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Treatment duration with PTH for osteoporosis

Muralidhar V Pai
Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis...
August 2017: Journal of Obstetrics and Gynaecology of India
Woong Chae Na, Sang Hong Lee, Sung Jung, Hyun Woong Jang, Suenghwan Jo
PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of -3.9 (range, -3.1 to -6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively...
June 2017: Hip & Pelvis
Seiji Ohtori, Sumihisa Orita, Kazuyo Yamauchi, Yawara Eguchi, Yasuchika Aoki, Junichi Nakamura, Miyako Suzuki, Gou Kubota, Kazuhide Inage, Yasuhiro Shiga, Koki Abe, Kazuki Fujimoto, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Takeo Furuya, Masao Koda
STUDY DESIGN: Retrospective case series. PURPOSE: The purpose of this study was to determine whether discontinuing teriparatide treatment and replacing it with bisphosphonate treatment maintains the volume of the fusion mass after posterolateral fusion (PLF) in women with postmenopausal osteoporosis. OVERVIEW OF LITERATURE: Clinical data support the efficacy of parathyroid hormone (PTH) for lumbar PLF. However, the use of PTH is limited to 2 years...
April 2017: Asian Spine Journal
Abolghasem Rahimdel, Ali Dehghan, Mahboubeh Abolhassani Moghadam, Ali Mellat Ardekani
INTRODUCTION: Chronic antiepileptic therapy has been associated with metabolic bone diseases including osteomalacia and osteoporosis. The aim of this study was to determine frequency of changes in biochemical and bone mineral density (BMD) in adults receiving valproaic acid (VPA) & carbamazepine (CBZ). METHODS: In a cross sectional study evaluating adults (age 20-50 y) epileptic patients receiving valproic acid or carbamazepine for at least 2 years. This study was conducted from May 2014 to May 2015 in Shahid Sadoughi Hospital of Yazd University of Medical Science, Yazd, Iran...
November 2016: Electronic Physician
Cafer Kaya, Abbas Ali Tam, Ahmet Dirikoç, Aylin Kılıçyazgan, Mehmet Kılıç, Şeyda Türkölmez, Reyhan Ersoy, Bekir Çakır
Objective: Primary hyperparathyroidism (PHP) is a common endocrine disease, and its most effective treatment is surgery. Postoperative hypocalcemia is a morbidity of parathyroid surgeries, and it may extend hospitalization durations. The purpose of this study is to determine the predictive factors related to the development of hypocalcemia and hungry bone syndrome (HBS) in patients who underwent parathyroidectomy for PHP. Materials and methods: Laboratory data comprising parathyroid hormone (PTH), calcium, phosphate, 25-OHD, albumin, magnesium, alkaline phosphatase (ALP), blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH) of the patients were recorded preoperatively, on the 1st and 4th days postoperatively, and in the 6th postoperative month, and their neck ultrasound (US) and bone densitometry data were also recorded...
October 2016: Archives of Endocrinology and Metabolism
Masaru Shimizu, Hiroshi Noda, Eri Joyashiki, Chie Nakagawa, Kentaro Asanuma, Akira Hayasaka, Motohiro Kato, Masahiko Nanami, Masaki Inada, Chisato Miyaura, Tatsuya Tamura
Parathyroid hormone (PTH) is a potential medicine for osteoporosis, and subcutaneous (s.c.) PTH treatment enhances bone mass; however, continuous infusion of PTH elicits bone resorption and induces bone loss. To clarify this contradictory phenomenon, we examined bone markers and bone mass in rats to assess the optimal duration of PTH(1-34) infusion. Continuous infusion of PTH at 1 µg/kg/h (Css, steady-state concentration ca. 300 pg/mL) for 1-4 h clearly stimulated the expression both of bone formation-related genes (c-fos, Wnt4, EphrinB2) and of bone resorption-related genes (tnfsf11, tnfsf11b, encoding receptor activator of nuclear factor-kappaB ligand (RANKL), osteoprotegerin (OPG)), but s...
2016: Biological & Pharmaceutical Bulletin
M Guren Dolu, A Canbolat Ayhan, M Erguven, C Timur, A Yoruk, S Ozdemir
AIM: Aim of the study was to assess bone metabolism disturbances in children with acute lymphoblastic leukemia following cessation of chemotherapy. For this purpose we measured bone mineral density (BMD) and evaluated bone metabolism markers. METHODS: Seventy-five patients (37 female, 38 males, mean age 10.77±3.80 years) were included. Lumbar spine BMD was measured by dual energy X-ray absorptiometry and serum calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone and 25OH vitamin D levels were analyzed...
