DIFFICULT TO TREAT PATIENTS WITH VERTEBRAL FRACTURES
Keywords:
PTH, parathormone, BMD, bone mineral densityAbstract
Patients with vertebral fractures, in addition to physical pain, have a reduced quality of life.Teriparatide is
the only osteoanabolic preparation for the treatment of osteoporosis, especially valuable in patients with vertebral
fractures, as well as in those who have not responded to therapy with it.
We studied 2 groups of patients with vertebral fractures - those in which teriparatide was the first drug of choice and
a second group with prior bisphosphonate therapy and worsened BMD indicators and subsequent treatment with
teriparatide. The studied patients were 21 aged 65-83 years, of which 12 patients with 2-4 vertebral fractures -
primary initiation of therapy with teriparatide (group 1) and 10 patients with severe osteoporosis with insufficient
response to current treatment - worse indicators - secondary initiation of treatment with teriparatide - (group 2).
Mean baseline BMD T-score in group 1 BMD T-score - 3.8 SD, and in group 2 - BMD T-score - 3.90 SD. The
evaluation intervals are 0-12-24 months. Control group of 20 patients without vertebral fractures (group 3) -
homogeneous in terms of demographics but heterogeneous in terms of therapy - BMD T-score - 2.98 SD.
The observed improvement in BMD was already at 12 months in both groups of patients with vertebral fractures,
with a better result in the group with primary initiation of Teriparatide and this continued until the 24th month.
BMD at month 12 improved by an average of 0.42 SD / p<0.005 /.
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