Elsevier

Bone

Volume 64, July 2014, Pages 75-81
Bone

Original Full Length Article
The effects of once-weekly teriparatide on hip geometry assessed by hip structural analysis in postmenopausal osteoporotic women with high fracture risk

https://doi.org/10.1016/j.bone.2014.04.004Get rights and content
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open access

Highlights

  • The effects of once-weekly teriparatide on hip geometry were assessed by hip structural analysis (HSA) in women with osteoporosis.

  • HSA showed that teriparatide improved biomechanical indices and reversed changes in hip geometry and strength with aging.

  • Once-weekly teriparatide administration may have the potential to prevent hip fractures.

Abstract

Weekly administration of teriparatide has been shown to reduce the risk of vertebral and non-vertebral fractures in patients with osteoporosis at higher fracture risk in Japan. However, its efficacy for hip fracture has not been established. To gain insight into the effect of weekly teriparatide on the hip, hip structural analysis (HSA) based on dual-energy X-ray absorptiometry (DXA) was performed using the data of 209 postmenopausal osteoporotic women who had participated in the original randomized, multicenter, double-blind, placebo-controlled trial assessing the effects of once-weekly 56.5 μg teriparatide for 72 weeks. The DXA scans, obtained at baseline, 48 weeks and 72 weeks, were analyzed to extract bone mineral density (BMD) and cross-sectional geometrical indices at the narrowest point on the neck (NN), the intertrochanteric region (IT), and the proximal shaft. Compared with placebo after 72 weeks, the teriparatide group showed significantly higher BMD, average cortical thickness, bone cross-sectional area, and section modulus, and lower buckling ratio at both the NN and IT regions. No significant expansion of periosteal diameter was observed at these regions. There were no significant differences in BMD and HSA indices at the shaft region. The results indicate that overall structural strength in the proximal femur increased compared to placebo, suggesting that once-weekly teriparatide effectively reverses changes in hip geometry and strength with aging.

Abbreviations

HSA
hip structural analysis
DXA
dual-energy X-ray absorptiometry
BMD
bone mineral density
NN
narrowest point on neck
IT
intertrochanteric region
Teriparatide
human parathyroid hormone: PTH 1–34
TOWER trial
Teriparatide Once-Weekly Efficacy Research trial
CSMI
cross-sectional moment of inertia
SM
section modulus
OD
outer diameter
ED
endocortical diameter
CoTh
average cortical thickness
CSA
total mineralized bone area in cross-section
BR
buckling ratio
ROI
region of interest
BMI
body mass index
QCT
quantitative computed tomography

Keywords

Teriparatide
Weekly injection
Hip geometry
Hip structural analysis
Osteoporosis

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