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The Effect of Teriparatide Treatment on Spinal Deformity Index in Severe Osteoporosis
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Original Investigation
VOLUME: 25 ISSUE: 1
P: 6-11
April 2019

The Effect of Teriparatide Treatment on Spinal Deformity Index in Severe Osteoporosis

Turk J Osteoporos 2019;25(1):6-11
DOI: 10.4274/tod.galenos.2019.39306
Fatma Gül Ülkü Demir 1
Mustafa Çalış 2
Havva Talay Çalış 1
Kürşad Ünlühızarcı 3
Esra Sonbahar Bolat 4
Selçuk Mıstık 5
1. Sağlık Bilimleri Üniversitesi, Kayseri Şehir Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Kayseri, Türkiye
2. Erciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Kayseri, Türkiye
3. Erciyes Üniversitesi Tıp Fakültesi, Endokrinoloji Anabilim Dalı, Kayseri, Türkiye
4. 29 Mayıs Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye
5. Erciyes Üniversitesi Tıp Fakültesi, Aile Hekimliği Anabilim Dalı, Kayseri, Türkiye
No information available.
No information available
Received Date: 04.11.2018
Accepted Date: 12.11.2018
Publish Date: 25.04.2019
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ABSTRACT

Objective:

This study’s purpose was to evaluate the efficacy of teriparatide (TPTD) therapy on back pain, quality of life, and spinal deformity index (SDI) in the presence of established postmenopausal osteoporosis.

Materials and Methods:

The mean ages of 21 patients with established osteoporosis were 72.43±4.06 years. The patients with L1-L4 mean vertebral and/or hip total T score -4 and less, and at least two vertebral and/or non-vertebral fractures, were included in the study. The patients received 20 microgram (μg)/day TPTD treatment and 800 IU/day vitamin D3 + 1200 mg/day calcium (Ca) treatment during six months. Biochemical parameters were examined before the treatment and sixth month controls. Visual analog scale (VAS) was used for back pain, short form 36 (SF-36) for quality of life, in addition, grading of vertebral fracture severity according to Genant method and SDI evaluation were performed.

Results:

The mean total alkaline phosphatase, uric acid, and 24-hour urinary Ca values of the patients demonstrated a statistically significant increase after TPTD treatment compared to the pre-treatment level (p<0.01, p<0.05, p<0.05; respectively). There was no statistically significant difference in other biochemical markers according to the pre-treatment. A statistically significant increase was observed in the L1-L4 bone mineral density of the patients (p<0.01). After the treatment, there was a statistically significant improvement in SF-36 and VAS values of the patients according to pre-treatment (p<0.01). A statistically significant increase was detected in SDI after TPTD treatment (p<0.01).

Conclusion:

It has been determined that the treatment of TPTD treatment improves back pain and quality of life by decreasing the risk of new fracture developments in advanced age group and in patients with multiple fractures, however, the expected increase in SDI is still continuing in the present fractures.

References

1
Locklin RM, Khosla S, Turner RT, Riggs BL. Mediators of the biphasic responses of bone to intermittent and continuously administered parathyroid hormone. J Cell Biochem 2003;89:180-90.
2
Jung HJ, Park YS, Seo HY, Lee JC, An KC, Kim JH, et al. Quality of Life in Patients with Osteoporotic Vertebral Compression Fractures. J Bone Metab 2017;24:187-96.
3
Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001;344:1434-41.
4
Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993;8:1137-48.
5
Genant HK, Siris E, Crans GG, Desaiah D, Krege JH. Reduction in vertebral fracture risk in teriparatide-treated postmenopausal women as assessed by spinal deformity index. Bone 2005;37:170-4.
6
Ware JE, Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
7
Knop C, Oeser M, Bastian L, Lange U, Zdichavsky M, Blauth M. [Development and validation of the Visual Analogue Scale (VAS) Spine Score]. Unfallchirurg 2001;104:488-97.
8
Kim HJ, Park S, Park SH, Park J, Chang BS, Lee CK, et al. Prevalence of Frailty in Patients with Osteoporotic Vertebral Compression Fracture and Its Association with Numbers of Fractures. Yonsei Med J 2018;59:317-24.
9
Yusuf AA, Cummings SR, Watts NB, Feudjo MT, Sprafka JM, Zhou J, et al. Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women. Arch Osteoporos 2018;13:33.
10
Koski AM, Loyttyniemi E, Vaananen H, Laine H, Niskanen L, Nevalainen PI, et al. The effectiveness of teriparatide in the clinical practice--attenuation of the bone mineral density outcome by increasing age and bisphosphonate pretreatment. Ann Med 2013;45:230-5.
11
Öncel S, editor. Osteoporozda klinik bulgular. Kutsal YG ed: Güneş Kitabevi Ltd. Şti. Ankara; 2005;95-101.
12
Anastasilakis AD, Polyzos SA, Goulis DG, Slavakis A, Efstathiadou Z, Kita M, et al. Endogenous intact PTH is suppressed during Teriparatide (rhPTH 1-34) administration in postmenopausal women with established osteoporosis. Endocr J 2008;55:613-6.
13
Gold DT. The nonskeletal consequences of osteoporotic fractures. Psychologic and social outcomes. Rheum Dis Clin North Am 2001;27:255-62.
14
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, March 7-29, 2000: highlights of the conference. South Med J 2001;94:569-73.
15
Iolascon G, Gimigliano F, Malavolta N, Tarantino U, Fornari R, Greco E, et al. Effectiveness of teriparatide treatment on back pain-related functional limitations in individuals affected by severe osteoporosis: a prospective pilot study. Clin Cases Miner Bone Metab. 2012;9:161-5.
16
Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kivircik B, et al. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health 2006;6:247.
17
Lindsay R, Scheele WH, Neer R, Pohl G, Adami S, Mautalen C, et al. Sustained vertebral fracture risk reduction after withdrawal of teriparatide in postmenopausal women with osteoporosis. Arch Intern Med 2004;164:2024-30.
18
Sindel D. Osteoporozda Görüntüleme Yöntemlerinde Gelişmeler. Turkiye Klinikleri J PM&R-Special Topics 2009;2:50-61.
19
Guglielmi G, Diacinti D, van Kuijk C, Aparisi F, Krestan C, Adams JE, et al. Vertebral morphometry: current methods and recent advances. Eur Radiol 2008;18:1484-96.
20
Crans GG, Genant HK, JH K. Measurement of vertebral heights. Bone 2005 37:175-9.
21
Krege JH, Kendler D, Krohn K, Genant H, Alam J, Berclaz PY, et al. Relationship Between Vertebral Fracture Burden, Height Loss, and Pulmonary Function in Postmenopausal Women With Osteoporosis. J Clin Densitomb 2015;18:506-11.
22
Kerkeni S, Kolta S, Fechtenbaum J, Roux C. Spinal deformity index (SDI) is a good predictor of incident vertebral fractures. Osteoporos Int 2009;20:1547-52.
23
Davis JW, Grove JS, Wasnich RD, Ross PD. Spatial relationships between prevalent and incident spine fractures. Bone 1999;24:261-4.