A Longitudinal Cohort Study of Weekly Teriparatide, Denosmab, and Bisphosphonates for Prevention of Vertebral Fractures in Glucocorticoid-Induced Osteoporosis

Hisaji Oshima¹, Mari Ushikubo¹, Kumiko Akiya¹, Ikuko Tanaka², Shigenori Tamaki² and Keisuke Izumi³, ¹Department of Connective Tissue Diseases, National Tokyo Medical Center, Tokyo, Japan, ²NAGOYA Rheumatology Clinic, Nagoya, Japan, ³National Tokyo Medical Center, Tokyo, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: denosumab, Fracture risk, glucocorticoids, osteoporosis and teriparatide

Session Information

Date: Sunday, November 8, 2015

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Although weekly teriparatide (56.5ug, wTPTD) and denosmab (DMAB) have been developed as potent anti-osteoporotic agents, effects of these agents on prevention of osteoporotic fractures in glucocorticoid-induced osteoporosis (GIO) have not yet well demonstrated. We conducted a cohort study to clarify effects of wTPTD and DMAB when compared with bisphosphonates (BIS) on osteoporotic vertebral fractures in GIO.

Methods: A one-year cohort study recruiting 223 patients (196 women) with connective tissue diseases was conducted in Tokyo, Japan. Means of age, disease duration, total prednisolone (PSL) dosages, and daily PSL dosages (dPSL) of subjects were 65+/-15 (yo, +/-SD), 11+/-11 (y), 25+/-29 (g) and 6.4+/-5.7 (mg/day), respectively. Vertebral fractures were defined from X-ray films with the semi-quantitated method (SQ; Genant, 1993). Lumbar bone mineral densities (BMD) were measured with Lunar 3030 (GE). Prevalent vertebral fractures were seen in 103 (46%) patients. Bisphosphonates, wTPTD, and DMAB were used in 149, 53, and 21 patients, respectively.

Results: 1) The BMD at the base line was 0.916 +/- 0.181, and showed no difference between treatment groups. The daily PSL was significantly increased (p<0.03) in the group of wTPTD than in BIS and DMAB (10.5, 6.0, and 6.0, respectively). 2) Incident vertebral fractures were observed in 24 (16%), 2 (4%), and 2 (10%) in BIS, DMAB, and wTPTD, respectively. 3) A multivariate logistic regression analysis revealed that statistically significant factors for incident fractures were BMD (per 0.1 decrease, OR; 1.40, 95%CI; 1.02–1.91), dPSL (per 5mg increase, 1.95, 1.29–2.95), prevalent fractures (5.16, 1.85–14.4), DMAB (vs BIS, 0.01, 0.001-0.05), wTPTD (vs BIS, 0.12, 0.03-0.88). 4) There were no significant differences in severe adverse effects between the treatment groups.

Conclusion: These results suggested that wTPTD and DMAB might be more effective than bisphosphonates for prevention of osteoporotic vertebral fractures in patients treated with glucocorticoids.

Disclosure: H. Oshima, None; M. Ushikubo, None; K. Akiya, None; I. Tanaka, None; S. Tamaki, None; K. Izumi, None.

To cite this abstract in AMA style:

Oshima H, Ushikubo M, Akiya K, Tanaka I, Tamaki S, Izumi K. A Longitudinal Cohort Study of Weekly Teriparatide, Denosmab, and Bisphosphonates for Prevention of Vertebral Fractures in Glucocorticoid-Induced Osteoporosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-longitudinal-cohort-study-of-weekly-teriparatide-denosmab-and-bisphosphonates-for-prevention-of-vertebral-fractures-in-glucocorticoid-induced-osteoporosis/. Accessed .

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