title: Combined use of teriparatide and TNFalpha blockade: safety.
abstract: Up to now, there have been no reports about the combined use of Teriparatide and Anti- TNFalpha blockers in patients affected by inflammatory bone diseases and osteoporosis. In this report, we evaluate the safety of the combined therapeutic use of Teriparatide and Anti-TNFalpha drugs in patients with inflammatory arthritis and severe osteoporosis. Six female patients were selected and treated with biological therapy (3 patients with Etanercept, 3 with Infliximab) for arthritis (2 RA, 4 SPA), having suffered at least 2 vertebral fragility fractures. The mean T-score value, tested by DEXA densitometry, was -2.8 SD - diagnostic for osteoporosis according to WHO criteria. All patients were treated with Teraparatide s.c. (20 microg daily), together with 1200 mg of calcium and 800 IU of vitamin D daily. Until the present time, we have observed no side-effects or therapeutic discontinuity. During the 9-month follow-up period, we did not observe any new symptomatic fractures or infections in treated patients, but we found a reduction in parameters indicating inflammation; no differences were found in biochemical parameters.
authors.affiliation: Department of Rheumatology, Ospedale S. Pietro, 00189 Rome, Italy. albertomigliore@terra.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Migliore
authors.forename: Umberto
authors.initials: U
authors.lastname: Massafra
authors.forename: Anna
authors.initials: A
authors.lastname: Capuano
authors.forename: Severino Martin
authors.initials: SM
authors.lastname: Martin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D010024:Osteoporosis / Q000188:drug therapy; D025241:Spondylarthritis / Q000188:drug therapy*; D019379:Teriparatide / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D050071:Bone Density Conservation Agents; D014409:Tumor Necrosis Factor-alpha; D019379:Teriparatide; D000069285:Infliximab