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Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures

Authors
 Eun Yeong Choe  ;  Je Eun Song  ;  Kyeong Hye Park  ;  Hannah Seok  ;  Eun Jig Lee  ;  Sung-Kil Lim  ;  Yumie Rhee 
Citation
 Journal of Bone and Mineral Metabolism, Vol.30(5) : 596-601, 2012 
Journal Title
 Journal of Bone and Mineral Metabolism 
ISSN
 0914-8779 
Issue Date
2012
Abstract
Pregnancy and lactation-associated osteoporosis (PLO) is very rare, but it can cause severe vertebral compression fractures with disabling back pain. PLO patients have commonly been treated with antiresorptive agents against high bone turnover. There are, however, some concerns regarding the use of bisphosphonates: (1) PLO occurs during the first pregnancy with a high possibility of recurrence during the second pregnancy, (2) long-term outcomes of bisphosphonates in PLO are lacking, and (3) there is a possibility of bisphosphonates accumulated in the bones crossing the placenta. Therefore, alternative therapies must be considered. We analyzed the effect of teriparatide (TPTD), the human recombinant parathyroid hormone (1-34), for 18 months in three women with PLO. Multiple vertebral fractures with severe back pain appeared within 6 months after their first childbirth. Two of them had a family history of osteoporosis. Lactation was discontinued immediately after diagnosis of PLO. Calcium carbonate, cholecalciferol, and TPTD were prescribed. The back pain immediately resolved. Bone mineral density (BMD) increased by 14.5-25.0% (mean 19.5%) at the lumbar spine and by 9.5-16.7% (mean 13.1%) at the femoral neck, after 18 months of treatment. The final Z scores in these PLO patients were nearly normalized. Two women had a second baby without any complication. BMD significantly improved after 18 months of treatment with TPTD without further fractures. In conclusion, TPTD should be considered to avoid long-term morbidity in young patients with PLO and is highly encouraged for use in PLO patients with multiple vertebral fractures.
Full Text
http://link.springer.com/article/10.1007%2Fs00774-011-0334-0
DOI
10.1007/s00774-011-0334-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박경혜(Park, Kyeong Hye)
석한나(Seok, Hannah)
송제은(Song, Je Eun)
이유미(Rhee, Yumie) ORCID logo https://orcid.org/0000-0003-4227-5638
이은직(Lee, Eun Jig) ORCID logo https://orcid.org/0000-0002-9876-8370
임승길(Lim, Sung Kil)
최은영(Choe, Eun Yeong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90636
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