Clin Osteol 2018; 23(3): 88-93

Teriparatid v liečbe ťažkej osteoporózy u starších pacientok: výsledky multicentrickej prospektívnej štúdieOriginal contributions

Payer Juraj1, Tomková Soňa2, Jackuliak Peter1, Kužma Martin1, Vaňuga Peter3, Letkovská Alexandra4, Masaryk Pavol4, Kmečová Zlata5, Killinger Zdenko1
1 -5th Department of Internal Medicine, Medical Faculty of Comenius University, and University Hospital Bratislava, Hospital Ružinov, Bratislava, Slovakia
2 Osteocentrum, Hospital Košice - Šaca, Košice, Slovakia
3 National Institute of Endcrinology and Diabetology, Lubochňa, Slovakia
4 National Institute of Rheumatic Diseases, Piešťany, Slovakia
5 Osteocentrum of Faculty Hospital F. D. Roosevelt, Banská Bystrica, Slovakia

Teriparatid (TPTD) je rekombinantný aminotermálny fragment (1-34) ľudského parathormónu (PTH), ktorý má najmä stimulujúci účinok na tvorbu kostí. Účinnosť liečby teriparatidom spočíva v znížení počtu zlomenín u žien s ťažkou osteoporózou. Uvádzame výsledky 18-mesačnej prospektívnej multicentrickej štúdie, v priebehu ktorej bolo 85 ženám s ťažkou osteoporózou denne podkožne aplikované 20 μg teriparatidu a bola sledovaná účinnosť, bezpečnosť a dodržiavanie liečby. Po 12 a 18 mesiacoch liečby sme sledovali nárast BMD v oblasti bedrovej chrbtice (9,2 % a 10,6 %; p = 0,001), konkrétne v oblasti krčka femoru (1,4 % a 4,6 %; p = 0,04), v proximálnom femoru (3,5 % a 3,7 %, p = 0,02) a taktiež nárast markerov kostného obratu po 6 a 18 mesiacoch (CTx 173% a 93%; p < 0,001 a osteokalcínu 134 %; p < 0,001). Typ predchádzajúcej antiosteoporotickej liečby nemal podľa ukazovateľov BMD a kostného obratu žiaden vplyv na účinnosť teriparatidu. Liečba bola dobre tolerovaná a neboli pozorované žiadne závažné nežiadúce účinky. U 5,3 % pacientok, ktoré užívali vyššie dávky vápnikových doplnkov, bola zistená hraničná hyperkalcémia, ktorá ale nemala klinický význam. Teriparatid je vysoko účinný osteoanabolický liečivý prípravok vhodný u starších žien s ťažkou osteoporózou a so zlomeninou stavca v anamnéze.

Keywords: BMD; osteoporóza; riziko zlomeniny; teriparatid

Published: December 11, 2018  Show citation

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Payer J, Tomková S, Jackuliak P, Kužma M, Vaňuga P, Letkovská A, et al.. Teriparatid v liečbe ťažkej osteoporózy u starších pacientok: výsledky multicentrickej prospektívnej štúdie. Clinical Osteology. 2018;23(3):88-93.
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    References

    1. Rovensky J, Payer J (eds). Dictionary of Rheumatology. Springer-Verlag, Wien 2009. 230 p. ISBN 978-3-211-68584-6. Go to original source...
    2. Vestergaard P. Bone diseases. Incident fractures during treatment for osteoporosis. Nat Rev Rheumatol 2013; 9(9): 508-510. Available on DOI: <http://doi:10.1038/nrrheum.2013.122>. Go to original source...
    3. Ballane G, Cauley JA, Luckey MM, EL-Hajj Fuleihan G. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 2017; 28(5): 1531-1542. Available on DOI: <http://doi:10.1007/s00198-017-3909-3>. Go to original source...
    4. McCarthy J, Davis A. Diagnosis and management of vertebral compression fractures. Am Fam Physician 2016; 94(1): 44-50.
    5. Adler RA, EL-Hajj Fuleihan G, Bauer DC et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2016; 31(1): 16-35. Available on DOI: <http://doi:10.1002/jbmr.2708>. Go to original source...
    6. Tella SH, Gallagher JC. Prevention and treatment of postmenopausal osteoporosis. J Steroid Biochem Mol Biol 2014; 142 : 155-170. Available on DOI: <http://doi:10.1016/j.jsbmb.2013.09.008>. Go to original source...
    7. Oswald AJ, Berg J, Milne G, Ralston SH. Teriparatide treatment of severe osteoporosis reduces the risk of vertebral fractures compared with standard care in routine clinical practice. Calcif Tissue Int 2014; 94(2): 176-182. Available on DOI: <http://doi:10.1007/s00223-013-9788-5>. Go to original source...
    8. Nardi A, Ventura L, Cozzi L et al. The bone anabolic therapy. Aging Clin Exp Res 2013; 25(Suppl 1): 121-124. Available on DOI: <http://doi:10.1007/s40520-013-0133-7>. Go to original source...
    9. Graeff C, Chevalier Y, Charlebois M et al. Improvements in Vertebral Body Strength Under Teriparatide Treatment Assesses in Vivo by Finite Element Analysis: Results From the EUROFORS Study. J Bone Miner Res 2009; 24(10): 1672-1680. Available on DOI: <http://doi:10.1359/jbmr.090416>. Go to original source...
    10. Ljunggren O, Barrett A, Stoykov I et al. Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in postmenopausal women with osteoporosis: the European Forsteo Observational Study. BMC Musculoskelet Disord 2013; 14 : 251 Available on DOI: <http://doi:10.1186/1471-2474-14-251>. Go to original source...
    11. Neer RM, Arnaud CD, Zanchetta JR et al. Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis. N Engl J Med 2001; 344(19): 1431-1441. Available on DOI: <http://doi:10.1056/NEJM200105103441904>. Go to original source...
    12. Paschalis EP, Glass EV, Donley DW et al. Bone mineral and collagen quality in iliac crest biopsies of patients given teriparatide: new results from the Fracture Prevention Trial. J Clin Endocrinol Metab 2005; 90(8): 4644-4649. Available on DOI: <http://doi:10.1210/jc.2004-2489>. Go to original source...
    13. Boonen S, Marin F, Obermayer-Pietsch B et al. Effects of Previous Antiresorptive Therapy on the Bone Mineral Density Response to Two Years of Teriparatide Treatment in Postmenopausal Women with Osteoporosis. J Clin Endocrinol Metab 2008; 93(3): 852-860. Available on DOI: <http://doi:10.1210/jc.2007-0711>. Go to original source...
    14. Obermayer-Pietsch B., Marin F., V McCloskey E. et al. Effects of Two Years of Daily Teriparatide Treatment on BMD in Postmenopausal Women with Severe Osteoporosis With and Without Prior Antiresorptive Treatment. J Bone Miner Res 2008; 23(10): 1591-1600. Available on DOI: <http://doi.org/10.1359/jbmr.080506>. Go to original source...
    15. Ettinger B, San Martin J, Crans G et al. Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate. J Bone Miner Res 2004; 19(5): 745-751. Available on DOI: <http://doi:10.1359/JBMR.040117>. Go to original source...
    16. Genant HK, Wu CY, van Kuijk C et al. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993; 8(9): 1137-1142. Available on DOI: <http://doi:10.1002/jbmr.5650080915>. Go to original source...

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