title: Efficacy of Daily Teriparatide Treatment in Low Levels of Walking State Patients.
abstract: BACKGROUND
  Little is known about the efficacy of osteoporosis medication in patients with low levels of walking state, namely, influence by immobilization levels. We retrospectively compared the efficacy of the daily teriparatide therapy in patients with low and high levels of walking state to detect possible immobilization-related differences.
  
  
  METHODS
  We analyzed 661 patients treated with 20 μg/day of teriparatide for 24 months. We measured the changes in the bone mineral density (BMD) of the lumbar spine (LS) and of the femoral neck (FN), the changes in serum procollagen type I N-terminal propeptide (PINP) levels and urinary N-telopeptide (uNTX) excretion. To compare the results of BMD and bone turnover marker, the patients were divided into two subgroups, low levels of walking state and high levels of walking state.
  
  
  RESULTS
  Compared with baseline, in the low levels of walking state subgroup, the percent LS BMD and FN BMD increased significantly by 12.8 ± 8.9% and 5.0 ± 13.8% at 24 months, respectively (p < 0.01 vs baseline for LS and FN, respectively); the mean absolute LS BMD and FN BMD change was 0.101 ± 0.067 g/cm2and 0.017 ± 0.063 g/cm2at 24 months, respectively. In the high levels of walking state subgroup, the percent LS BMD and FN BMD increased significantly by 13.4 ± 9.5% and 3.1 ± 7.8% at 24 months, respectively; the mean absolute LS BMD and FN BMD change was 0.104 ± 0.068 g/cm2and 0.017 ± 0.042 g/cm2at 24 months, respectively. The increases in percent and absolute BMD in LS and FN, and the changes in PINP and uNTX were similar between the subgroups.
  
  
  CONCLUSIONS
  The efficacy of the daily teriparatide treatment is similar between low levels of walking state patients and high levels of walking state patients and was not influenced by immobilization levels.
authors.affiliation: Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan. furikakefuri@hotmail.co.jp.
authors.forename: Rui
authors.initials: R
authors.lastname: Niimi
authors.affiliation: Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan.
authors.forename: Toshibumi
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nishihara
authors.affiliation: Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie, 514-8507, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie, 514-8507, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects; D024042:Collagen Type I / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000652:urine; D011347:Procollagen / Q000097:blood; D012189:Retrospective Studies; D019379:Teriparatide / Q000627:therapeutic use*; D016138:Walking
chemical_list: D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D019379:Teriparatide