients. Design: Retrospective cohort study. Methods: Patients treated with TPTD followed by ZOL (TPTD–ZOL) or with a single ZOL infusion were identified in the database of a tertiary referral center. Clinical and laboratory data, including C-terminal telopeptide of type I collagen (CTX) following ZOL treatment, were compared. Results: Twenty-six patients (93% women) treated with TPTD–ZOL and 41 with ZOL were comparable in age (median 70.1 versus 69.6 years, p = 0.6) and sex. Timing of CTX measurement post-ZOL was the same, median 1.0 year. CTX was lower following TPTD–ZOL (median 142.1 versus 184.2 pg/mL, p = 0.005). In a multivariable regression model (controlled for baseline characteristics), pretreatment with TPTD strongly predicted CTX <150 pg/mL, 1 year following ZOL (odds ratio = 7.5, 95% CI 1.3–58.1, p = 0.03). In a subgroup with sequential CTX measurements following one ZOL, significantly lower levels persisted in the TPTD–ZOL group for a median of 4.4 years follow-up. Conclusion: ZOL-administered sequential to TPTD yielded deeper and more prolonged bone resorption suppression than ZOL alone. Prospective data are needed to confirm whether in a sequential treatment scenario, subsequent ZOL dosing interval should be less frequent.https://doi.org/10.1177/20420188231213639 |
| spellingShingle | Sharon Giveon Galia Zacay Iris Vered A. Joseph Foldes Liana Tripto-Shkolnik Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone Therapeutic Advances in Endocrinology and Metabolism |
| title | Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| title_full | Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| title_fullStr | Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| title_full_unstemmed | Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| title_short | Zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| title_sort | zoledronic acid sequential to teriparatide may promote greater inhibition of bone resorption than zoledronic acid alone |
| url | https://doi.org/10.1177/20420188231213639 |
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