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Bone Density After Teriparatide Discontinuation With or Without Antiresorptive Therapy in Pregnancy- and Lactation-Associated Osteoporosis

Authors
 Seunghyun Lee  ;  Namki Hong  ;  Kyoung Jin Kim  ;  Chung Hyun Park  ;  Jooyeon Lee  ;  Yumie Rhee 
Citation
 CALCIFIED TISSUE INTERNATIONAL, Vol.109(5) : 544-553, 2021-11 
Journal Title
CALCIFIED TISSUE INTERNATIONAL
ISSN
 0171-967X 
Issue Date
2021-11
MeSH
Adult ; Bone Density Conservation Agents* / therapeutic use ; Bone Density* ; Female ; Humans ; Lactation ; Lumbar Vertebrae ; Osteoporosis* ; Pregnancy ; Retrospective Studies ; Teriparatide / therapeutic use*
Keywords
Anabolics ; Antiresorptives ; DXA ; Osteoporosis
Abstract
Pregnancy- and lactation-associated osteoporosis (PLO) is a rare and severe disorder that causes low-trauma or spontaneous fractures, most commonly multiple vertebral fractures, in the late pregnancy or lactation period [1]. In severe PLO, teriparatide (TPTD) might aid in bone mineral density (BMD) recovery and subsequent fracture risk reduction. However, it is unclear whether TPTD can be discontinued without sequential antiresorptive therapy (ART) in premenopausal women with PLO. In this retrospective cohort study, we investigated the changes in BMD in premenopausal women with PLO treated with TPTD 20 mcg daily with or without sequential ART. Data for 67 patients diagnosed with PLO from 2007 through 2017 were reviewed. Among 43 women with annual follow-up dual-energy X-ray absorptiometry data for 3 years, 33 were treated with TPTD (median 12 months) with (TPTD-ART, n = 13; median, 18 months) or without (TPTD-no ART, n = 20) sequential ART. The two groups showed no differences in the mean age (31 vs. 31 years), body mass index (BMI, 20.5 vs. 21.0 kg/m2), and baseline lumbar spine (LS) BMD (0.666 vs. 0.707 g/cm2; p > 0.05 for all). LSBMD increased at 1, 2, and 3 years from baseline in both the TPTD-ART (14.1%, 21.8%, and 24.0%, respectively) and TPTD-no ART (17.3%, 24.1%, and 23.4%, respectively) groups, without significant between-group differences. Similar results were observed for the total hip BMD. LSBMD gain at 3 years did not differ by ART use (adjusted β, 0.40; p = 0.874) in univariable and multivariable models adjusted for age, BMI, and baseline LSBMD. In summary, BMD gain by TPTD administration in premenopausal women with PLO can be well maintained without sequential ART treatment.
Full Text
https://link.springer.com/article/10.1007%2Fs00223-021-00869-6
DOI
10.1007/s00223-021-00869-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Chung Hyun(박정현)
Lee, Seunghyun(이승현)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186749
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