Variability in the measured response of bone to teriparatide

R. P. Heaney, P. Watson

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Summary: Apparent failures of bone mineral density (BMD) response to teriparatide at spine or hip occur even in a high compliance context (15% spine and 55% hip). Apparent non-responders nevertheless show good biomarker response, suggesting that apparent BMD non-response is due to measurement imprecision. Calcium intake may be an important determinant of hip response. Introduction: Individuals vary in response to bone active agents, but that variability is poorly quantified and its basis is not well understood. The study included 203 postmenopausal women with moderately severe osteoporosis, all treated with teriparatide, calcium, and vitamin D. The study was performed at the Creighton University Medical Center, a single site. Methods: This is a prospective study of change in bone mineral density and resorption biomarkers over a 12-month treatment period. BMD response at spine and total hip was quantified by computing slopes for each participant's values, and biomarker change by the difference in values across the 12-month study period. Results: Of the total number of participants, 85.2% exhibited a significant spine BMD response, while only 44.8% had a significant change at the hip. However, mean biomarker response was marginally larger for the BMD non-responders at either site than for the responders, indicating biological, if not measurable densitometric, activity of teriparatide in essentially all participants. Conclusions: Occasional apparent failures of BMD response in patients receiving teriparatide are probably not due to failure of response at the level of the bone remodeling apparatus, but instead reflect a combination of measurement imprecision and variable bone remodeling balance. The reason for the latter remains unclear.

Original languageEnglish
Pages (from-to)1703-1708
Number of pages6
JournalOsteoporosis International
Volume22
Issue number6
DOIs
StatePublished - Jun 2011

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Teriparatide
Bone Density
Bone and Bones
Hip
Spine
Biomarkers
Bone Remodeling
Calcium
Bone Resorption
Vitamin D
Osteoporosis
Compliance
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Variability in the measured response of bone to teriparatide. / Heaney, R. P.; Watson, P.

In: Osteoporosis International, Vol. 22, No. 6, 06.2011, p. 1703-1708.

Research output: Contribution to journalArticle

Heaney, R. P. ; Watson, P. / Variability in the measured response of bone to teriparatide. In: Osteoporosis International. 2011 ; Vol. 22, No. 6. pp. 1703-1708.
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