Teriparatide and denosumab combination therapy and skeletal metabolism
| Autor: | Vania Braga, Maurizio Rossini, S. Adami, Luca Idolazzi, C. Benini, Davide Gatti, Vidya Satheesn Kunnathully, Ombretta Viapiana, Angelo Fassio |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Combination therapy Endocrinology Diabetes and Metabolism Urology Turnover markers 030209 endocrinology & metabolism Bone remodeling 03 medical and health sciences chemistry.chemical_compound Postmenopausal osteoporosis 0302 clinical medicine N-terminal telopeptide Bone Density Teriparatide Internal medicine medicine Humans Prospective Studies Osteoporosis Postmenopausal Aged Aged 80 and over Bone Density Conservation Agents business.industry Combined therapy Denosumab Rheumatology 030104 developmental biology chemistry Sclerostin Female Bone Remodeling business Biomarkers Type I collagen medicine.drug |
| Zdroj: | Osteoporosis International. 27:3301-3307 |
| ISSN: | 1433-2965 0937-941X |
| Popis: | Several therapies are available for osteoporis. Understanding the bone turnover changes and their mutual realtionship gives an overall view and might lead to a target therapy INTRODUCTION: The aim of this study is to compare the changes in bone turnover markers in patients treated with either denosumab alone, teriparatide (TPTD) alone, or in a third therapeutic scheme, when TPTD was added to patients previously treated with denosumab.Fifty-nine women over 65 years old with severe postmenopausal osteoporosis (evidence of at least two moderate-severe vertebral fractures) were enrolled in the study. Serum samples were collected every 3 months. They were assayed for intact N-propeptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), intact parathyroid hormone (PTH), 25 hydroxy-vitamin D (25 OHD), Sclerostin (SOST), and Dickkopf-related protein 1 (DKK1). Bone mass density was assessed by dual-energy X-ray absorptiometry at the lumbar spine and at the total hip.In the groups treated only with TPTD or with denosumab, bone turnover markers increased and decreased, respectively. In TPTD group, a later significant increase in DKK1 was observed, while in denosumab group, a progressive increase in SOST was associated with a progressive significant decrease in DKK1. In the group treated first with denosumab and in which TPTD was added 3 months later, both CTX and P1NP increased 3 months after the beginning of TPTD. The strong effect of denosumab on bone turnover seems to be reversed by TPTD treatment.In this study, we showed that TPTD is able to express its biological activity even when bone turnover is fully suppressed by denosumab treatment. The combination therapy is associated with significant increases in both DKK1 and SOST. |
| Databáze: | OpenAIRE |
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