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Better Drug Emerges for Steroid-Induced Bone Loss

Teriparatide outperforms alendronate for type of osteoporosis, study finds

THURSDAY, Oct. 29, 2009 (HealthDay News) -- The drug teriparatide is better at increasing bone density and reducing vertebral fractures in patients with glucocorticoid-induced osteoporosis than the drug alendronate, a new study finds.

Glucocorticoids are steroid hormones produced in the body or contained in drugs that are used to control inflammation in patients with autoimmune diseases, such as rheumatoid arthritis, lupus and Crohn's disease, as well as inflammatory conditions such as asthma. Glucocorticoid-induced osteoporosis can occur in people taking steroid medications such as prednisone, prednisolone, dexamethasone and cortisone, according to background information provided in a news release about the study.

The study participants included 428 patients, aged 22 to 89, with confirmed osteoporosis who had received more than 5 milligrams a day of prednisone or the equivalent for more than three months. For the study, 150 patients were randomly assigned to receive 20 micrograms a day of injectable teriparatide plus oral placebo, and 144 patients received 10 milligrams a day of oral alendronate plus injectable placebo. All the participants received supplements of calcium (1,000 milligrams a day) and vitamin D (800 International Units a day).

After 36 months, lumbar spine bone mineral density was 11 percent higher than at the start of the study in the teriparatide group compared with 5.3 percent higher in the alendronate group, the researchers found. Bone mineral density improvement for total hip was 5.2 percent in the teriparatide group versus 2.7 percent in the alendronate group, and 6.3 percent versus 3.4 percent, respectively, in the femoral neck.

Patients in the teriparatide group had fewer vertebral fractures (1.7 percent) than those in the alendronate group (7.7 percent) and also had higher levels of calcium concentrations (21 percent versus 7 percent), according to the study findings published in the November issue of the journal Arthritis & Rheumatism.

A significant number of individuals are regularly treated with steroids to control inflammation, "which puts them at risk for developing osteoporosis. A need for therapies that mitigate this side effect of steroid use and substantially improve bone mass is vital," study leader Dr. Kenneth Saag, of the University of Alabama, said in a news release from the journal's publisher.

"Our research shows that teriparatide is a safe and effective treatment for patients with steroid-induced [osteoporosis] and should be considered as a therapeutic option for those at high risk of bone fracture," he concluded.

More information

The American College of Rheumatology has more about glucocorticoid-induced osteoporosis.

SOURCE: Arthritis & Rheumatism, news release, Oct. 29, 2009
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