Comparative effects of Teriparatide and Risedronate in glucocorticoid‐induced osteoporosis in men: 18‐month results of the EuroGIOPs trial

Glüer, Claus-C.; Marin, Fernando; Ringe, Johann D.; Hawkins, Federico; Möricke, Rüdiger; Papaioannu, Nikolaos; Farahmand, Parvis; Minisola, Salvatore; Martínez, Guillermo; Nolla, Joan M.; Niedhart, Christopher; Guañabens, Nuria; Nuti, Ranuccio; Martín-Mola, Emilio; Thomasius, Friederike; Kapetanos, Georgios; Peña, Jaime; Graeff, Christian; Petto, Helmut; Sanz, Beatriz; ... (2013). Comparative effects of Teriparatide and Risedronate in glucocorticoid‐induced osteoporosis in men: 18‐month results of the EuroGIOPs trial. Journal of bone and mineral research, 28(6), pp. 1355-1368. Wiley-Blackwell 10.1002/jbmr.1870

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Data on treatment of glucocorticoid-induced osteoporosis (GIO) in men are scarce. We performed a randomized, open-label trial in men who have taken glucocorticoids (GC) for ≥3 months, and had an areal bone mineral density (aBMD) T-score ≤ –1.5 standard deviations. Subjects received 20 μg/d teriparatide (n = 45) or 35 mg/week risedronate (n = 47) for 18 months. Primary objective was to compare lumbar spine (L1–L3) BMD measured by quantitative computed tomography (QCT). Secondary outcomes included BMD and microstructure measured by high-resolution QCT (HRQCT) at the 12th thoracic vertebra, biomechanical effects for axial compression, anterior bending, and axial torsion evaluated by finite element (FE) analysis from HRQCT data, aBMD by dual X-ray absorptiometry, biochemical markers, and safety. Computed tomography scans were performed at 0, 6, and 18 months. A mixed model repeated measures analysis was performed to compare changes from baseline between groups. Mean age was 56.3 years. Median GC dose and duration were 8.8 mg/d and 6.4 years, respectively; 39.1% of subjects had a prevalent fracture, and 32.6% received prior bisphosphonate treatment. At 18 months, trabecular BMD had significantly increased for both treatments, with significantly greater increases with teriparatide (16.3% versus 3.8%; p = 0.004). HRQCT trabecular and cortical variables significantly increased for both treatments with significantly larger improvements for teriparatide for integral and trabecular BMD and bone surface to volume ratio (BS/BV) as a microstructural measure. Vertebral strength increases at 18 months were significant in both groups (teriparatide: 26.0% to 34.0%; risedronate: 4.2% to 6.7%), with significantly higher increases in the teriparatide group for all loading modes (0.005 < p < 0.015). Adverse events were similar between groups. None of the patients on teriparatide but five (10.6%) on risedronate developed new clinical fractures (p = 0.056). In conclusion, in this 18-month trial in men with GIO, teriparatide showed larger improvements in spinal BMD, microstructure, and FE-derived strength than risedronate.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB [discontinued]
UniBE Contributor:	Zysset, Philippe
Subjects:	500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health 600 Technology > 620 Engineering
ISSN:	0884-0431
Publisher:	Wiley-Blackwell
Language:	English
Submitter:	Philippe Zysset
Date Deposited:	12 May 2014 09:51
Last Modified:	05 Dec 2022 14:34
Publisher DOI:	10.1002/jbmr.1870
URI:	https://boris.unibe.ch/id/eprint/52161