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Teriparatide (Forteo) Increases Bone Mineral Density in Men with Glucocorticoid-Induced Osteoporosis

Treatment more effective than risedronate (May 29)

In a new study published in the Journal of Bone and Mineral Research, teriparatide [rDNA origin] injection (Forteo; Eli Lilly) significantly increased lumbar spine volumetric bone mineral density (vBMD) compared with risedronate in men with glucocorticoid-induced osteoporosis. Glucocorticoid-induced osteoporosis is caused by excess intake of glucocorticoids, a class of steroid hormones used to treat inflammatory, autoimmune, and allergic disorders.

At 18 months, a significantly greater increase in lumbar spine vBMD was achieved with teriparatide compared with risedronate (mean change from baseline: 16.3% vs. 3.8%, respectively; P = 0.004).

The measurements were conducted using conventional and high-resolution quantitative computed tomography (QCT), a newer technology that uses modern clinical scanners to provide tri-dimensional BMD and bone-structure evaluations. According to the drug’s developer (Lilly), QCT is better able to discriminate between subjects with and without prevalent vertebral fractures compared with conventional dual X-ray absorptiometry (DXA) and is better suited to identify patients with glucocorticoid-induced osteoporosis at highest risk for fracture.

Secondary outcomes included:

  • A significant increase in estimated vertebral strength in both treatment groups, with statistically higher increases in patients taking teriparatide (26.0% to 34.0%; P < 0.005) compared with risedronate (4.2% to 6.7%; P < 0.015) after 18 months of therapy
  • A trend toward a higher bone volume fraction in patients taking teriparatide versus risedronate (mean change from baseline: +23.1% vs. +7.3%, respectively; P = 0.098)
  • A significant increase in vBMD at the lumbar spine and the total hip after 18 months of treatment for both groups, with significantly higher increases for teriparatide compared with risedronate at the lumbar spine (mean: +6.94% vs. +3.33%, respectively; P = 0.045) and at the femoral neck (mean: +1.52% vs. –1.10%, respectively; P = 0.026)
  • A trend toward fewer clinical fractures in patients taking teriparatide compared with those taking risedronate (0% [0/45] vs. 10.6% [5/47], respectively; P = 0.056)

Source: Eli Lilly; May 29, 2013.

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