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Teriparatide is safe and effectively increases bone biomarkers in institutionalized individuals with osteoporosis

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Abstract

Institutionalized adults with severe developmental disabilities have a high rate of minimal trauma and appendicular fracture. There is little information about osteoporosis treatment in this population. In this efficacy and safety study, men and women with severe developmental disabilities and osteoporosis received 20 mcg teriparatide subcutaneously daily for 18–24 months. Markers of bone formation [procollagen type 1 intact N-terminal propeptide (P1NP)] and resorption [C-telopeptide (CTx)] were measured at three-month intervals. Serum calcium was measured at two-week intervals for 12 weeks and thereafter at three-month intervals. Twenty-seven individuals received at least one injection. The incidence of hypercalcemia was 11.1% but was persistent and led to medication discontinuation in only one participant. Biomarkers of bone formation increased rapidly, doubling by three months. At 12 months, P1NP and CTx remained elevated from baseline; P1NP had risen from 66.95 ± 83.71 μg/l (mean ± SD) to 142.42 ± 113.85 μg/l (P = 0.05), and CTx had increased from 0.377 ± 0.253 to 1.016 ± 1.048 ng/ml (P = 0.01). The majority of participants had an increase in P1NP of over 10 μg/l. In conclusion, teriparatide is safe and effective in developmentally disabled institutionalized adults. Serial calcium measurements are warranted, particularly during the first three months of therapy.

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Acknowledgments

This work is supported by K23 RR16047 and Eli Lilly.

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Authors and Affiliations

  1. Department of Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA

    Kathryn M. Ryder & Laura Carbone

  2. Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA

    Kathryn M. Ryder & Andrew Bush

  3. Veterans Affairs Medical Center, Memphis, TN, USA

    Kathryn M. Ryder & Laura Carbone

  4. Vanderbilt University School of Medicine, Nashville, TN, USA

    S. Bobo Tanner

  5. Gardner Center for Developing Minds, Greenville Hospital System, Greenville, SC, USA

    John E. Williams

  6. State of Tennessee Division of Mental Retardation Services, Nashville, USA

    Henry M. Taylor

  7. The Department of Physiology, The University of Tennessee Health Science Center, Memphis, TN, USA

    Victorina Pintea & Mitchell A. Watsky

  8. Division of General Internal Medicine, Department of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Suite 381, Memphis, TN, 38105, USA

    Kathryn M. Ryder

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  1. Kathryn M. Ryder
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  2. S. Bobo Tanner
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  3. Laura Carbone
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Correspondence to Kathryn M. Ryder.

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Ryder, K.M., Bobo Tanner, S., Carbone, L. et al. Teriparatide is safe and effectively increases bone biomarkers in institutionalized individuals with osteoporosis. J Bone Miner Metab 28, 233–239 (2010). https://doi.org/10.1007/s00774-009-0123-1

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  • DOI: https://doi.org/10.1007/s00774-009-0123-1

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