Clin Osteol 2015; 20(1): 3-9

Comparison of the effect of teriparatide and risedronate on bone loss in postmenopausal women with multiple sclerosis treated with low-dose glucocorticoidsReview articles

D. Michalská, V. Zikán, M. Týblová, M. Rašková, E. Havrdová, I. Raška Jr.

The aim of the study was to compare changes in bone mineral density (BMD) and bone turnover markers (BTM) in postmenopausal women with multiple sclerosis (MS) treated with teriparatide (TPTD) or risedronate. The study involved 71 MS women treated with low-dose glucocorticoids (GC). Motor function was evaluated using the Kurtzke Expanded Disability Status Scale (EDSS). At 12 months, the BMD of the lumbar spine significantly increased from baseline in both treatment groups (p < 0.001) without significant differences between them (+7.4 ± 8 % and +2.8 ± 2.9 % for TPTD and risedronate, respectively, p = 0.09). There were no significant chan­ ges from baseline in total hip or femoral neck BMD in either treatment group. At 6 months, PINP and CTX levels decreased in the risedronate group (p < 0.001) and increased in the TPTD group (p < 0.001). Our results confirmed a significant inverse relationship between baseline EDSS and baseline total hip or femoral neck BMD.

Conclusion: In postmenopausal women with MS treated with low-dose GC, TPTD as well as risedronate treatment resulted in a significant increase in BMD at the lumbar spine, but not at the hip. Limited walking ability in MS contributes to loss of BMD at the hip. Further studies should evaluate whether combined or sequential treatment with TPTD and risedronate is effective in preventing bone loss at the hip.

Keywords: multiple sclerosis, osteoporosis, glucocorticoids, teriparatide, risedronate

Published: June 11, 2015  Show citation

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Michalská D, Zikán V, Týblová M, Rašková M, Havrdová E, Raška I. Comparison of the effect of teriparatide and risedronate on bone loss in postmenopausal women with multiple sclerosis treated with low-dose glucocorticoids. Osteologický bulletin. 2015;20(1):3-9.
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    References

