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Teriparatide Treatment in Patients with Pregnancy- and Lactation-Associated Osteoporosis
Calcified Tissue International ( IF 3.3 ) Pub Date : 2021-06-16 , DOI: 10.1007/s00223-021-00871-y
Kalliopi Lampropoulou-Adamidou 1 , Georgios Trovas 1 , Ioannis K Triantafyllopoulos 1, 2 , Maria P Yavropoulou 3 , Athanasios D Anastasilakis 4 , Panagiotis Anagnostis 5 , Konstantinos A Toulis 4 , Konstantinos Makris 6 , Sousana Gazi 7 , Alexia Balanika 8 , Symeon Tournis 1
Affiliation  

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare disease, presenting in most cases with severe back pain due to low energy vertebral fractures (VFs). Our purpose was to assess the effect of teriparatide (TPTD) vs. conventional management on areal bone mineral density (aBMD) and trabecular bone score (TBS) in patients with PLO. A multicenter retrospective cohort study concerning premenopausal women with PLO. Nineteen women were treated with TPTD (20 μg/day) (group A) plus calcium and vitamin D and eight women with calcium and vitamin D only (group B) for up to 24 months. The primary end-point was between group differences in lumbar spine (LS) and total hip (TH) aBMD, and TBS at 12 and 24 months. Patients in group A had sustained a median of 4.0 VFs (3–9) vs. 2.5 VFs (1–10) in group B (p = 0.02). At 12 months, patients on TPTD vs. controls achieved a mean aBMD increase of 20.9 ± 11.9% vs. 6.2 ± 4.8% at the LS (p < 0.001), 10.0 ± 11.6% vs. 5.8 ± 2.8% at the TH (p = 0.43), and 6.7 ± 6.9% vs. 0.9 ± 3.7% in TBS (p = 0.09), respectively. At 24 months, seven patients on TPTD and six controls achieved a mean LS aBMD increase of 32.9 ± 13.4% vs. 12.2 ± 4.2% (p = 0.001). P1NP levels during the first month of TPTD treatment were positively correlated with the 1-year LS aBMD change (r = 0.68, p = 0.03). No new clinical fractures occurred while on-treatment. In patients with PLO, TPTD treatment resulted in significantly greater increases in LS aBMD compared with calcium and vitamin D supplementation at 12 and 24 months.



中文翻译:

妊娠和哺乳期相关骨质疏松症患者的特立帕肽治疗

妊娠和哺乳期相关的骨质疏松症 (PLO) 是一种罕见的疾病,在大多数情况下会因低能量椎骨骨折 (VF) 而出现严重的背痛。我们的目的是评估特立帕肽 (TPTD). PLO 患者面积骨密度 (aBMD) 和骨小梁评分 (TBS) 的常规管理。一项关于患有 PLO 的绝经前妇女的多中心回顾性队列研究。19 名女性接受 TPTD(20 微克/天)(A 组)加钙和维生素 D 治疗,8 名女性仅接受钙和维生素 D(B 组)治疗长达 24 个月。主要终点是 12 个月和 24 个月时腰椎 (LS) 和全髋 (TH) aBMD 和 TBS 的组间差异。A 组患者的 VF 中位数为 4.0 (3–9),. B 组中有 2.5 个 VF (1–10) ( p  = 0.02)。在12个月,患者TPTD控制达到20.9±11.9%的平均增幅ABMD VS。LS 6.2 ± 4.8% ( p  < 0.001),10.0 ± 11.6% vs . 在TH(5.8±2.8%p  = 0.43),和6.7±6.9%VS。在 TBS 中 分别为0.9 ± 3.7% ( p = 0.09)。在24个月,七名病人对TPTD和六个控制达到32.9±13.4%的平均LS ABMD增加VS。12.2 ± 4.2% ( p  = 0.001)。TPTD 治疗第一个月的 P1NP 水平与 1 年 LS aBMD 变化呈正相关(r  = 0.68,p = 0.03)。治疗期间未发生新的临床骨折。在 PLO 患者中,在 12 个月和 24 个月时,与补充钙和维生素 D 相比,TPTD 治疗导致 LS aBMD 显着增加。

更新日期:2021-06-17
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