Jyväskylä Central Hospital, Jyväskylä, Finland.
Ann Med. 2013 May;45(3):230-5. doi: 10.3109/07853890.2012.742560. Epub 2013 Jan 20.
Teriparatide is a potent anabolic agent for severe osteoporosis.
A primary objective of this retrospective study was to define the efficacy of teriparatide in terms of bone mineral density (BMD) changes and relief of back pain in clinical practice.
The patient population comprises 119 osteoporotic patients treated with teriparatide for median 539 (range 179-926) days.
The mean BMD gain was 0.9% in the total hip (P = 0.0075), 2.1% in the femoral neck (P = 0.0006), and 8.5% in the lumbar spine (P = 0.0085). In the whole patient population age associated inversely with BMD changes in the total hip (P = 0.019) and in the femoral neck (P = 0.0036). A history of significant bisphosphonate pretreatment (n = 90) reduced BMD response in the total hip (P = 0.039). The total exposure of any prior bisphosphonate was negatively correlated with BMD response in the total hip (P = 0.0421). Half of the patients reported relief of back pain during the treatment. Leg pain, nausea, and dizziness were most frequent adverse concerns.
Teriparatide works in clinical practice as well as in clinical trials. Younger subjects benefited more than older patients from teriparatide in the total hip and in the femoral neck. Bisphosphonate pretreatment attenuated teriparatide-induced BMD gain.
特立帕肽是一种治疗严重骨质疏松症的有效合成代谢药物。
本回顾性研究的主要目的是从骨密度（BMD）变化和缓解背痛的角度来评估特立帕肽在临床实践中的疗效。
该患者人群包括 119 例骨质疏松症患者，接受特立帕肽治疗的中位时间为 539 天（范围 179-926 天）。
总髋部的平均 BMD 增加了 0.9%（P = 0.0075），股骨颈增加了 2.1%（P = 0.0006），腰椎增加了 8.5%（P = 0.0085）。在整个患者人群中，年龄与总髋部（P = 0.019）和股骨颈（P = 0.0036）的 BMD 变化呈负相关。有显著双膦酸盐预处理史的患者（n = 90），其总髋部的 BMD 反应降低（P = 0.039）。任何先前使用双膦酸盐的总暴露量与总髋部的 BMD 反应呈负相关（P = 0.0421）。一半的患者在治疗期间报告背痛缓解。腿部疼痛、恶心和头晕是最常见的不良反应。
特立帕肽在临床实践中的疗效与临床试验相似。在总髋部和股骨颈中，年轻患者比老年患者从特立帕肽中获益更多。双膦酸盐预处理减弱了特立帕肽诱导的 BMD 增加。
