The impact of sequential therapy from short-term teriparatide to denosumab compared with denosumab alone in patients wit
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RESEARCH ARTICLE
Open Access
The impact of sequential therapy from short-term teriparatide to denosumab compared with denosumab alone in patients with osteoporotic hip fracture: a 1year follow-up study Chan Ho Park1†, Jun-Il Yoo2†, Chang Hyun Choi1 and You-Sung Suh3*
Abstract Background: Sequential therapy from bone-forming medication to resorptive agents is reportedly effective for patients with severe osteoporosis. The objective of this study is to determine the impact of implementing shortterm teriparatide (TPTD) intervention before denosumab (DMab) therapy compared with DMab therapy alone for 1 year after hip fracture. Methods: We retrospectively reviewed the medical records and radiographs of patients who were treated due to osteoporotic hip fracture. TPTD was administered to 22 patients for an average of 12.1 weeks after which the intervention was switched to DMab therapy for 12 months (group 1). DMab alone was administered to 16 patients for 12 months (group 2). Bone mineral density (BMD) was evaluated before and after treatment at the 1-year followup. The improvement of BMD in hip and spine was compared with the levels of bone turnover marker. Results: The difference in femoral neck BMD was 0.005 ± 0.04 in group 1 and − 0.014 ± 0.10 in group 2 (p = 0.442). The difference of spine BMD was 0.043 ± 0.05 in group 1 and 0.052 ± 0.06 in group 2 (p = 0.640). BMD of the spine improved significantly in groups 1 and 2 (p < 0.001, p = 0.002). There was no statistical difference in C-terminal telopeptide and osteocalcin level. Conclusion: Short-term TPTD administration followed by DMab alone was effective only in improving spine BMD. Short-term treatment with TPTD caused mild improvement in femur neck BMD compared with DMab alone. However, further research with a longer duration of TPTD treatment is warranted, as our findings lack statistical significance. Keywords: Teriparatide, Denosumab, Osteoporosis, Hip fracture, Sequential therapy
* Correspondence: [email protected] † Chan Ho Park and Jun-Il Yoo contributed equally to this work and should be considered co-first author 3 Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, South Korea Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission d
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