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Matthew T Morris, Sandip P Tarpada, Vafa Tabatabaie, Woojin Cho
PURPOSE: In patients undergoing lumbar fusion, osteoporosis has been shown to lead to poorer outcomes and greater incidence of fusion-related complications. Given the undesirable effect of osteoporosis on lumbar fusion surgery, a number of medications have been proposed for use in the peri- and postoperative period to mitigate risks and enhance outcomes. The purpose of this review was to summarize and synthesize the current literature regarding medical management of osteoporosis in the context of lumbar fusion surgery...
March 14, 2018: Archives of Osteoporosis
D Burkard, T Beckett, E Kourtjian, C Messingschlager, R Sipahi, M Padley, J Stubbart
Teriparatide is an anabolic therapy used to treat patients with osteoporosis and is only approved for 2 years of treatment. This is the first study to look at two common osteoporosis drugs in maintaining its beneficial effects: denosumab and zoledronic acid. Denosumab treatment was associated with the greatest increase in bone mineral density (BMD) at the femoral neck and lumbar spine, an amount that was statistically greater than no treatment and zoledronic acid treatment. INTRODUCTION: Teriparatide, a hallmark treatment for osteoporosis, has been shown to increase BMD and bone turnover...
March 14, 2018: Osteoporosis International
M A Paggiosi, L Yang, D Blackwell, J S Walsh, E McCloskey, N Peel, R Eastell
The central and peripheral skeleton was characterised using imaging techniques during 104 weeks of teriparatide treatment. Teriparatide exerts differential effects on the central and the peripheral skeleton. Overall, we did not observe a change in total body bone mineral. Our conclusions are constrained by the study limitations. INTRODUCTION: Teriparatide stimulates bone formation and resorption and therefore can cause bone gain and loss. We simultaneously characterised the central and peripheral skeleton using imaging techniques to better understand the mechanism of action of teriparatide...
March 8, 2018: Osteoporosis International
Jeffrey B Ziffra, Brian Olshansky
We present the case of a patient who presented with worsening chest pain and tachycardia. We were able to monitor her remotely through her pacemaker. She had been started on the injectable medication teriparatide (Forteo) and since then she had an increase in her symptoms. She was found to have intermittent atrial tachycardia with 1:1 conduction and occasional atrioventricular block transiently, coinciding with her injection of teriparatide. This specific-associated arrhythmia has yet to be described.
February 27, 2018: BMJ Case Reports
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Enshi Nakayama
Surgical treatment of multiple vertebral fractures in patients with glucocorticoid-induced osteoporosis is difficult because of a high rate of secondary fracture postoperatively. A case is described in which initial treatment with teriparatide to improve osteoporosis followed by treatment of kyphosis with correction fusion achieved a favorable outcome. INTRODUCTION: Secondary fracture frequently occurs after treatment of vertebral fracture with vertebroplasty and balloon kyphoplasty in patients with glucocorticoid-induced osteoporosis, but effective treatment of multiple vertebral fractures has rarely been reported...
February 23, 2018: Osteoporosis International
Megan N Michalski, Anna L Seydel, Erica M Siismets, Laura E Zweifler, Amy J Koh, Benjamin P Sinder, J Ignacio Aguirre, Kamran Atabai, Hernan Roca, Laurie K McCauley
A prolonged increase in proinflammatory cytokines is associated with osteoporotic and autoimmune bone loss and, conversely, anti-inflammatory pathways are associated with protection against bone loss. Milk fat globule-epidermal growth factor (MFG-E)-8 is a glycoprotein that is proresolving, regulates apoptotic cell clearance, and has been linked to autoimmune disease and skeletal homeostasis. The role of MFG-E8 in the young vs. adult skeleton was determined in mice deficient in MFG-E8 (KO). In vivo, trabecular bone was similar in MFG-E8KO and wild-type (WT) mice at 6 and 16 wk, whereas 22 wk adult MFG-E8KO mice displayed significantly reduced trabecular BV/TV...
February 22, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Rafael A Buerba, Akshay Sharma, Chason Ziino, Alexander Arzeno, Remi M Ajiboye
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare the efficacy of the use of either bisphosphonates or teriparatide on radiographic and functional outcomes of patients that had thoracolumbar spinal fusion. SUMMARY OF BACKGROUND DATA: Controversy exists as to whether bisphosphonates interfere with successful spinal arthrodesis. An alternative osteoporosis medication is teriparatide, a synthetic parathyroid hormone that has an anabolic effect on osteoblast function...
