title: Active comparator trial of teriparatide vs alendronate for treating glucocorticoid-induced osteoporosis: results from the Hispanic and non-Hispanic cohorts.
abstract: Glucocorticoid use is a leading cause of secondary osteoporosis. This post hoc analysis compared teriparatide vs alendronate on bone mineral density (BMD) in Hispanic and non-Hispanic patients with glucocorticoid-induced osteoporosis. The 18-mo results from all patients (N=428) in a double-blind trial of teriparatide (20 microg/d) and alendronate (10 mg/d) who had taken glucocorticoids for >or=3 mo were reported (Saag et al. N Engl J Med 2007). The present study analyzed results from the Hispanic (n=61) and non-Hispanic (n=367) cohorts. The BMD was measured by dual-energy X-ray absorptiometry (DXA). In the Hispanic cohort at 18 mo, there were significantly greater increases from baseline in the teriparatide vs alendronate group in lumbar spine BMD (9.8%+/-1.7% vs 4.2%+/-1.4%; p<0.001; mean+/-SE) and total hip BMD (5.9%+/-1.6% vs 1.3%+/-1.3%, p<0.001), with no significant difference between groups at the femoral neck (4.3%+/-2.2% vs 2.0%+/-1.8%, p=0.228). Within each treatment group, the BMD responses were not significantly different in the Hispanic vs non-Hispanic cohort. The number of patients reporting >or=1 adverse event was not significantly different between treatments in either cohort, with more patients reporting nausea in the teriparatide group. In summary, teriparatide was more efficacious than alendronate in increasing BMD in Hispanic and non-Hispanic patients with glucocorticoid-induced osteoporosis. Both treatments were generally well tolerated.
authors.affiliation: Hospital Universitario de Caracas, Ciudad Universitaria, Los Chaguaramos, Caracas, Venezuela. losbeni@gmail.com
authors.forename: Benito R
authors.initials: BR
authors.lastname: Losada
authors.forename: Jose R
authors.initials: JR
authors.lastname: Zanchetta
authors.forename: Cristiano
authors.initials: C
authors.lastname: Zerbini
authors.forename: Jose F
authors.initials: JF
authors.lastname: Molina
authors.forename: Pilar
authors.initials: P
authors.lastname: De la Peña
authors.forename: Charlie C
authors.initials: CC
authors.lastname: Liu
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Smith
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Nino
authors.forename: Kelly
authors.initials: K
authors.lastname: Krohn
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Warner
mesh_terms: D019386:Alendronate / Q000494:pharmacology*; D001118:Argentina; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology*; D001938:Brazil; D015331:Cohort Studies; D003105:Colombia; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy* / Q000208:ethnology*; D019379:Teriparatide / Q000494:pharmacology*; D014687:Venezuela
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D019379:Teriparatide; D019386:Alendronate