A Real-Life Study in Sequential Therapy for Severe Menopausal Osteoporosis

Area of Science:

• Endocrinology
• Pharmacology
• Bone Metabolism

Background:

• Teriparatide (TPT) is used for severe postmenopausal osteoporosis (MOP).
• Continuous therapy with anti-resorptive drugs (AR) is needed after TPT to maintain fracture risk reduction.
• Real-world data on sequential TPT and AR therapy in MOP are limited.

Purpose of the Study:

• To analyze sequential pharmacotherapy in MOP patients.
• To evaluate a 24-month TPT protocol followed by 12 months of AR.
• To assess fracture risk profile, bone mineral density (BMD), and bone turnover markers (BTM).

Main Methods:

• Longitudinal, retrospective, multicenter study of MOP patients.
• Cohort divided into TPT and non-TPT groups.
• TPT group further divided into those completing 24 months (P) and early droppers (ED), both followed by 12 months of AR.

Main Results:

• TPT candidates had lower T-scores and higher age/menopause duration than non-TPT.
• Significant BMD increases at the lumbar spine (+8.21% to +12.22%) after 24 months of TPT.
• BMD gains were maintained during 12 months of AR, with no new fractures.

Conclusions:

• Sequential pharmacotherapy with TPT followed by AR is effective in high-risk MOP.
• This regimen improves BMD and reduces fracture risk.
• The study confirmed all initial hypotheses regarding TPT efficacy and sequential therapy.