October 2015: Minerva Pediatrica
Maurizio Rossini, Ombretta Viapiana, Silvano Adami, Elena Fracassi, Luca Idolazzi, Carmela Dartizio, Maria Rosaria Povino, Giovanni Orsolini, Davide Gatti
OBJECTIVES: The objective of this study is to compare the serum levels of Dickkopf-1 (DKK1), a natural inhibitor of Wnt signalling, with parathyroid hormone (PTH) and bone involvement in patients with rheumatoid arthritis (RA). METHODS: This cross-sectional study includes 154 postmenopausal women with RA and 125 healthy controls. DKK1, 25OH vitamin D (25OHD), bone turnover markers, and PTH serum levels were measured by ELISA; lumbar spine and hip bone mineral density (BMD) and the erosion score were obtained...
January 2015: Clinical and Experimental Rheumatology
Cora McGreevy, David Williams
A number of drug classes are licensed for the treatment of osteoporosis including bisphosphonates, recombinant human parathyroid hormone (PTH), strontium, hormone replacement therapy (HRT), selective oestrogen receptor modulators (SERMS) and denosumab. This review discusses the safety of osteoporosis treatments and their efficacies. Recent concerns about the safety of calcium and high-dose vitamin D are discussed. Bisphosphonates have substantial postmarketing experience and a clearer picture of safety issues is emerging...
August 2011: Therapeutic Advances in Drug Safety
Kyung-Eun Song, Yong-Ki Min, Jeong-Keun Lee, Kyi Beom Lee, Hee Jae Joo, Kyu-Sung Kwack, Yoon-Sok Chung
INTRODUCTION: Bisphosphonates are effective for treating osteoporosis, Paget's disease of bone, and malignancy-associated bone diseases. Bisphosphonate-associated osteonecrosis of the jaw (ONJ) is a rare but serious adverse effect of bisphosphonate therapy. Due to inhibitory actions on bone turnover, bisphosphonate therapy may result in the accumulation of microdamage. CASE SUMMARY: A 74-year-old Korean woman (height, 150 cm; weight, 51 kg) was referred to the Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea, for evaluation of pain and persistent abnormal exposure of jaw bone after extraction of teeth...
August 2008: Current Therapeutic Research, Clinical and Experimental
Tetsuo Nakano
Teriparatide (human PTH 1-34) transiently stimulate both bone formation and bone resorption and subsequently bone formation markers increased. The changes in bone turnover markers 24 h after each injection of once-weekly 56.5μg teriparatide were constant for 24 weeks. Once-weekly injections of teriparatide increased bone mineral density by 8.1% at the lumbar spine and reduced the risk of new vertebral fracture with a relative risk reduction of 80% compared to placebo for the patients with osteoporosis. Significant vertebral fracture risk reductions were also observed in the patients with high risk for fracture such as higher age, low bone mineral density, or sever vertebral fracture grade...
January 2014: Clinical Calcium
Amy Sturmer, Nozer Mehta, Jenna Giacchi, Tulin Cagatay, Roxanne Tavakkol, Sheela Mitta, Lorraine Fitzpatrick, Jeff Wald, John Trang, William Stern
BACKGROUND AND OBJECTIVES: Teriparatide [rhPTH(1-34)OH] is a subcutaneously administered bone anabolic drug that increases bone mineral density (BMD) and reduces the risk of osteoporotic fracture. Because rhPTH(1-34)OH is administered by injection, oral delivery is a desirable alternative. However, the peroral delivery of peptides is challenging due to their susceptibility to protease digestion and low permeability through the intestinal layers. The objective of this study was to assess the pharmacokinetics of a PTH analog (rhPTH(1-31)NH2) in a novel oral tablet formulation and to compare them to subcutaneously administered teriparatide in postmenopausal osteoporotic women in a phase 2 proof-of-concept clinical study...
November 2013: Clinical Pharmacokinetics
Sushmita Banerjee, Surupa Basu, Jayati Sengupta
BACKGROUND: Vitamin D deficiency may contribute to osteoporosis in nephrotic syndrome (NS). METHODS: A cross-sectional case-control study was performed to investigate 25 hydroxycholecalciferol [25(OH)D] status in 40 patients with NS in remission and 40 healthy controls. Serum levels of 25(OH)D, calcium, phosphate, alkaline phosphatase (ALP), and intact parathyroid hormone (PTH) were assayed. NS patients were segregated by age at onset, current age, type and duration of NS, months since relapse and current drug therapy...
October 2013: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Antonio Cabal, Khamir Mehta, David S Ross, Rajiv P Shrestha, Wendy Comisar, Andrew Denker, Sudhakar M Pai, Tomohiro Ishikawa
JTT-305/MK-5442 is a calcium-sensing receptor (CaSR) allosteric antagonist being investigated for the treatment of osteoporosis. JTT-305/MK-5442 binds to CaSRs, thus preventing receptor activation by Ca(2+) . In the parathyroid gland, this results in the release of parathyroid hormone (PTH). Sharp spikes in PTH secretion followed by rapid returns to baseline are associated with bone formation, whereas sustained elevation in PTH is associated with bone resorption. We have developed a semimechanistic, nonpopulation model of the time-course relationship between JTT-305/MK-5442 and whole plasma PTH concentrations to describe both the secretion of PTH and the kinetics of its return to baseline levels...
