title: The impact of secondary hyperparathyroidism on the efficacy of antiresorptive therapy.
abstract: BACKGROUND
  The aim of the present study was to assess whether the efficacy of bisphosphonate treatment is influenced by PTH levels measured in newly diagnosed osteoporotic patients and to identify the threshold value, beyond which PTH level negatively influences therapeutic efficacy.
  
  
  METHODS
  One hundred and thirty-eight osteoporotic patients were enrolled into the study. All subjects underwent laboratory screening, bone densitometry with DEXA, and x-ray imaging. The changes in bone density were evaluated after a mean follow-up period of 13.37 ± 1.29 months. Correlation analysis was performed on the clinical data of patients, the percentage changes of BMD values, and the PTH levels measured at the beginning of study, using SPSS software.
  
  
  RESULTS
  The mean age of the subjects was 64.82 ± 10.51 years, and the female-to-male ratio was 116/22. Baseline BMD value measured with AP DEXA scanning was 0.854 ± 0.108 g/cm(2) in the L(1-4) vertebrae and 0.768 ± 0.115 g/cm(2) in the left femoral neck. By the end of the follow-up period, these values changed to 0.890 ± 0.111 g/cm(2) and 0.773 ± 0.111 g/cm(2), respectively. We found a statistically significant, negative correlation between PTH levels and the percentage changes of lumbar BMD values measured at the end of the follow-up (correlation coefficient R(2) = 0.121, p < 0.0001). The analysis of frequency histograms suggested that negative effects on bone might be expected above a PTH level of 60 pg/mL (7.3 pmol/L).
  
  
  CONCLUSIONS
  Our findings imply that a baseline PTH level over 60 ng/mL can reduce the efficacy of bisphosphonate treatment.
authors.affiliation: Department of Rheumatology, Kenézy Gyula Hospital, Debrecen, Hungary.
authors.forename: Gyöngyvér
authors.initials: G
authors.lastname: Kincse
authors.forename: József
authors.initials: J
authors.lastname: Varga
authors.forename: Péter
authors.initials: P
authors.lastname: Somogyi
authors.forename: Péter
authors.initials: P
authors.lastname: Szodoray
authors.forename: Péter
authors.initials: P
authors.lastname: Surányi
authors.forename: János
authors.initials: J
authors.lastname: Gaál
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001862:Bone Resorption / Q000097:blood / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D010281:Parathyroid Hormone