title: [Efficacy of teriparatide in treatment of glucocorticoid-induced osteoporosis].
abstract: The skeletal effects of glucocorticoids include both direct and indirect actions on bone that result early, transient in bone resorption accompanied by a decrease in bone formation, which is maintained for the duration of glucocorticoid therapy. Teriparatide exerts anabolic effects on bone, so it is understandable why teriparatide is thought to be a rational treatment option. The effects of 36 months' treatment with teriparatide and alendronate in women and men with glucocorticoid-induced osteoporosis were examined in an active-comparator randomized, double-blind, controlled trial. This study confirmed the superiority of teriparatide over alendronate with respect BMD changes in the spine and hip and significantly reduced risk of vertebral fractures in teriparatide-treated patients. However, because teriparatide is significantly more expensive than bisphosphonates and has not been demonstrated in adequately powered studies to be superior in reducing fractures, bisphosphonates remain the first-line treatment option for the majority of glucocorticoid-treated patients at increased risk of fracture.
authors.affiliation: Department of Orthopaedic Surgery and Rheumatology, Kinki University School of Medicine, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Soen
mesh_terms: D019386:Alendronate / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D019379:Teriparatide; D019386:Alendronate