Endocrine Abstracts

Introduction: Teriparatide is prescribed for severe osteoporosis based on national protocols. The osteoanabolic drug is followed by an anti-resorbtive medication.

Aim: We analyze the treatment sequence options after Teriparatide in patients who finished the 2-year protocol or were early droppers.

Material and method: This is a real life study based on Romanian protocol of Teriparatide for severe primary or/and glucocorticoid osteoporosis (subcutaneous 20 μg/day, for 2 years, once in a lifetime). The inclusion and exclusion criteria are the specific features for free reimbursement of the drug in the country in addition to general approach of the medication. SPSS was used for statistical analyze (the cut-off of significance is P<0.05).

Results: 28 patients (female/male ratio is 27/1) of 66 years (median, ranges between 47 and 83 years) were offered Teriparatide. First time users of specific anti-osteoporotic drugs are one of ten. 16 subjects finished the 24 months protocol, while 12 persons were early droppers (before 2 years). No statistical significance was found between Bone Mineral Density at central DXA, neither age, number of fractures, of time of prior exposure to specific anti-osteoporotic medication before osteoanabolic medication between two groups. 84% of all subjects continued with bisphosphonates, and 80% of all were offered non-oral drugs. The drug sequence following Teriparatide was: 28% zolendronate, 4% risendronate, 16% alendronate, 36% ibandronate (regardless the route of administration), and 16% denosumab.

Discussion: As limits of the study we mention the size of the cohort and the need for longitudinal data.

Conclusion: Based on our observations, the treatment sequence following Teriparatide includes mostly bisphoshonates and injectable medication.