ECE2013 Poster Presentations Bone and Osteoporosis (41 abstracts)
Efficacy and safety of the anabolic therapies in severe osteoporosis: experience of a team of endocrinologists and spine surgeons
Marilda Mormando 1 , Alessandra Fusco 1 , Enrico Pola 1, , Serena Piacentini 1 , Luigi Aurelio Nasto 1, , Debora Colangelo 1, , Sabrina Chiloiro 1 , Antonio Bianchi 1 , Alfredo Pontecorvi 1 & Laura De Marinis 1
1Division of Endocrinology, Catholic University, Rome, Italy; 2Division of Spinal Surgery, Department of Orthopaedics and Traumatology, Catholic University, Rome, Italy.
Anabolic therapies represent a major advance in the management of severe osteoporosis. Parathyroid hormone (PTH) and human recombinant PTH peptide 1–34 (Teriparatide) demonstrated an increase in bone mineral density and a significant reduction in vertebral fractures in patients with osteoporosis when given for 18–24 months. The intermittent administration of PTH or teriparatide stimulates osteoblastic function, improves bone architecture and has an additional analgesic effect.
We retrospectively analyzed the safety, efficacy and adherence to therapy with anabolic agents given for 18 months in 79 patients (F/M: 72/7) with severe osteoporosis resistant to antiresorptive therapy. Patients were followed by a team of spine surgeons and endocrinologists from 2007 to 2012. Before anabolic therapy 40 patients underwent percutaneus kyphoplasty, 23 were treated with brace and 16 patients refused any orthopaedic treatment. Anabolic agents were administered as a daily injection, and vitamin D supplementation was given, when necessary. The change in BMD value was measured at the beginning of therapy and after 18 months through lumbar and femoral DEXA scan.
A total of 64 patients completed the 18 months treatment with anabolic agents. 15 patients (19%) discontinued the treatment: 11 patients because of side effects occurring during the first 3 months of therapy (hypercalcemia occurred in eight patients) and four patients due to non adherence to therapy. All patients had vertebral fractures (VF) (mean number of VF 3.2±1.4) and suffered from back pain. During anabolic therapy, 31% of patients showed an improvement of back pain. At the end of the treatment, there was a substantial increase in BMD at both lumbar spine (+8.5%) and femoral neck (+5%).
This study confirms that anabolic agents are safe and effective. Adherence to therapy is very high, despite the daily administration. Of note, this therapy reduce back pain in a significant percentage of patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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