title: The effectiveness of teriparatide in the clinical practice--attenuation of the bone mineral density outcome by increasing age and bisphosphonate pretreatment.
abstract: BACKGROUND
  Teriparatide is a potent anabolic agent for severe osteoporosis.
  
  
  OBJECTIVE
  A primary objective of this retrospective study was to define the efficacy of teriparatide in terms of bone mineral density (BMD) changes and relief of back pain in clinical practice.
  
  
  METHODS
  The patient population comprises 119 osteoporotic patients treated with teriparatide for median 539 (range 179-926) days.
  
  
  RESULTS
  The mean BMD gain was 0.9% in the total hip (P = 0.0075), 2.1% in the femoral neck (P = 0.0006), and 8.5% in the lumbar spine (P = 0.0085). In the whole patient population age associated inversely with BMD changes in the total hip (P = 0.019) and in the femoral neck (P = 0.0036). A history of significant bisphosphonate pretreatment (n = 90) reduced BMD response in the total hip (P = 0.039). The total exposure of any prior bisphosphonate was negatively correlated with BMD response in the total hip (P = 0.0421). Half of the patients reported relief of back pain during the treatment. Leg pain, nausea, and dizziness were most frequent adverse concerns.
  
  
  CONCLUSIONS
  Teriparatide works in clinical practice as well as in clinical trials. Younger subjects benefited more than older patients from teriparatide in the total hip and in the femoral neck. Bisphosphonate pretreatment attenuated teriparatide-induced BMD gain.
authors: Jyväskylä Central Hospital, Jyväskylä, Finland. anna-mari.koski@ksshp.fi
authors: Anna-Mari
authors: AM
authors: Koski
authors: Eliisa
authors: E
authors: Löyttyniemi
authors: Hannu
authors: H
authors: Väänänen
authors: Hanna
authors: H
authors: Laine
authors: Leo
authors: L
authors: Niskanen
authors: Pasi I
authors: PI
authors: Nevalainen
authors: Eeva
authors: E
authors: Korpi-Hyövälti
authors: Matti J
authors: MJ
authors: Välimäki
mesh_terms: D015502:Absorptiometry, Photon; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001416:Back Pain / Q000517:prevention & control*; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D024042:Collagen Type I / Q000097:blood / Q000652:urine; D004164:Diphosphonates / Q000009:adverse effects; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control; D010455:Peptides / Q000652:urine; D011347:Procollagen / Q000097:blood; D012189:Retrospective Studies; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; D019379:Teriparatide