Bone microstructure changes due to once-/twice-weekly teriparatide administration: A report of five cases using...

Area of Science:

• Orthopedics
• Radiology
• Endocrinology

Background:

• Osteoporosis treatment often involves anabolic agents like teriparatide (TPTD).
• Assessing TPTD's effects on bone microstructure is crucial for understanding treatment efficacy.
• High-resolution peripheral quantitative computed tomography (HR-pQCT) offers detailed insights into bone changes.

Observation:

• This case series analyzed five osteoporosis patients from the TWICE study, comparing once-weekly and twice-weekly TPTD regimens.
• Patients underwent HR-pQCT scans before and after 48 weeks of TPTD treatment.
• Bone microstructure changes in the tibia and radius were assessed.

Findings:

• Both once-weekly and twice-weekly TPTD demonstrated a sufficient anabolic effect on trabecular and cortical bone in the tibia.
• The average increase in cortical porosity (Ct.Po) was minimal: 0.3% in the tibia and 0.2% in the radius.
• HR-pQCT confirmed improvements in bone microarchitecture.

Implications:

• Once-weekly and twice-weekly TPTD regimens are effective in improving bone microstructure in osteoporosis.
• TPTD treatment appears to effectively suppress the increase in cortical porosity, a key factor in bone fragility.
• HR-pQCT is a valuable tool for evaluating the microstructural effects of osteoporosis therapies.