Effects of teriparatide on cortical histomorphometric variables in postmenopausal women with or without prior alendronate treatment |
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| Institution: | 1. Lilly Research Laboratories, Indianapolis, IN, USA;2. Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA;3. Department of Biology, Indiana University Purdue University, Indianapolis, IN, USA;4. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria;5. 3rd Dept. of Internal Medicine, Charles University Faculty of Medicine 1, Prague, Czech Republic;6. Lilly Research Centre, Windlesham, United Kingdom;7. Institute of Rheumatology, and Charles University Faculty of Medicine 1, Prague, Czech Republic;1. Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Skeleton Materials and Biocompatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;3. Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;4. Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, I-Lan, Taiwan;5. Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;6. Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;7. Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan;1. Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom;2. Metabolic Bone Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, United Kingdom;1. Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva.;2. The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva.;1. Department of Nuclear Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan;2. Medical Science Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan;3. Bioclinica, Inc., 11731 Northeast Glenn Widing Drive Portland, Oregon 97220, United States;4. Biostatistics and Data Management Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan;5. Clinical Development Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan;6. Post-Marketing Regulatory Affairs Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan;7. Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan;8. Center for Diversity and Inclusion, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan;9. Touto Sangenjaya Rehabilitation Hospital, 1-24-3 Sangenjaya, Setagaya-ku, Tokyo 154-0024, Japan |
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| Abstract: | Cortical bone, the dominant component of the human skeleton by volume, plays a key role in protecting bones from fracture. We analyzed the cortical bone effects of teriparatide treatment in postmenopausal women with osteoporosis who had previously received long-term alendronate (ALN) therapy or were treatment naïve (TN). Tetracycline-labeled paired iliac crest biopsies obtained from 29 ALN-pretreated and 16 TN women were evaluated for dynamic histomorphometric parameters of bone formation at the periosteal, endocortical and intracortical bone compartments, before and after 24 months of teriparatide treatment. At baseline, the frequency of specimens without any endocortical and periosteal tetracycline labeling, and the percentage of quiescent osteons, was higher in the ALN than the TN group. Endocortical and periosteal mineralizing surface (MS/BS%), periosteal bone formation rate (BFR/BS), mineral apposition rate (MAR) and the number of intracortical forming osteons were significantly lower in the ALN-pretreated patients than in the TN group. Following teriparatide treatment, the frequency of endocortical and periosteal unlabeled biopsies decreased; in the ALN-pretreated group the percentage of quiescent osteons decreased and, in contrast, forming and resorbing osteons were increased. Teriparatide treatment resulted in significant increases of MAR in the endocortical, and MS/BS% in the periosteal compartment in the ALN-pretreated group. Most indices of bone formation remained lower in the ALN-pretreated group compared with the TN group at study end. Endocortical wall width was increased in both ALN-pretreated and TN groups. Cortical porosity and cortical thickness were significantly increased in the ALN-pretreated group after teriparatide treatment. Our results suggest that 24 months of teriparatide treatment increases cortical bone formation and cortical turnover in patients who were either TN or had previous ALN therapy. |
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