Sequential treatment of severe postmenopausal osteoporosis after teriparatide: final results of the randomized, controlled European Study of Forsteo (EUROFORS)

2.50
Hdl Handle:
http://hdl.handle.net/2336/67622
Title:
Sequential treatment of severe postmenopausal osteoporosis after teriparatide: final results of the randomized, controlled European Study of Forsteo (EUROFORS)
Authors:
Eastell, Richard; Nickelsen, Thomas; Marin, Fernando; Barker, Clare; Hadji, Peyman; Farrerons, Jordi; Audran, Maurice; Boonen, Steven; Brixen, Kim; Gomes, Jose Melo; Obermayer-Pietsch, Barbara; Avramidis, Avraam; Sigurdsson, Gunnar; Glüer, Claus C
Citation:
J. Bone Miner. Res. 2009, 24(4):726-36
Issue Date:
1-Apr-2009
Abstract:
It is unclear which treatment should be given after stopping teriparatide therapy for severe osteoporosis. In a prospective, randomized, controlled, 2-yr study, we compared BMD effects and clinical safety of three follow-up treatments (anabolic with teriparatide, antiresorptive with raloxifene, or no active treatment) after 1 yr of teriparatide. Postmenopausal women with osteoporosis and a recent fragility fracture received open-label teriparatide (20 microg/d) for 12 mo before they were randomized (3:1:1) to continue teriparatide (n = 305), switch to raloxifene 60 mg/d (n = 100), or receive no active treatment for the second year (n = 102). All patients received calcium and vitamin D supplementation. Changes in areal BMD from baseline to 24 mo were analyzed using mixed-model repeated measures. Daily teriparatide treatment for 2 yr significantly increased spine BMD by 10.7%. Patients receiving raloxifene in year 2 had no further change in spine BMD from year 1 (change from baseline, 7.9%), whereas patients receiving no active treatment had a BMD decrease of 2.5% in year 2 (change from baseline, +3.8%). At the total hip, BMD increases from baseline at 2 yr were 2.5% with teriparatide, 2.3% with raloxifene, and 0.5% with no active treatment; the respective changes at the femoral neck were 3.5%, 3.1%, and 1.3%. The study had insufficient power to assess antifracture efficacy. In conclusion, BMD increases progressively over 2 yr of teriparatide therapy in women with severe osteoporosis. After discontinuation of teriparatide, raloxifene maintains spine BMD and increases hip BMD.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://dx.doi.org/10.1359/jbmr.081215

Full metadata record

DC FieldValue Language
dc.contributor.authorEastell, Richard-
dc.contributor.authorNickelsen, Thomas-
dc.contributor.authorMarin, Fernando-
dc.contributor.authorBarker, Clare-
dc.contributor.authorHadji, Peyman-
dc.contributor.authorFarrerons, Jordi-
dc.contributor.authorAudran, Maurice-
dc.contributor.authorBoonen, Steven-
dc.contributor.authorBrixen, Kim-
dc.contributor.authorGomes, Jose Melo-
dc.contributor.authorObermayer-Pietsch, Barbara-
dc.contributor.authorAvramidis, Avraam-
dc.contributor.authorSigurdsson, Gunnar-
dc.contributor.authorGlüer, Claus C-
dc.date.accessioned2009-05-08T09:19:20Z-
dc.date.available2009-05-08T09:19:20Z-
dc.date.issued2009-04-01-
dc.date.submitted2009-05-08-
dc.identifier.citationJ. Bone Miner. Res. 2009, 24(4):726-36en
dc.identifier.issn1523-4681-
dc.identifier.pmid19049337-
dc.identifier.doi10.1359/jbmr.081215-
dc.identifier.urihttp://hdl.handle.net/2336/67622-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractIt is unclear which treatment should be given after stopping teriparatide therapy for severe osteoporosis. In a prospective, randomized, controlled, 2-yr study, we compared BMD effects and clinical safety of three follow-up treatments (anabolic with teriparatide, antiresorptive with raloxifene, or no active treatment) after 1 yr of teriparatide. Postmenopausal women with osteoporosis and a recent fragility fracture received open-label teriparatide (20 microg/d) for 12 mo before they were randomized (3:1:1) to continue teriparatide (n = 305), switch to raloxifene 60 mg/d (n = 100), or receive no active treatment for the second year (n = 102). All patients received calcium and vitamin D supplementation. Changes in areal BMD from baseline to 24 mo were analyzed using mixed-model repeated measures. Daily teriparatide treatment for 2 yr significantly increased spine BMD by 10.7%. Patients receiving raloxifene in year 2 had no further change in spine BMD from year 1 (change from baseline, 7.9%), whereas patients receiving no active treatment had a BMD decrease of 2.5% in year 2 (change from baseline, +3.8%). At the total hip, BMD increases from baseline at 2 yr were 2.5% with teriparatide, 2.3% with raloxifene, and 0.5% with no active treatment; the respective changes at the femoral neck were 3.5%, 3.1%, and 1.3%. The study had insufficient power to assess antifracture efficacy. In conclusion, BMD increases progressively over 2 yr of teriparatide therapy in women with severe osteoporosis. After discontinuation of teriparatide, raloxifene maintains spine BMD and increases hip BMD.en
dc.language.isoenen
dc.publisherAmerican Society for Bone and Mineral Researchen
dc.relation.urlhttp://dx.doi.org/10.1359/jbmr.081215en
dc.subject.meshOsteoporosis, Postmenopausalen
dc.subject.meshBone Densityen
dc.titleSequential treatment of severe postmenopausal osteoporosis after teriparatide: final results of the randomized, controlled European Study of Forsteo (EUROFORS)en
dc.typeArticleen
dc.contributor.departmentUniversity of Sheffield, Sheffield, United Kingdom.en
dc.identifier.journalJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Researchen

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