In women with postmenopausal osteoporosis, teriparatide treatment for 24 months restores bone mineral quality indices to premenopausal levels, according to study results presented at the American Society for Bone and Mineral Research (ASBMR) Annual Meeting 2021, held from October 1 to 4, 2021, in San Diego, California, and real-time virtually.

This study assessed teriparatide treatment (20 mg daily) in women with postmenopausal osteoporosis compared with healthy premenopausal women, treatment-naive women with postmenopausal osteoporosis, and a placebo group of women with postmenopausal osteoporosis.

Iliac-crest biopsies at 3 tissue ages (mid-distance between the second label and the bone surface, mid-distance between the 2 labels, and 1 μm behind the first label) were analyzed at 6 and 24 months using Raman microspectroscopy. The researchers determined bone mineral quality indices including mineral-to-matrix ratio (MM), mineral maturity/crystallinity (MMC), tissue water (TW), glycosaminoglycan (GAGs), and pyridinoline (Pyd). ANCOVA analyses were used to compare outcomes between treatment groups.


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Researchers noted the following results:

  • At 6 and 24 months, MM was higher in the teriparatide group vs the placebo group. At 6 months, the teriparatide group had MM values similar with the premenopausal group. After 24 months, MM increased in the teriparatide group and was higher than in the premenopausal group. 
  • At 6 and 24 months, MMC was lower in the teriparatide group vs the placebo group, and was similar with that of the premenopausal group.
  • At 6 months, TW was higher in the teriparatide group compared with the premenopausal and treatment-naive groups. At 24 months, TW levels were similar with the premenopausal group and lower than the placebo group.
  • The teriparatide group at 6 and 24 months had lower GAG content compared with premenopausal and treatment naive groups. This was noted to be consistent with higher bone turnover rates expected in patients treated with teriparatide. At 6 months, the teriparatide group had higher GAG content compared with that of the placebo.
  • At 6 months, Pyd content in the teriparatide group was higher than in the premenopausal group and lower than in the placebo group. At 24 months, Pyd content in the teriparatide group declined to premenopausal levels.

The researchers concluded, “The results of the present study indicate that effects of [teriparatide] on forming trabecular bone quality indices depend on treatment duration. At the recommended length of 24 [months], [teriparatide] restores bone mineral and organic matrix quality indices (MMC, TW, Pyd content) to premenopausal healthy [l]evels.”

Reference

Paschalis E, Gamsjaeger S, Klaushofer K, et al. Treatment of postmenopausal osteoporosis patients with teriparatide for 24 months restores forming bone quality indices to premenopausal healthy control values. Presented at: ASBMR Annual Meeting 2021; October 1-4, 2021; San Diego, CA. Abstract 1059.