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Teriparatide Stimulates Bone Turnover in Patients Treated With Previous Antiresorptive Therapy: Presented at ASBMR

By Mary Beth Nierengarten

MINNEAPOLIS, MN -- October 6, 2003 -- Postmenopausal women treated with teriparatide after discontinuation of long-term antiresorptive therapy show increases in bone markers and bone mineral density (BMD), particularly if they were treated previously with raloxifene.

Bruce Ettinger, MD, of the Kaiser Permanente Medical Care Program, Oakland, California, United States, presented these findings here September 21^st at the 25^th Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).

In this 18-month update of a study presented at last year's 2002 ASBMR meeting, postmenopausal women treated with teriparatide after long-term treatment with either alendronate or raloxifene continue to show increases in BMD, although cumulative changes with alendronate are considerably less.

The study was conducted in collaboration with Eli Lilly Research Laboratories, Indianapolis, Indiana, United States, to determine if prior treatment with alendronate or raloxifene would affect response to teriparatide. Postmenopausal women received teriparatide (20 mcg subcutaneously once-daily) immediately after they discontinued 18 months or more of treatment with either 10 mg alendronate (n=33) or 60 mg raloxifene (n=26). Baseline scores were comparable in all patients at study initiation, except for significantly lower markers of bone turnover in the patients treated with alendronate. Eli Lilly manufactures both raloxifene and teriparatide.

Although rapid significant increases in bone markers were seen from baseline for both treatment groups, and both groups experienced significant increases in lumbar spine BMD from baseline (p<0.05), only the patients previously treated with raloxifene also had increased total hip BMD after 12 months. In addition, increases in BMD were less for the patients previously treated with alendronate, compared with those treated with raloxifene.

According to Dr. Ettinger, although there is speculation about the reason for the discrepancy between the rapid increases in bone markers and reduced BMD response in the alendronate-treated patients, the real answer is not fully known and awaits longer study follow-up. He said it is not yet clear whether women who are exposed to alendronate for a length of time are less likely to respond to teriparatide. "I have to withhold judgement until we see how much these women [previously treated with alendronate] ultimately gain [in BMD]," he said.


[Study title: Response of Markers of Bone Turnover and Bone Density to Teriparatide in Postmenopausal Women Previously Treated with an Antiresorptive Drug. Abstract 1055]

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