Pregnancy- and lactation-associated osteoporosis (PLO) is a rare and severe disorder that causes low-trauma or spontaneous fractures, most commonly multiple vertebral fractures, in the late pregnancy or lactation period [1]. In severe PLO, teriparatide (TPTD) might aid in bone mineral density (BMD) recovery and subsequent fracture risk reduction. However, it is unclear whether TPTD can be discontinued without sequential antiresorptive therapy (ART) in premenopausal women with PLO. In this retrospective cohort study, we investigated the changes in BMD in premenopausal women with PLO treated with TPTD 20 mcg daily with or without sequential ART. Data for 67 patients diagnosed with PLO from 2007 through 2017 were reviewed. Among 43 women with annual follow-up dual-energy X-ray absorptiometry data for 3 years, 33 were treated with TPTD (median 12 months) with (TPTD-ART, n = 13; median, 18 months) or without (TPTD-no ART, n = 20) sequential ART. The two groups showed no differences in the mean age (31 vs. 31 years), body mass index (BMI, 20.5 vs. 21.0 kg/m²), and baseline lumbar spine (LS) BMD (0.666 vs. 0.707 g/cm²; p > 0.05 for all). LSBMD increased at 1, 2, and 3 years from baseline in both the TPTD-ART (14.1%, 21.8%, and 24.0%, respectively) and TPTD-no ART (17.3%, 24.1%, and 23.4%, respectively) groups, without significant between-group differences. Similar results were observed for the total hip BMD. LSBMD gain at 3 years did not differ by ART use (adjusted β, 0.40; p = 0.874) in univariable and multivariable models adjusted for age, BMI, and baseline LSBMD. In summary, BMD gain by TPTD administration in premenopausal women with PLO can be well maintained without sequential ART treatment.

妊娠和哺乳期相关骨质疏松症 (PLO) 是一种罕见的严重疾病，可在妊娠晚期或哺乳期引起低创伤或自发性骨折，最常见的是多发性椎体骨折 [1]。在严重的 PLO 中，特立帕肽 (TPTD) 可能有助于骨矿物质密度 (BMD) 恢复和随后的骨折风险降低。然而，对于患有 PLO 的绝经前女性，是否可以在不进行连续抗吸收治疗 (ART) 的情况下停用 TPTD 尚不清楚。在这项回顾性队列研究中，我们调查了 PLO 绝经前女性每天 20 mcg TPTD 治疗后，无论是否接受序贯 ART，其 BMD 的变化。审查了 2007 年至 2017 年诊断为 PLO 的 67 名患者的数据。在 43 名每年随访双能 X 线骨密度仪数据 3 年的女性中，n  = 13; 中位数，18 个月）或没有（TPTD-无 ART，n  = 20）顺序 ART。两组的平均年龄（31 岁对 31 岁）、体重指数（BMI，20.5 对 21.0 kg/m ²）和基线腰椎 (LS) BMD（0.666 对 0.707 g/cm ² ; p  > 0.05 为所有）。在 TPTD-ART（分别为 14.1%、21.8% 和 24.0%）和 TPTD-no ART（分别为 17.3%、24.1% 和 23.4%）组中，LSBMD 在基线 1、2 和 3 年增加，没有显着的组间差异。对全髋骨 BMD 也观察到了类似的结果。3 年的 LSBMD 增益没有因 ART 使用而不同（调整后的β，0.40；p = 0.874) 在针对年龄、BMI 和基线 LSBMD 进行调整的单变量和多变量模型中。总之，TPTD 对 PLO 绝经前妇女的 BMD 增益可以很好地维持，而无需连续 ART 治疗。