Effects of teriparatide on hip structure and bone microarchitecture in women with anorexia nervosa: a...

Women with anorexia nervosa have low bone mineral density and increased fracture risk. We conducted a randomized, placebo-controlled trial investigating the effects of 6 months of teriparatide in anorexia nervosa. Teriparatide led to trends in improvements in bone structure. Longer-term studies are needed to evaluate the benefit of teriparatide in anorexia nervosa.

Women with anorexia nervosa have low BMD and increased fracture risk. Currently, there are no approved therapies for bone loss in anorexia nervosa. This study investigated the effects of teriparatide (TPT) on bone microarchitecture and structure in anorexia nervosa.

We conducted a randomized placebo-controlled study including women with anorexia nervosa and a T-score: ≤ - 2.5. Twenty-one women were randomized to (1) TPT (N = 10; 47.7 ± 8.6yrs) or (2) placebo (N = 11; 47.7 ± 7.7yrs) for 6 months. Primary outcomes included changes in trabecular and cortical bone microarchitecture (HR-pQCT) and hip structural analysis parameters (HSA program). Secondary outcomes included bone turnover markers (ELISA).

After TPT treatment, no changes were observed in bone microarchitecture, but trends in HSA parameters in the intertrochanteric region (IT) of the proximal femur were noted. IT cortical thickness increased by 13% (p = 0.075 vs. baseline) after TPT (vs. a non-significant decrease in IT cortical thickness in placebo), and IT buckling ratio decreased 9% (vs baseline) in the TPT group (vs a 5% increase in placebo, p = 0.076). After TPT treatment, circulating levels of osteocalcin and osteopontin increased significantly in TPT (osteocalcin: 216.4%, p = 0.01 vs. baseline and osteopontin: 68.6%, p = 0.03 vs. baseline). No significant changes in osteocalcin or osteopontin levels were observed in the placebo group.

Six months of TPT treatment in women with anorexia nervosa led to trends in improvements in bone structure. Long-term studies are needed to evaluate the potential benefit of TPT in anorexia nervosa.