August 2013: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Seiji Ohtori, Gen Inoue, Sumihisa Orita, Kazuyo Yamauchi, Yawara Eguchi, Nobuyasu Ochiai, Shunji Kishida, Kazuki Kuniyoshi, Yasuchika Aoki, Junichi Nakamura, Tetsuhiro Ishikawa, Masayuki Miyagi, Hiroto Kamoda, Miyako Suzuki, Gou Kubota, Yoshihiro Sakuma, Yasuhiro Oikawa, Kazuhide Inage, Takeshi Sainoh, Masashi Takaso, Tomoyuki Ozawa, Kazuhisa Takahashi, Tomoaki Toyone
STUDY DESIGN: Prospective trial. OBJECTIVE: To examine the clinical efficacy of teriparatide for bone union after instrumented lumbar posterolateral fusion using local bone grafting in women with postmenopausal osteoporosis. SUMMARY OF BACKGROUND DATA: Intermittent parathyroid hormone (PTH) treatment increases bone mass and reduces the risk for osteoporotic vertebral fractures. Recombinant human PTH (1-34) has already been approved as a treatment for severe osteoporosis...
November 1, 2012: Spine
Bente Lomholt Langdahl, Torben Harsløf
A vertebral fracture is a serious symptom of osteoporosis. Vertebral fractures cause moderate-to-severe back pain for a shorter or longer duration, increase the risk of a subsequent vertebral fracture approximately four-fold, reduce quality of life significantly and are associated with increased mortality. In order to choose the optimal treatment for the patient, the severity and type of osteoporosis should be investigated. Prevention of new osteoporotic fractures can be accomplished through treatment with both antiresorptive and anabolic treatments...
February 2011: Therapeutic Advances in Musculoskeletal Disease
Tulasi Ponnapakkam, Ranjitha Katikaneni, Hirofumi Suda, Shigeru Miyata, Osamu Matsushita, Joshua Sakon, Robert C Gensure
Parathyroid hormone (PTH) is the most effective osteoporosis treatment, but it is only effective if administered by daily injections. We fused PTH(1-33) to a collagen binding domain (PTH-CBD) to extend its activity, and have shown an anabolic bone effect with monthly dosing. We tested the duration of action of this compound with different routes of administration. Normal young C57BL/6J mice received a single intraperitoneal injection of PTH-CBD (320 μg/kg). PTH-CBD treated mice showed a 22.2 % increase in bone mineral density (BMD) at 6 months and 12...
September 2012: Calcified Tissue International
Santiago Palacios, Claus Christiansen, Rafael Sánchez Borrego, Marco Gambacciani, Payman Hadji, Morten Karsdal, Irene Lambrinoudaki, Stefano Lello, Barbara O'Beirne, Fatima Romao, Serge Rozenberg, John C Stevenson, Zion Ben-Rafael
The risk for fragility fracture represents a problem of enormous magnitude. It is estimated that only a small fraction of women with this risk take the benefit of preventive measures. The relationship between estrogen and bone mass is well known as they are the other factors related to the risk for fracture. There are precise diagnostic methods, including a tool to diagnose the risk for fracture. Yet there continues to be an under-diagnosis, with the unrecoverable delay in instituting preventive measures. Women under the age of 70 years, being much more numerous than those older, and having risk factors, are a group in which it is essential to avoid that first fragility fracture...
October 2012: Gynecological Endocrinology
S-L Han, S-L Wan
To determine the efficacy of teriparatide supplementation for improving bone mineral density (BMD) and fracture risk in postmenopausal osteoporosis and if effects vary with factors. We identified eight randomised controlled trials (n = 2388) using electronic databases, supplemented by a hand-search of the reference lists. All trials aimed to evaluate the efficacy of daily subcutaneous teriparatide injection in postmenopausal osteoporosis. The main outcomes were fracture risk and percentage change of BMD from baseline...
February 2012: International Journal of Clinical Practice
Peter Schwarz, Niklas Rye Jorgensen, Leif Mosekilde, Peter Vestergaard
We studied the effects of increasing age, dosage, and duration of parathyroid hormone (PTH) treatment on changes in bone mineral density (BMD). Randomized placebo controlled trials on PTH treatment in men or women were retrieved from PubMed (1951 to present), Web of Science (1945 to present), or Embase (1974 to present). The search date was November 16, 2010. All studies comparing PTH treatment to either placebo or antiresorptive drugs--for example, bisphosphonates or hormone replacement therapy--were included...
March 2012: Calcified Tissue International
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