ORIGINAL ARTICLE
Teriparatide versus alendronate for treating
glucocorticoid-induced osteoporosis: an analysis
by gender and menopausal status
B. L. Langdahl
&
F. Marin
&
E. Shane
&
H. Dobnig
&
J. R. Zanchetta
&
M. Maricic
&
K. Krohn
&
K. See
&
M. R. Warner
Received: 18 December 2008 /Accepted: 4 March 2009 /Published online: 7 April 2009
#
International Osteoporosis Foundation and National Osteoporosis Foundation 2009
Abstract
Summary The effects of teriparatide versus alendronate were
compared by gender and menopausal status in patients
with glucocorticoid-induced osteoporosis. At 18 months,
increases in lumbar spine BMD were significantly greater in
the teriparatide versus alendronate group in postmenopausal
women (7.8% versus 3.7%, p<0.001), premenopausal
women (7.0% versus 0.7%, p<0.001), and men (7.3%
versus 3.7%, p=0.03).
Introduction In patients with glucocorticoid-induced osteo-
porosis (GIO), teriparatide significantly increased bone
mineral density (BMD) and decreased vertebral fractures
compared with alendronate. We examined effects of teripara-
tide versus alendronate by gender and menopausal status.
Methods This was a multicenter, randomized, double-blind
study of teriparatide 20 µg/day versus alendronate 10 mg/
day in patients with GIO (277 postmenopausal women, 67
premenopausal women, 83 men). Primary outcome was
change in lumbar spine BMD. Secondary outcomes
included change in hip BMD, change in bone biomarkers,
fracture incidence, and safety.
Results At 18 months, mean percent increases from
baseline in lumbar spine BMD were significantly greater
in the teriparatide versus alendronate group in postmeno-
pausal women (7.8% versus 3.7%, p<0.001), premeno-
pausal women (7.0% versus 0.7%, p<0.001), and men
(7.3% versus 3.7%, p=0.03). Radiographic vertebral
fractures occurred in one teriparatide (one postmenopausal)
and ten alendronate patients (six postmenopausal, four
men), and nonvertebral fractures occurred in 12 teriparatide
(nine postmenopausal, two premenopausal, one man) and
eight alendronate patients (six postmenopausal, two men).
The proportion of patients reporting adverse events in
teriparatide versus alendronate groups was consistent across
subgroups.
Conclusion Among men and pre- and postmenopausal
women with GIO, lumbar spine BMD increased more in
patients receiving teriparatide compared with alendronate.
Keywords Alendronate
.
Bone biomarkers
.
Glucocorticoid-induced osteoporosis
.
PINP
.
Premenopausal
.
Teriparatide
Osteoporos Int (2009) 20:2095–2104
DOI 10.1007/s00198-009-0917-y
B. L. Langdahl (*)
Åarhus University Hospital, Åarhus Sygehus,
Tage Hansens Gade 2,
8000 Åarhus, Denmark
e-mail: bente.langdahl@aarhus.rm.dk
F. Marin
:
K. Krohn
:
K. See
:
M. R. Warner
Lilly Research Laboratories, Eli Lilly and Company,
Indianapolis, IN, USA
E. Shane
Columbia University,
New York, NY, USA
H. Dobnig
Medical University of Graz,
Graz, Austria
J. R. Zanchetta
Instituto de Investigaciones Metabólicas, School of Medicine,
USAL University,
Buenos Aires, Argentina
M. Maricic
Catalina Pointe Arthritis and Rheumatology Specialists,
Tucson, AZ, USA