The effects of teriparatide on the incidence of back pain in postmenopausal women with osteoporosis

Genant, Harry K.; Halse, Johan; Briney, Walter G.; Xie, Lechun; Glass, Emmett V.; Krege, John H.

doi:10.1185/030079905x49671

Cited by 60 publications

(46 citation statements)

References 29 publications

(25 reference statements)

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“…The observed reduction in back pain with longer duration of teriparatide treatment is complementary to previous observations that postmenopausal women treated with teriparatide had reduced incidence of back pain, which appeared to track with a reduction in vertebral fracture risk [14][15][16]. Genant previously reported that women in the teriparatide group had a reduced risk for back pain with a subsequent finding of new vertebral fractures, more severe vertebral fractures, and multiple vertebral fractures compared with placebo [14]. The reduced risk of back pain in teriparatidetreated patients was consistent with a reduction in the risk of new painful vertebral fractures [14].…”

Section: Discussionsupporting

confidence: 76%

“…Genant previously reported that women in the teriparatide group had a reduced risk for back pain with a subsequent finding of new vertebral fractures, more severe vertebral fractures, and multiple vertebral fractures compared with placebo [14]. The reduced risk of back pain in teriparatidetreated patients was consistent with a reduction in the risk of new painful vertebral fractures [14]. Also, increased duration of treatment appeared to be associated with decreased incidence clinical vertebral fractures, defined as treatment-emergent back pain plus a subsequent finding at the end of the study of at least one vertebral fracture.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between duration of teriparatide therapy and clinical outcomes in postmenopausal women with osteoporosis

et al. 2008

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Relationship between duration of teriparatide therapy and clinical outcomes in postmenopausal women with osteoporosis

et al. 2008

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“…These data, combined with the severity of PLO and the improvement of back pain in postmenopausal women with vertebral fractures after TRP treatment, led us to the decision to manage our patient with TRP. 22 After 13 months of treatment, BMD was increased by 24.4% at the lumbar spine, 9.9% and 4.6% at the left and the right total hip, and 12.6% and 7.8% at the left and right femur neck, respectively, without any further fracture occurrence. To our knowledge, there are three articles reporting the outcomes of TRP treatment in PLO.…”

Section: Discussionmentioning

confidence: 95%

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Lampropoulou-Adamidou¹,

Trovas²,

Stathopoulos³

et al. 2012

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OBJEcTIVE: Pregnancy-and lactation-associated osteoporosis (PLO) is an uncommon disease. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and aetiology of this disorder are as yet unclear and there are no guidelines for its treatment. cAsE rEPOrT: We report the outcomes of teriparatide (TrP) treatment in a woman suffering from severe PLO with 6 vertebral fragility fractures, severe back pain and very low BMD. rEsULTs: Thirteen months after the initiation of therapy, the patient was almost free of back pain. There was no new clinical vertebral fracture. Her laboratory tests were all normal. BMD increased by 24.4% at the lumbar spine, 9.9% and 4.6% at the left and the right total hip and 12.6% and 7.8% at the left and right femur neck, respectively. cONcLUsION: TrP treatment simultaneously with weaning and calcium and vitamin D supplementation seems to considerably increase BMD, improve severe back pain and quality of life and prevent further occurrence of vertebral fractures, making TrP a helpful tool in restoring bone strength in PLO patients. Key words: Lactation, Osteoporosis, Pregnancy, Premenopausal osteoporosis, TeriparatideCase report HORMONES 2012, 11(4):495-500 Address for correspondence: Kalliopi Lampropoulou-Adamidou, MD, MSc, Laboratory for the Research of the Musculoskeletal System "Th. Garofalidis", KAT General Hospital of Athens, 10 Athinas Str., 14561, Kifissia, Athens, Greece, Tel.: +306984229202, +302108018123, Fax: +302108018122, E-mail: kilampropoulou@gmail.com of PLO was made by Nordin et al in 1955. 1 It is characterised by the occurrence of fragility fracture(s), most commonly involving the lower thoracic and/ or lumbar vertebral bodies. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and the ae tiology of this disorder are unclear. To date, more than 120 cases have been reported, mostly as individual case reports.2 Due to the lack of controlled trials and the rarity of the disease there are no formal guidelines.

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“…Other osteoporosis treatments that have been shown to reduce back pain include teriparatide treatment. (15,16) A meta-analysis of five randomized trials showed that teriparatide (20 or 40 mg/d) reduced the risk of any back pain by 34%, moderate or severe back pain by 40%, and severe back pain by 54% compared with a pooled comparison group that consisted of placebo, alendronate, or hormone therapy. The median length of the trials was 11 to 20 months, and participants, on average, were much younger (58 to 70 years) than the women in the HORIZON trial.…”

Section: Discussionmentioning

confidence: 99%

Once-yearly zoledronic acid and days of disability, bed rest, and back pain: Randomized, controlled HORIZON Pivotal Fracture Trial

Cauley

Black

Boonen

et al. 2010

Journal of Bone and Mineral Research

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The objective of this study was to determine the effect of once-yearly zoledronic acid on the number of days of back pain and the number of days of disability (ie, limited activity and bed rest) owing to back pain or fracture in postmenopausal women with osteoporosis. This was a multicenter, randomized, double-blind, placebo-controlled trial in 240 clinical centers in 27 countries. Participants included 7736 postmenopausal women with osteoporosis. Patients were randomized to receive either a single 15-minute intravenous infusion of zoledronic acid (5 mg) or placebo at baseline, 12 months, and 24 months. The main outcome measures were selfreported number of days with back pain and the number of days of limited activity and bed rest owing to back pain or a fracture, and this was assessed every 3 months over a 3-year period. Our results show that although the incidence of back pain was high in both randomized groups, women randomized to zoledronic acid experienced, on average, 18 fewer days of back pain compared with placebo over the course of the trial ( p ¼ .0092). The back pain among women randomized to zoledronic acid versus placebo resulted in 11 fewer days of limited activity ( p ¼ .0017). In Cox proportional-hazards models, women randomized to zoledronic acid were about 6% less likely to experience 7 or more days of back pain [relative risk (RR) ¼ 0.94, 95% confidence interval (CI) 0.90-0.99] or limited activity owing to back pain (RR ¼ 0.94, 95% CI 0.87-1.00). Women randomized to zoledronic acid were significantly less likely to experience 7 or more bedrest days owing to a fracture (RR ¼ 0.58, 95% CI 0.47-0.72) and 7 or more limited-activity days owing to a fracture (RR ¼ 0.67, 95% CI 0.58-0.78). Reductions in back pain with zoledronic acid were independent of incident fracture. Our conclusion is that in women with postmenopausal osteoporosis, a once-yearly infusion with zoledronic acid over a 3-year period significantly reduced the number of days that patients reported back pain, limited activity owing to back pain, and limited activity and bed rest owing to a fracture. ß

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The effects of teriparatide on the incidence of back pain in postmenopausal women with osteoporosis

Abstract: Teriparatide-treated women had reduced risk for moderate or severe back pain, severe back pain, and back pain associated with vertebral fractures. The mechanism of the back pain reduction likely includes the reduction both in severity and number of new vertebral fractures.

Cited by 60 publications

References 29 publications

Relationship between duration of teriparatide therapy and clinical outcomes in postmenopausal women with osteoporosis

Relationship between duration of teriparatide therapy and clinical outcomes in postmenopausal women with osteoporosis

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Once-yearly zoledronic acid and days of disability, bed rest, and back pain: Randomized, controlled HORIZON Pivotal Fracture Trial

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