February 16, 2018: Spine
Jeffrey J Hsu, Jinxiu Lu, Soban Umar, Jason T Lee, Rajan Kulkarni, Yichen Ding, Chih-Chiang Chang, Tzung K Hsiai, Akishige Hokugo, Ioannis Gkouveris, Sotirios Tetradis, Ichiro Nishimura, Linda L Demer, Yin Tintut
Calcific aortic vasculopathy correlates with bone loss in osteoporosis in an age-independent manner. Prior work suggests that teriparatide, the bone anabolic treatment for postmenopausal osteoporosis, may inhibit onset of aortic calcification. Whether teriparatide affects progression of pre-existing aortic calcification, widespread among this patient population, is unknown. Female apolipoprotein E-deficient mice were aged for over one year to induce aortic calcification, treated for 4.5 weeks with daily injections of control vehicle (PBS), teriparatide 40 µg/kg (PTH40) or 400 µg/kg (PTH400), and assayed for aortic calcification by micro-computed tomography (microCT) before and after treatment...
February 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Takahiro Nonaka, Noriko Tsurui, Teruhisa Mannen, Yoshimi Kikuchi, Kentaro Shiraki
This paper describes a new pH-responsive peptide tag that adds a protein reversible precipitation and redissolution character. This peptide tag is a part of a cell surface protein B (CspB) derived from Corynebacterium glutamicum. Proinsulin that genetically fused with a peptide of N-terminal 6, 17, 50, or 250 amino acid residues of CspB showed that the reversible precipitation and redissolution depended on the pH. The transition occurred within a physiological and narrow pH range. A CspB50 tag comprising 50 amino acid residues of N-terminal CspB was further evaluated as a representative using other pharmaceutical proteins...
February 9, 2018: Protein Expression and Purification
Shogo Oki, Takahiro Nonaka, Kentaro Shiraki
Protein purification using non-chromatographic methods is a simple technique that avoids costly resin. Recently, a cell surface protein B (CspB) tag has been developed for a pH-responsive tag for protein purification by solid-liquid separation. Proteins fused with the CspB tag show reversible insolubilization at acidic pH that can be used in solid-liquid separation for protein purification. However, brown-color impurities from co-precipitation hamper further analysis of the target proteins. In this study, we investigated the effect of additives on the co-precipitation of CspB-tagged Teriparatide (CspB50TEV-Teriparatide) expressed in Corynebacterium glutamicum and associated impurities...
February 6, 2018: Protein Expression and Purification
Panagiotis Anagnostis, Stavroula A Paschou, Nifon N Gkekas, Aikaterini-Maria Artzouchaltzi, Konstantinos Christou, Dimitrios Stogiannou, Andromachi Vryonidou, Michael Potoupnis, Dimitrios G Goulis
PURPOSE: Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have been associated with bone fragility and increased fracture risk. However, little is known regarding the effect of anti-osteoporotic treatment on bone mineral density (BMD) and/or fracture risk in these patients. We aimed to systematically investigate the efficacy of anti-osteoporotic medications in patients with diabetes in comparison with non-diabetic subjects. METHODS: MEDLINE and Scopus databases were searched (up to 31st October 2017)...
February 6, 2018: Endocrine
Kiminori Yukata, Chao Xie, Tian-Fang Li, Matthew L Brown, Tsukasa Kanchiku, Xinping Zhang, Hani A Awad, Edward M Schwarz, Christopher A Beck, Jennifer H Jonason, Regis J O'Keefe
Genetic ablation of cyclooxygenase-2 (COX-2) in mice is known to impair fracture healing. To determine if teriparatide (human PTH1-34) can promote healing of Cox-2-deficient fractures, we performed detailed in vivo analyses using a murine stabilized tibia fracture model. Periosteal progenitor cell proliferation as well as bony callus formation was markedly reduced in Cox-2-/- mice at day 10 post-fracture. Remarkably, intermittent PTH1-34 administration increased proliferation of periosteal progenitor cells, restored callus formation on day 7, and enhanced bone formation on days 10, 14 and 21 in Cox-2-deficient mice...
February 2, 2018: Bone
Mohammad Zandi, Arash Dehghan, Najmeh Zandipoor, Payam Amini, Shideh Doulati
OBJECTIVE: To evaluate the effects of different doses and durations of teriparatide therapy on MRONJ resolution in rats. SUBJECTS AND METHODS: A total of 120 rats that had been affected with MRONJ (after six weekly zoledronate injections and tooth extraction) were randomly divided into eight subgroups: 2, 10, and 20 μg/kg/day teriparatide were administered to L4, M4, and H4 for 4 weeks, and to L8, M8, and H8 for 8 weeks, respectively. C4 and C8 received saline for 4 and 8 weeks, respectively...
