Probability of achieving treatments goals with twice-weekly teriparatide followed by bisphosphonate in Japanese postmenopausal osteoporosis.

introductionThe purpose of this study is to evaluate the increase in bone mineral density (BMD) and achievement of treatment goals based on the ASBMR/BHOF position statement over 3 years of sequential therapy with 2 years of twice-weekly teriparatide (2/W TPTD) followed by 1 year of bisphosphonate (BP) therapy. MATERIALS AND

methodsThis was a multicenter, retrospective study. Thirty-eight postmenopausal patients with primary osteoporosis at very high risk of fracture according to the Diagnostic Criteria for Primary Osteoporosis in Japan were enrolled. Changes in BMD at the lumbar spine (LS) and total hip (TH) were evaluated. Patients were divided into the naïve group (no history of osteoporosis treatment) and the pre-BP group (prior BP treatment). The treatment goals were assessed using the BMD T-score as follows; Baseline T-score ≤ - 2.5: Greater than - 2.5 at 3 years and baseline T-score > - 2.5: Increase at least 0.5 for LS and 0.2 for TH.

resultsThe naïve group showed a significant increase in LS-BMD and TH-BMD of 14.6% and 4.8%, respectively, and the pre-BP group only showed a significant increase in LS-BMD of 8.4% over 3 years. In the naïve group, 60.7% (17/28) achieved the treatment goal for LS-BMD, and 39.3% (11/28) achieved for TH-BMD. In the pre-BP group, 50.0% (4/8) achieved the treatment goal for LS-BMD, but no patient achieved the goal for TH-BMD.

conclusionAfter 3 years of sequential therapy from 2/W TPTD to BP, 50% or more of the patients achieved the treatment goal in the LS-BMD but not in the TH-BMD.