title: hPTH 1-34 treatment of osteoporosis with added hormone replacement therapy: biochemical, kinetic and histological responses.
abstract: Twelve patients with vertebral fracture osteoporosis were recruited into a trial of treatment with hPTH 1-34 by daily injection for 1 year combined (from the 5th month) with an anti-resorptive agent (oestrogen, n = 9; nandrolone, n = 3). Treatment outcomes were monitored by biochemical and radiotracer measurements together with histomorphometry of transiliac biopsies before and at the end of treatment following double in vivo pre-labelling with demethylchlortetracycline. Indices of whole body bone formation, obtained from the analysis of 85Sr data, showed substantial increases (P less than 0.005) for all three indices measured) while biochemical (hydroxyproline) and kinetic measurements of bone resorption showed modest and equivocal changes only. As a result calcium balance improved. Gastrointestinal calcium absorption showed a tendency to improve, while urine calcium decreased; but these changes were statistically not significant except for radiocalcium absorption in the oestrogen treated subgroup. Histomorphometry revealed substantial increases in cancellous bone volume as reported previously with hPTH 1-34 given alone. However, iliac (as distinct from whole body) indices related to bone formation and resorption appeared to have returned towards pre-treatment values by the time of the second biopsy under the influence of the anti-resorptive agent given with the hPTH 1-34. It is confirmed that hPTH 1-34 therapy can increase iliac cancellous bone mass (as well as spinal cancellous bone mass as reported earlier) without a long-term increment in whole body bone resorption, providing the hPTH is combined with an anti-resorptive agent.
authors.affiliation: MRC Clinical Research Centre, Harrow, UK.
authors.forename: J
authors.initials: J
authors.lastname: Reeve
authors.forename: J N
authors.initials: JN
authors.lastname: Bradbeer
authors.forename: M
authors.initials: M
authors.lastname: Arlot
authors.forename: U M
authors.initials: UM
authors.lastname: Davies
authors.forename: J R
authors.initials: JR
authors.lastname: Green
authors.forename: L
authors.initials: L
authors.lastname: Hampton
authors.forename: C
authors.initials: C
authors.lastname: Edouard
authors.forename: R
authors.initials: R
authors.lastname: Hesp
authors.forename: P
authors.initials: P
authors.lastname: Hulme
authors.forename: J P
authors.initials: JP
authors.lastname: Ashby
mesh_terms: D000368:Aged; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007085:Ilium / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D010281:Parathyroid Hormone / Q000627:therapeutic use*; D010446:Peptide Fragments / Q000627:therapeutic use*; D019379:Teriparatide; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone; D010446:Peptide Fragments; D019379:Teriparatide