December 30, 2017: Journal of Cranio-maxillo-facial Surgery
Namki Hong, Jo Eun Kim, Su Jin Lee, Se Hwa Kim, Yumie Rhee
CONTEXT: Teriparatide (TPTD) therapy has been proposed as a potential treatment strategy in severe cases of pregnancy- and lactation-associated osteoporosis (PLO) characterized by the occurrence of fragility fractures in the third trimester or early postpartum. OBJECTIVE: To investigate the changes in bone mineral density (BMD) and bone turnover markers in patients with PLO with and without TPTD treatment. DESIGN: Retrospective cohort study...
February 1, 2018: Clinical Endocrinology
Youqing Huang
Postmenopausal osteoporosis is a degenerative disease caused by lack of estrogen whereby bone degeneration exceeds bone formation, resulting in loss of bone mass. Various drugs have been utilized in an attempt to ameliorate bone strength in such patients. The aim of the present study was to compare the effects of vitamin K or teriparatide alone and combined on bone metabolism and biomechanics in rats with osteoporosis. The ovaries of rats were excised to construct a rat model of osteoporosis. Rats were subjected to oral intake of vitamin K or subcutaneous injection of teriparatide or both for 8 weeks...
January 2018: Experimental and Therapeutic Medicine
Jun Komatsu, Nana Nagura, Hideaki Iwase, Mamoru Igarashi, Osamu Ohbayashi, Isao Nagaoka, Kazuo Kaneko
Grafting β-tricalcium phosphate (TCP) is a well-established method for restoring bone defects; however, there is concern that the mechanical stability of the grafted β-TCP is not maintained during bone translation. Teriparatide has an anabolic effect, stimulating bone formation and increasing bone mineral density for the treatment of osteoporosis. The aim of the present study was to evaluate the effect of intermittent teriparatide treatment on changes in bone grafted with β-TCP using a rabbit bone defect model...
January 2018: Experimental and Therapeutic Medicine
Kristie N Tu, Janette D Lie, Chew King Victoria Wan, Madison Cameron, Alaina G Austel, Jenny K Nguyen, Kevin Van, Diana Hyun
Approximately 10 million men and women in the U.S. have osteoporosis,1 a metabolic bone disease characterized by low bone density and deterioration of bone architecture that increase the risk of fractures.2 Osteoporosis-related fractures can increase pain, disability, nursing home placement, total health care costs, and mortality.3 The diagnosis of osteoporosis is primarily determined by measuring bone mineral density (BMD) using noninvasive dual-energy x-ray absorptiometry. Osteoporosis medications include bisphosphonates, receptor activator of nuclear factor kappa-B ligand inhibitors, estrogen agonists/antagonists, parathyroid hormone analogues, and calcitonin...
February 2018: P & T: a Peer-reviewed Journal for Formulary Management
Akito Morimoto, Junichi Kikuta, Masayuki Furuya, Masaru Ishii
Teriparatide, recombinant human PTH(1-34), is the only anabolic agent widely used for osteoporosis. This drug is thought to promote bone formation by modulating bone remodeling system, although the detailed mechanism remains unclear. Recently, we developed a novel intravital imaging technique to visualize mature osteoclasts and mature osteoblasts simultaneously. By means of this system, we revealed the effect of teriparatide on three-dimensional distribution and cell-to-cell interactions between these cells...
2018: Clinical Calcium
Bancha Chernchujit, Renaldi Prasetia
INTRODUCTION: Tuberosity healing is known to be one of the factors that increase functional outcome in Reverse Total Shoulder Arthroplasty (rTSA). In fragility fractures, tuberosity healing is difficult to be achieved. The fragment stability and bone-forming agent application become strategies to overcome this problem. The purpose of this study was to evaluate the benefit of teriparatide application to promote tuberosity union in rTSA on four-part proximal humeral fractures to achieve better functional outcome...
January 2018: Journal of Orthopaedic Surgery
Fatma Gossiel, Jessica R Scott, Margaret A Paggiosi, Kim E Naylor, Eugene V McCloskey, Nicola F A Peel, Jennifer S Walsh, Richard Eastell
Context: Treatment of postmenopausal osteoporosis with teriparatide (PTH 1-34) increases bone formation and improves bone microarchitecture. A possible modulator of this mechanism of action is periostin. In vitro experiments have shown that periostin may regulate osteoblast differentiation and bone formation through Wnt signaling. Periostin secretion is increased by PTH in preclinical models, but the effect of teriparatide treatment of postmenopausal osteoporosis on periostin is not currently known...
January 22, 2018: Journal of Clinical Endocrinology and Metabolism
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