Teriparatide Followed by Denosumab in Premenopausal Idiopathic Osteoporosis: Bone Microstructure and Strength by High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT)
Authors' conclusion
Significant increases in total vBMD and bone strength parameters after sequential treatment with teriparatide followed by denosumab support the use of this regimen in PreMenIOP.
Study context
- Population
- Premenopausal women with idiopathic osteoporosis (PreMenIOP); HR-pQCT of distal radius and tibia26 entered denosumab extension
- Participants
- 34 women
- Comparison
- Sequential teriparatide followed by denosumab
- Teriparatiden = 24
- Placebon = 10reference
- Outcome
- Percentage change in vBMD, microstructure and stiffness after teriparatide and after denosumab
Methodological detailspreplanned analyses, placebo-controlled initial 6 months, phase 2B denosumab extension
- Preplanned analyses
- Placebo-controlled initial 6 months
- Phase 2B denosumab extension
Main finding
As reported in the abstract
Percentage change in HR-pQCT parameters
- After teriparatide: tibial trabecular number
- 3.3%, p = 0.01
- After teriparatide: tibial cortical area and thickness
- both 2.7%, p < 0.001
- After teriparatide: radial trabecular number, thickness, separation
- 6.8%, 2.2%, −5.1%, all p < 0.02
- After denosumab: total volumetric BMD (vBMD), tibia and radius
- 3.5%, p < 0.001 and 3.3%, p = 0.02
- After denosumab: cortical vBMD, tibia and radius
- 1.7% and 3.2%; both p < 0.01
- After denosumab: failure load, tibia and radius
- 1.1% and 3.6%; both p < 0.05
- After denosumab: tibial trabecular density
- 3.5%, p < 0.001
- After denosumab: tibial trabecular number
- 2.4%, p = 0.03
- After denosumab: radial trabecular thickness
- 3.0%, p = 0.02
Secondary outcomes
Changes after sequential teriparatide and denosumab · 48 months
- Total vBMD increased (tibia; radius)
- P < 0.001; p = 0.01
- Trabecular microstructure increased
- P < 0.05
- Cortical thickness increased (tibia; radius)
- P < 0.001; p = 0.02
- Whole bone strength increased at both sites
- P < 0.02
Original publication
Teriparatide Followed by Denosumab in Premenopausal Idiopathic Osteoporosis: Bone Microstructure and Strength by HR-pQCT. J Bone Miner Res. Published 6 November 2022. doi:10.
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