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Once Daily Teriparatide Helps Bone Architecture Among Postmenopausal Women With Osteoporosis

Teriparatide appears to induce beneficial changes in bone architecture structure, increasing mechanical strength, and has few adverse effects on total bone mineral density or cortical mineral content.

A placebo-controlled trial, carried out by Dr J R Zanchetta and colleagues among various departments at the Universidad del Salvador, Buenos Aires, Argentina, studied postmenopausal women with osteoporosis and the effects of once-daily teriparatide.

The clinicians point out that treatment with teriparatide (which is of rDNA origin) injection [teriparatide, recombinant human parathyroid hormone (1-34) [rhPTH(1-34)]] reduces the risk of vertebral and non-vertebral fragility fractures. It also increases cancellous bone mineral density in postmenopausal osteoporosis. What has not been elucidated thoroughly is its effects on cortical bone, however.

In this cross-sectional study, the researchers assessed parameters of cortical bone quality by peripheral quantitative computed tomography (pQCT) in the non-dominant distal radius of 101 postmenopausal women.

Thirty eight women were randomly allocated to once-daily self-administered subcutaneous injections of teriparatide, 20 micrograms; 28 to teriparatide, 40 micrograms; and 35 to placebo.

After a median 18 months' treatment, the clinicians obtained measurements of moments of inertia, bone circumferences, bone mineral content, and bone area. Results were adjusted for age, height, and weight.

Patients who received teriparatide 40 micrograns, compared with patients who received placebo, had significantly higher total bone mineral content, total and cortical bone areas, periosteal and endocortical circumferences, and axial and polar cross-sectional moments of inertia.

At the same time, patients treated with teriparatide 20 micrograms, compared with patients on placebo, had considerably higher total bone mineral content, total and cortical bone areas, periosteal circumference, and polar cross-sectional moment of inertia.

There were no differences in total bone mineral density, cortical thickness, cortical bone mineral density, or cortical bone mineral content among groups.
J Bone Miner Res 2003 Mar;18:3:539-43. "Effects of teriparatide [recombinant human parathyroid hormone (1-34)] on cortical bone in postmenopausal women with osteoporosis"

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