title: ANABOLIC BONE WINDOW WITH WEEKLY TERIPARATIDE THERAPY IN POSTMENOPAUSAL OSTEOPOROSIS: A PILOT STUDY.
abstract: OBJECTIVE
  Osteoporosis is a major public health problem that reduces bone strength and increases fracture risk. Teriparatide is an established and the only currently available anabolic therapy for the treatment of postmenopausal osteoporosis (PMO) with a recommended daily dose of 20 μg given subcutaneously. However, there are limited data regarding the long-term effect of once-weekly teriparatide therapy on bone mineral density (BMD), bone turnover markers (BTMs), and anabolic bone window.
  
  
  METHODS
  In this prospective observational study, 26 patients with PMO were treated with weekly teriparatide therapy (60 μg) for 2 years. BMD was measured at baseline, 12 months, and 24 months. The bone formation marker type 1 collagen C-terminal propeptide (P1NP) and the bone resorption marker C-terminal telopeptide of type 1 collagen (CTx) were measured at baseline; 6 weeks; and 6, 12, 18, and 24 months.
  
  
  RESULTS
  BMDs at the lumbar spine increased by 3.1% and 10.8% after 1 and 2 years of weekly teriparatide therapy, respectively. The T-score increased significantly at the lumbar spine compared to baseline after 2 years of therapy (P = .015). Serum P1NP levels increased significantly at 6 months (P = .024), peaked at 1 year, and remained above the baseline even after 2 years. Serum CTx levels decreased significantly at 6 months (P = .025) and remained below baseline after 2 years of teriparatide therapy.
  
  
  CONCLUSIONS
  Weekly teriparatide therapy (60 μg) appears to be as effective as daily teriparatide for the treatment of PMO by extending the anabolic bone window.
  
  
  BACKGROUND
  AE = adverse event; BMD = bone mineral density; BTM = bone turnover marker; CTx = C-terminal telopeptide of type 1 collagen; DXA = dual-energy X-ray absorptiometry; iPTH = intact parathyroid hormone; P1NP = type 1 collagen C-terminal propeptide; PMO = postmenopausal osteoporosis.
authors.forename: Vinaya
authors.initials: V
authors.lastname: Gopalaswamy
authors.forename: Deba Prasad
authors.initials: DP
authors.lastname: Dhibar
authors.forename: Vipin
authors.initials: V
authors.lastname: Gupta
authors.forename: Ashutosh Kumar
authors.initials: AK
authors.lastname: Arya
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
authors.forename: Sudhir Kumar
authors.initials: SK
authors.lastname: Garg
authors.forename: Neelam
authors.initials: N
authors.lastname: Agarwal
authors.forename: Sudhaker D
authors.initials: SD
authors.lastname: Rao
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Bhadada
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D024042:Collagen Type I / Q000378:metabolism; D004334:Drug Administration Schedule; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D010455:Peptides / Q000378:metabolism; D010865:Pilot Projects; D011347:Procollagen / Q000378:metabolism; D011446:Prospective Studies; D019379:Teriparatide / Q000008:administration & dosage*
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