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Early changes in biochemical markers of bone turnover and their relationship with bone mineral density changes after 24 months of treatment with teriparatide

Blumsohn, A., Marin, F., Nickelsen, T., Brixen, K., Sigurdsson, G., Gonzalez de la Vera, J., Boonen, S., Liu-Leage, S., Eastell, R., Obermayer-Pietsch, B., Erlacher, L., Finkenstedt, G., Geusens, P., Raeman, F., van den Bosch, F., Bouston, Y., Kaufman, J.M., Langdahl, B., Jensen, J.E., Audran, M., Alexandre, C., Roux, C., Benhamou, C.L., Ribot, C., Cormier, C., Kuntz, J.L., Daragon, A., Cortet, B., Laroche, M., de Vernejoul, M.C., Fardellone, P., Weryha, G., Minne, H.W., Heberling, H.J., Badenhoop, K., Fritz, H.G., Kekow, J., Moenig, H., Brabant, T., Kruse, H.P., Spieler, W., Moricke, R., Wagenitz, A., Flohr, F., Semler, J., Hadji, P., Kaps, P., Hennigs, T., Fritzen, R.R., Feldkamp, J., Hein, G., Haschke, U., Kasperk, C., Ringe, J.D., Radspieler, H., Vollmann, N., Blind, E., Runge, M., Jakob, F., Dammann, H.G., Scharla, S., Lyritis, G., Avramides, A., Gudbjornsson, B., Simoes, M.E., Melo-Gomes, J., Branco, J.C., Malcata, A., Diaz-Lopez, C., Farrerons, J., Virgen Macarena, H.U., Roman, J.A., Pesset, H.U., Sans, X., Laffon, A., Rejon, E., del Pino, J., de Toro, J., Coruna, A., Babio, J., Gonzalez, C., Cooper, Cyrus, Fogelman, I., Doherty, S., Purdie, D., Reid, D., Stone, M., Orme, S., Belchetz, P., Fraser, W., Hosking, D., O'Neill, T., Compston, J., Reeve, J., Adams, K., Taggart, H., Bhalla, A., Brown, M., Palferman, T., Woolf, A., Wheatley, T., Thompson, P., Keen, R., Ryan, P. and Selby, P. (2011) Early changes in biochemical markers of bone turnover and their relationship with bone mineral density changes after 24 months of treatment with teriparatide Osteoporosis International, 22, (6), pp. 1935-1946. (doi:10.1007/s00198-010-1379-y). (PMID:20938767).

Record type: Article


Summary: We report the changes in biochemical markers of bone formation during the first 6 months of teriparatide therapy in postmenopausal women with osteoporosis according to previous antiresorptive treatment. Prior therapy does not adversely affect the response to teriparatide treatment. Similar bone markers levels are reached after 6 months of treatment.

Introduction: The response of biochemical markers of bone turnover with teriparatide therapy in subjects who have previously received osteoporosis drugs is not fully elucidated. We examined biochemical markers of bone formation in women with osteoporosis treated with teriparatide and determined: (1) whether the response is associated with prior osteoporosis therapy, (2) which marker shows the best performance for detecting a response to therapy, and (3) the correlations between early changes in bone markers and subsequent bone mineral density (BMD) changes after 24 months of teriparatide.

Methods: We conducted a prospective, open-label, 24-month study at 95 centers in 10 countries in 758 postmenopausal women with established osteoporosis (n?=?181 treatment-naïve) who had at least one post-baseline bone marker determination. Teriparatide (20 ?g/day) was administered for up to 24 months. We measured procollagen type I N-terminal propeptide (PINP), bone-specific alkaline phosphatase (b-ALP), and total alkaline phosphatase (t-ALP) at baseline, 1 and 6 months, and change in BMD at the lumbar spine, total hip and femoral neck from baseline to 24 months.

Results: Significant increases in formation markers occurred after 1 month of teriparatide regardless of prior osteoporosis therapy. The absolute increase at 1 month was lower in previously treated versus treatment-naïve patients, but after 6 months all groups reached similar levels. PINP showed the best signal-to-noise ratio. Baseline PINP correlated positively and significantly with BMD response at 24 months.

Conclusions: This study suggests that the long-term responsiveness of bone formation markers to teriparatide is not affected in subjects previously treated with antiresorptive drugs.

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Published date: June 2011
Keywords: bmd, bone markers, bone turnover, osteoporosis, postmenopausal women, teriparatide


Local EPrints ID: 192511
ISSN: 0937-941X
PURE UUID: d6792e74-298d-4a5b-ba33-f782810dee50
ORCID for Cyrus Cooper: ORCID iD

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Date deposited: 05 Jul 2011 10:43
Last modified: 18 Jul 2017 11:31

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Author: A. Blumsohn
Author: F. Marin
Author: T. Nickelsen
Author: K. Brixen
Author: G. Sigurdsson
Author: J. Gonzalez de la Vera
Author: S. Boonen
Author: S. Liu-Leage
Author: R. Eastell
Author: B. Obermayer-Pietsch
Author: L. Erlacher
Author: G. Finkenstedt
Author: P. Geusens
Author: F. Raeman
Author: F. van den Bosch
Author: Y. Bouston
Author: J.M. Kaufman
Author: B. Langdahl
Author: J.E. Jensen
Author: M. Audran
Author: C. Alexandre
Author: C. Roux
Author: C.L. Benhamou
Author: C. Ribot
Author: C. Cormier
Author: J.L. Kuntz
Author: A. Daragon
Author: B. Cortet
Author: M. Laroche
Author: M.C. de Vernejoul
Author: P. Fardellone
Author: G. Weryha
Author: H.W. Minne
Author: H.J. Heberling
Author: K. Badenhoop
Author: H.G. Fritz
Author: J. Kekow
Author: H. Moenig
Author: T. Brabant
Author: H.P. Kruse
Author: W. Spieler
Author: R. Moricke
Author: A. Wagenitz
Author: F. Flohr
Author: J. Semler
Author: P. Hadji
Author: P. Kaps
Author: T. Hennigs
Author: R.R. Fritzen
Author: J. Feldkamp
Author: G. Hein
Author: U. Haschke
Author: C. Kasperk
Author: J.D. Ringe
Author: H. Radspieler
Author: N. Vollmann
Author: E. Blind
Author: M. Runge
Author: F. Jakob
Author: H.G. Dammann
Author: S. Scharla
Author: G. Lyritis
Author: A. Avramides
Author: B. Gudbjornsson
Author: M.E. Simoes
Author: J. Melo-Gomes
Author: J.C. Branco
Author: A. Malcata
Author: C. Diaz-Lopez
Author: J. Farrerons
Author: H.U. Virgen Macarena
Author: J.A. Roman
Author: H.U. Pesset
Author: X. Sans
Author: A. Laffon
Author: E. Rejon
Author: J. del Pino
Author: J. de Toro
Author: A. Coruna
Author: J. Babio
Author: C. Gonzalez
Author: Cyrus Cooper ORCID iD
Author: I. Fogelman
Author: S. Doherty
Author: D. Purdie
Author: D. Reid
Author: M. Stone
Author: S. Orme
Author: P. Belchetz
Author: W. Fraser
Author: D. Hosking
Author: T. O'Neill
Author: J. Compston
Author: J. Reeve
Author: K. Adams
Author: H. Taggart
Author: A. Bhalla
Author: M. Brown
Author: T. Palferman
Author: A. Woolf
Author: T. Wheatley
Author: P. Thompson
Author: R. Keen
Author: P. Ryan
Author: P. Selby

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