Objectives To evaluate change in bone quality in patients at high risk of fracture by quantification of several bone biochemical markers and bone mineral density (BMD), before and after teriparatide (TPD) treatment.
Methods Sixty patients with rheumatoid arthritis (RA) and eighteen patients with osteoarthritis (OA) were assessed. Levels of serum osteocalcin (OC), serum undercarboxylated osteocalcin (ucOC), serum bone specific alkaline phosphatase (BAP), procollagen type I N-terminal propeptide (PINP) serum tartrate resistant acid phosphatase isoform 5b (TRAP-5b), urinary N-teropeptide of type I collagen/creatinine (NTx), serum calcium (Ca), serum phosphorus (P), vitamin D metabolites 1,25-dihydroxyvitamin D3 (1,25D3), intact parathyroid hormone (iPTH), calcitonin (CT) and BMD at the lumbar spine (LS) and total hip (TH) were measured at baseline and 6 months after TPD by subcutaneous injection (20 microg once a day). Statistical analysis also performed.
Conclusions Although no additional vitamin D supplementation intake were recommended, significant increasing was found in level of 1,25,D3 in both RA and OA groups. Significant differences between RA group and OA group were found on mean serum Ca levels before and after treatment.TPD administration significantly stimulated bone formation and bone resorption and increased BMD after 6 months in both OA and RA groups (data not shown). Concurrently, ucOC level was significantly higher and CT level was significantly lower after 6 months in both OA and RA groups. Therefore, it is possible that beneficial reactivation of the osteoblast system by TPD administration might require high amounts of vitamin K and/or calcitonin.
Disclosure of Interest None Declared
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