Functional Outcome in Patient with Osteoporosis Undergoing Teriparatide Treatment: A Prospective Observational Study
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Abstract
Background : Osteoporosis increases in the risk of fragility fracture which decreases in the quality of life with the limitation of daily living of patients. Once-daily administration of teriparatide (parathyroid hormone) stimulates new bone formation on trabecular and cortical bone surfaces. The anabolic effects of teriparatide are manifest as an increase in skeletal mass, an increase in markers of bone formation and resorption, and an increase in bone strength. Recently there is no study of functional outcome after teriparatide administration for 24 months. We conduct the study about the functional outcome, the adherence and the cardiovascular adverse event after teriparatide administration for 24 months.
Objective : To study the functional outcome, adherence and cardiovascular adverse event in postmenopausal osteoporosis patients whom undergoing teriparatide treatment.
Material and methods : In this prospective cohort study, we enrolled postmenopausal women with at least hip fracture or two vertebral fracture and bone mineral density T score of less than or equal to -2.50. SF36 scores, serum NT-proBNP level were measured before treatment, 6 months, 12 months, 18 months, and 24 months after treatment. Serum NT-proBNP is a useful cardiovascular biomarker for the diagnosis of heart failure. Increased levels of NT-proBNP in patient treated with teriparatide are associated with cardiovascular adverse event. Adherence is measured by medical procession ratio.
Results : Functional outcome is improved significantly at 12 months (P=0.008). Patients had high adherence for 87 % and the mean of MPR is 0.94. There is no effect of teriparatide on serum NT-proBNP level (P=0.144).
Conclusion : Functional outcome is improved from 12 months after the initiation of teriparatide treatment with high adherence. Teriparatide did not change the concentration of NT-proBNP in plasma after
completion of treatment, suggesting that teriparatide does not affect heart function
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References
Domenico M, Enzo R, Salvatore L, Carmelo L, Grazia M, Rosaria S, Maurizio R, Sara M, Valentina F, Giuseppe T,
Biagio C, Michele C. Changes of the quality-of-life under the treatment of severe senile osteoporosis with
teriparatide. Archives of Gerontology and Geriatrics 2009;49:35-8.
Ljunggren O, Barrett A, Stoykov I, Langdahl BL, Lems WF , Walsh JB, Pammer AF, Gerald Rajzbaum, Jakob F,
Karras, Marin F. Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in
postmenopausal women with osteoporosis: the European Forsteo Observational Study. BMC Musculoskeletal
Disorder 2013;14:251.
McNeilly T, Mcnally C, Finch M, Beringer T. Recombinant PTH: A Study of the Outcome of Teriparatide Therapy
for 138 patients with Osteroporsis. Ulster Med J 2013;82(2):89-93.
Iolascon G, Gimigliano F, Malavolta N, Tarantino U, Fornari R, Greco E, Di Pietro G, Gimigliano R, Lenzi A,
Resmini G, Migliaccio S. Effectiveness of teriparatide treatment on back pain-related functional limitations in
individuals affected by severe osteoporosis: a prospective pilot study. Clinical Cases in Mineral and Bone
Metabolism 2012;9(3):161-5.
Udombhomprabha A, Boonhong J, Tejapongvorachai T. Health-Related Quality of Life of the Thai Hip Fracture
Patients after the one year of Post-Hospital Discharge. Srinagarind Med J 2012;27(2).
Sally W. Wade, Jeffrey R. Curtis, Jingbo Yu, Jeffrey White, Bradley S. Stolshek, Claire Merinar, Akhila
Balasubramanian, Joel D. Kallich, John L. Adams, Hema N. Viswanathan. Medication adherence and fracture risk
among patients on bisphosphonate therapy in a large United States health plan. Bone 2012;50:870-5.
Tanaka I, Sato M, Sugihara T, Faries DE, Nojiri S, Graham-Clarke P, Flynn JA, Burge RT. Adherence and
Persistence with Once-Daily Teriparatide in Japan: A retrospective, Prescription Database, Cohort Study. Journal
of Osteoporosis 2013;654218:8.
Bonafede M.M., Shi N., Bower AG, Barron RL, A. Grauer, Chandler DB. Teriparatide treatment patterns in
osteoporosis and subsequent fracture events: a US claims analysis. Osteoporos Int 2015;26:1203-12.
Ellegaard M, Schwarz P, Hansen CR, Faber J, Vestergaard H. Short-term teriparatide treatment does not affect
NT-proBNP, a maker of cardiac disease. Scandinavian Journal of Clinical and Laboratory Investigation 2012;7:518-
Bay M, Kirk V, Parner J, Hassager C, Nielsen H, Krogsgaard K, Trawinski J, Boesgaard S, Aldershvile J. NT-
proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left
ventricular systolic function. Heart 2003;89:150-4.
Rajzbaum G, Grados F, Evan D, Liu-Leage S, Petto H, Augendre-Ferrante B. Treatment persistence and changes
in fracture risk, back pain, and quality of life amongst patients treated with teriparatide in routine clinical care in
France: Results from the European Forsteo Observational study. Joint Bone Spine 2014;81:69-75.
Tsan-Wen Huang, Po-Yao Chuang, Shih-Jie Lin, Po-Yao Chuang, Hsin-Nung Shih, Mel S.Lee, Robert Wen-Wei
Hsu and Wun-Jer Shen. Effects of teriparatide on cementless bipolar hemiarthroplasty in patients with
osteoporotic femoral neck fractures. BMC Musculoskeletal Disorders 201617:300.
Songpatanasilp T, Mumtaz M, Chhabra,H Maria Yu, Sorsaburu S. Back pain in patients with severe osteoporosis
on teriparatide or antiresorptives: a prospective observational study in multiethnic population. Singapore Med J
;55(9):493-501.
Bente L. Langdahl, Ljunggren O, Benhamou CL, Marin F, Kapetanos G, Kocjan T, et al. Fracture Rate, Quality of
Life and Back Pain in Patients with Osteoporosis Treated with Teriparatide:24-Month Results from the Extended
Forsteo Observational Study (ExFOS). Calcif Tissue Int 2016;99:259-71.
วีระชัย โควสุวรรณ, ณรงค์ บุณยะรัตเวช, เสก อักษรานุเคราะห์ และ มูลนิธิโรคกระดูกพรุนแห่งประเทศไทย. 2011. แนวทางปฏิบัติ
บริการดูแลรักษาโรคกระดูกพรุน พ.ศ. 2553.