title: Teriparatide vs. alendronate as a treatment for osteoporosis: changes in biochemical markers of bone turnover, BMD and quality of life.
abstract: BACKGROUND
  We studied the use of teriparatide in postmenopausal women with severe osteoporosis.
  
  
  METHODS
  Two groups (A and B) of patients affected by severe osteoporosis (T-score ≤-2.5 at bone mineral density were analyzed and 2 vertebral fractures on radiograph). Group A was treated for 18 months with 20 µg/day of teriparatide. Group B was treated with bisphosphonates 70 mg/week. Every woman assumed 1 g of calcium and 800 IU of vitamin D3 daily. We evaluated the effects of therapy after 18 months (T18) from the beginning with bone turnover markers (alkaline phosphatase, procollagen type 1 N-terminal propeptide, and N-telopeptide cross-links) and dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Group A, at T18 procollagen type 1 N-terminal propeptide levels, increased 127%; bone alkaline phosphatase levels increased to 65%; N-telopeptide cross-links levels increased to 110%. Group B, at T18 procollagen type 1 N-terminal propeptide levels, decreased to 74%; bone alkaline phosphatase levels decreased to 41%; N-telopeptide cross-links levels decreased to 72%. After 18 months, lumbar bone mineral density increased to 12.4% and femoral bone mineral density increased to 5.2% in group A. Group B lumbar bone mineral density increased to 3.85% and femoral bone mineral density increased to 1.99%. Only a new vertebral fracture occurred in group A (2.4%), whereas 6 fractures occurred in group B (15.7%). The quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO) revealed a significant improvement in daily living, performed domestic jobs, and locomotor function in groups A and B.
  
  
  CONCLUSIONS
  The use of rhPTH in patients with severe osteoporosis offers more protection against fractures and improves the QoL more than bisphosphonates.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, Naples, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Panico
authors.forename: Gelsy Arianna
authors.initials: GA
authors.lastname: Lupoli
authors.forename: Francesca
authors.initials: F
authors.lastname: Marciello
authors.forename: Roberta
authors.initials: R
authors.lastname: Lupoli
authors.forename: Marianna
authors.initials: M
authors.lastname: Cacciapuoti
authors.forename: Addolorata
authors.initials: A
authors.lastname: Martinelli
authors.forename: Luciana
authors.initials: L
authors.lastname: Granieri
authors.forename: Daniela
authors.initials: D
authors.lastname: Iacono
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lupoli
mesh_terms: D000368:Aged; D019386:Alendronate / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D011446:Prospective Studies; D011788:Quality of Life; D013131:Spine / Q000473:pathology; D019379:Teriparatide / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D019379:Teriparatide; D019386:Alendronate