Effects of teriparatide in postmenopausal women with osteoporosis on prior alendronate or raloxifene

Differences between stopping and continuing the antiresorptive agent

Felicia Cosman, Robert A. Wermers, Christopher Recknor, Karen F. Mauck, Li Xie, Emmett V. Glass, John H. Krege

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures:Wemeasured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401%); bone ALP (15 vs. 71%); βCTX (27 vs. 250%); all P < 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. -0.8%; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8%; P = 0.003) and total hip (3.2 vs. 0.9%; P = 0.02), but not in femoral neck (2.7 vs. 2.3%; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259%; P<0.001), bone ALP (31 vs. 44%; P=0.035), and βCTX (67 vs. 144%; P=0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5%; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1%), total hip (2.8 vs. 1.8%), and femoral neck (3.8 vs. 2.2%) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide.

Original languageEnglish (US)
Pages (from-to)3772-3780
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number10
DOIs
StatePublished - 2009

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Teriparatide
Bone Density Conservation Agents
Alendronate
Bone Density
Bone Remodeling
Osteoporosis
Bone
Pelvic Bones
Femur Neck
Minerals
Switches
Bone and Bones
Hip
Spine
Outcome Assessment (Health Care)
Raloxifene Hydrochloride
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ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Effects of teriparatide in postmenopausal women with osteoporosis on prior alendronate or raloxifene : Differences between stopping and continuing the antiresorptive agent. / Cosman, Felicia; Wermers, Robert A.; Recknor, Christopher; Mauck, Karen F.; Xie, Li; Glass, Emmett V.; Krege, John H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 10, 2009, p. 3772-3780.

Research output: Contribution to journalArticle

Cosman, Felicia ; Wermers, Robert A. ; Recknor, Christopher ; Mauck, Karen F. ; Xie, Li ; Glass, Emmett V. ; Krege, John H. / Effects of teriparatide in postmenopausal women with osteoporosis on prior alendronate or raloxifene : Differences between stopping and continuing the antiresorptive agent. In: Journal of Clinical Endocrinology and Metabolism. 2009 ; Vol. 94, No. 10. pp. 3772-3780.
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title = "Effects of teriparatide in postmenopausal women with osteoporosis on prior alendronate or raloxifene: Differences between stopping and continuing the antiresorptive agent",
abstract = "Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures:Wemeasured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401{\%}); bone ALP (15 vs. 71{\%}); βCTX (27 vs. 250{\%}); all P < 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. -0.8{\%}; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8{\%}; P = 0.003) and total hip (3.2 vs. 0.9{\%}; P = 0.02), but not in femoral neck (2.7 vs. 2.3{\%}; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259{\%}; P<0.001), bone ALP (31 vs. 44{\%}; P=0.035), and βCTX (67 vs. 144{\%}; P=0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5{\%}; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1{\%}), total hip (2.8 vs. 1.8{\%}), and femoral neck (3.8 vs. 2.2{\%}) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide.",
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T2 - Differences between stopping and continuing the antiresorptive agent

AU - Cosman, Felicia

AU - Wermers, Robert A.

AU - Recknor, Christopher

AU - Mauck, Karen F.

AU - Xie, Li

AU - Glass, Emmett V.

AU - Krege, John H.

PY - 2009

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N2 - Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures:Wemeasured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401%); bone ALP (15 vs. 71%); βCTX (27 vs. 250%); all P < 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. -0.8%; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8%; P = 0.003) and total hip (3.2 vs. 0.9%; P = 0.02), but not in femoral neck (2.7 vs. 2.3%; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259%; P<0.001), bone ALP (31 vs. 44%; P=0.035), and βCTX (67 vs. 144%; P=0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5%; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1%), total hip (2.8 vs. 1.8%), and femoral neck (3.8 vs. 2.2%) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide.

AB - Objective: The aim of the study was to assess adding vs. switching to teriparatide 20μg/d in patients on alendronate or raloxifene. Design: We conducted a randomized, open-label trial. Patients and Interventions: Postmenopausal women with osteoporosis on alendronate or raloxifene for at least 18 months added teriparatide (Add groups) or switched to teriparatide (Switch groups) for 18 months. Main Outcome Measures:Wemeasured bone turnover markers (BTM) and bone mineral density (BMD). Results: In the alendronate stratum, increases in BTM were smaller in the Add vs. Switch group [6-month PINP (64 vs. 401%); bone ALP (15 vs. 71%); βCTX (27 vs. 250%); all P < 0.001]. However, at 6 months, total hip BMD increased more in the Add vs. Switch group (1.4 vs. -0.8%; P = 0.002). In the Add vs. Switch group, 18-month BMD increments were higher in lumbar spine (8.4 vs. 4.8%; P = 0.003) and total hip (3.2 vs. 0.9%; P = 0.02), but not in femoral neck (2.7 vs. 2.3%; P = 0.75). In the raloxifene stratum, increases in BTM were also smaller in the Add vs. Switch group [6-month PINP (131 vs. 259%; P<0.001), bone ALP (31 vs. 44%; P=0.035), and βCTX (67 vs. 144%; P=0.001)]. At 6 months, total hip BMD increase was greater in the Add vs. Switch group (1.8 vs. 0.5%; P = 0.028). At 18 months, increases in lumbar spine (9.2 vs. 8.1%), total hip (2.8 vs. 1.8%), and femoral neck (3.8 vs. 2.2%) were not significantly different between groups. Conclusions: In women with osteoporosis treated with antiresorptives, greater bone turnover increases were achieved by switching to teriparatide, whereas greater BMD increases were achieved by adding teriparatide.

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