Rheumatology

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Baseline glucocorticoid dose and bone mineral density response with teriparatide or alendronate therapy in patients with glucocorticoid-induced osteoporosis
Journal of Rheumatology, 11/19/09

Devogelaer J-P et al. – Teriparatide and alendronate increased LS and hip BMD across a range of baseline glucocorticoid doses. LS BMD increases with teriparatide were greater in the low-dose category than in the high-dose category. Overall LS BMD increases were significantly greater with teriparatide compared with alendronate, which may reflect the respective anabolic and antiresorptive mechanisms of action.

• This post-hoc analysis studied the effect of baseline glucocorticoid dose on the 18-month bone mineral density (BMD) response to teriparatide 20 µg/day or alendronate 10 mg/day in 387 patients with glucocorticoid-induced osteoporosis (GIO) from a randomized, double-blind trial.
• Lumbar spine (LS), femoral neck (FN), and total hip (TH) BMD were measured at baseline and 18 months

• Baseline LS, FN, and TH BMD were similar between groups, and between glucocorticoid dose categories within each group.
• LS BMD increases at the low, medium, and high glucocorticoid doses were 8.1%, 6.6%, and 4.6%, respectively, with teriparatide, and 3.6%, 2.8%, and 2.3% with alendronate.
• Analyzed as a continuous variable, higher glucocorticoid doses had a negative, but nonsignificant, effect on the percentage increase in LS BMD in both groups.
• Glucocorticoid dose did not significantly affect FN or TH BMD increases in either group.
• Across the 3 glucocorticoid dose categories, the overall LS BMD increases were different for both treatments combined, but the relative differences between the treatment groups were not different.

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