    1. Compston A, Coles A Multiple sclerosis. Lancet 2008;372:1502-1517. Go to original source...
    2. Hughes JM, Petit MA Biological underpinnings of Frost's mechanostat thres­ holds: the 10:128-135.
    3. Zikan V. Bone health in patients wi 2011:596294. doi: 10.4061/2011/596294.
    4. Marrie RA, Cutter G, Tyry T, Vollmer T. A cross-sectional study of bone hea in multiple sclerosis. Neurology 2009;73:1394-1398. Go to original source...
    5. Weinstock-Guttman B, Gallagher E, Baier M, Green L, Feichter J, Ptrick K, Miller C, Wrest K, Ramanathan M. Risk of bone loss in men with multiple scle­ rosis. Mult Scler 2004;10:170-175. Go to original source...
    6. Gupta S, Ahsan I, Mahfooz N, Abdelhamid N, Ramanathan M, WeinstockGuttman B. Osteoporosis and multiple sclerosis: risk factors, pathophysiology, and therapeutic interventions. CNS Drugs 2014;28(8):731-742. Go to original source...
    7. Moen SM, Celius EG, Sandvik L, Brustad M, Nordsletten L, Eriksen EF, Holm0y T. Bone turnover and metabolism in patients with early multiple sclero­ sis and prevalent bone mass deficit: a population-based c One 2012; 7(9):e45703. doi: 10.1371/journal.pone.0045703. Go to original source...
    8. Moen SM, Celius EG, Nordsletten L, Holm0y T. Fractures and falls in patients with newly diagnosed clinically isol Neurol Scand Suppl 2011;(191):79-82. Go to original source...
    9. Kurtzke JF. Historical and clinical perspectives of the expanded disability s scale. Neuroepidemiology 2008;31(1):1-9. Go to original source...
    10. Ozgocmen S, Bulut S, Ilhan N, Gulkesen A, Ardicoglu O, Ozkan Y. Vitamin D deficiency and reduced bone mineral density in multiple sclerosis: effect of am­ bulatory status and functional capacity. J Bone Miner Metab 2005;23:309-313. Go to original source...
    11. Hotermans C, Dive D, Rinkin C et al. Hip bone mineral density is correlated w EDSS in patients with multiple sclerosis. J Neurol 2006;257:410-418.
    12. Terzi T, Terzi M, Tander B, Canturk F, Onar M. Changes in bone mineral densi­ ty and bone metabolism markers in premenopausal women with multiple sclero­ sis and the relationship to clinical variables. J Clin Neurosci 2010;17:1260-12 Go to original source...
    13. Zikán V, Týblová M, Raška I Jr, Havrdová E, Luchavová M, Michalská D, Kuběna AA Bone mineral density and body composition in men with multiple sclerosis chronically treated with low-dose glucocorticoids. Physiol Res 2012; 61(4):405-417. Go to original source...
    14. Havrdová E, Týblová M, Štěpán J, Horáková D, Tichá V, Nováková I, Zelená L, Zikán V, Hlásenská J. Osteoporosis in multiple sclerosis patients: Dependence on corticosteroid therapy and motor deficit [Výskyt osteoporózy u pacientů s roz­ troušenou sklerózou v závislosti na míře kortikoterapie a stupni hybného posti ní] Česká a slovenská neurologie a neurochirurgie 2004;67(4):234-240.
    15. Týblová M, Zikán V, Luchavová M, Havrdová E, Raška I Jr, Michalská D, Kuběna AA Snížená denzita kostního minerálu u žen s roztroušenou sklerózou: vliv motorického deficitu, úbytku svalové hmoty a léčby glukokortikoidy. Česká a slovenská neurologie a neurochirurgie 2013;76(1):35-44.
    16. Formica CA, Cosman F, Nieves J, Herbert J, Lindsay R. Reduced bone mass and fat-free mass in women with multiple sclerosis: effects of ambulatory stat glucocorticoid use. Calcif Tissue Int 1997;61(2):129-133. Go to original source...
    17. Li CY, Price C, Delisser K, Nasser P, Laudier D, Clement M, Jepsen KJ, Schaffler MB. Long-term disuse osteoporosis seems less sensitive to bisphosp nate treatment than other osteoporosis. J Bone Miner Res 2005;20(1):117-124. Go to original source...
    18. Siu WS, Ko CH, Hung LK, Lau CP, Lau CB, Fung KP, Leung PC. Effect of antiosteoporotic agents on t Rep 2013;8(4):1188-1194. Go to original source...
    19. Thomas T, Horlait S, Ringe JD, Abelson A, Gold DT, Atlan P, Lange JL. Oral bisphosphonates reduce the risk of clinical fractures in glucocortico osteoporosis in clinical practice. Osteoporos Int 2013;24(1):263-269. Go to original source...
    20. Devogelaer JP, Sambrook P, Reid DM, Goemaere S, Ish-Shalom S, Collette J, Su G, Bucci-Rechtweg C, Papanastasiou P, Reginster JY. Effect on bone turnover markers of once-yearly intravenous infusion of zoledronic acid versus daily oral risedronate in patients treated with glucocorticoids. Rheumatology (Oxford) 52(6):1058-1069. Go to original source...
    21. Gluer CC, Marin F, Ringe JD, Hawkins F, Moricke R, Papaioannu N, Farahmand P, Minisola S, Martínez G, Nolla JM, Niedhart C, Guaňabens N, Nuti R, Martín-Mola E, Thomasius F, Kapetanos G, Psňa J, Graeff C, Pstto H, Sanz B, Reisinger A, Zysset PK. Comparative effects of teriparatide and rised nate in glucocorticoid-induced osteoporosis in men: 18-month results of the EuroGIOPs trial. J Bone Miner Res 2013;28(6):1355-1368. Go to original source...
    22. Saag KG, Shane E, Boonen S, Marin F, Donley DW, Taylor KA, Dalsky GP, Marcus R. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007;357:2028-2039. Go to original source...
    23. Bruel A, Vegger JB, Raffalt AC, Andersen JE, Thomsen JS. PTH (1-34), but not strontium ranelate counteract loss oftrabec use osteopenic rats. Bone 2013;53(1):51-58. Go to original source...
    24. Eriksen EF, Keaveny TM, Gallagher ER, Krege JH. Literature review: The effe of teriparatide therapy at the hip in patients with osteoporosis. Bone 2014;67: 246-256. Go to original source...
    25. Meunier PJ, Boivin G. Bone mineral density reflects bone mass but also the gree of mineralization of bone: therapeutic implications. Bone 1997;21:373-377. Go to original source...
    26. Giusti A, Hamdy NA, Papapoulos SE. Atypical fractures of the femur and bis­ phosphonate 47:169-180.
    27. Lespessailles E. Bisphosphonates and glucocorticoid-induced osteoporosis: ef cacy and tolerability. Joint Bone Spine 2013;80(3):258-264. Go to original source...
    28. Rosen CJ, Hochberg MC, Bonnick SL et al. Fosamax Actonel Comparison Trial Investigators. Treatment with once-weekly alendronate 70 mg compared with once-weekly risedronate 35 mg in women with postmenopausal osteoporosis: a ran­ domized double-blind study. J Bone Miner Res 2005;20:141-145. Go to original source...
    29. Slade JM, Bickel CS, Modlesky CM, Majumdar S, Dudley GA Trabecular bone is more deteriorated in spinal cord injured versus estrogen-free postmenopausal women. Osteoporos Int 2005;16:263-272. Go to original source...
    30. Jorgensen L, Jacobsen BK, Wilsgaard T, Magnus JH. Walking after stroke: does it matter? Changes in bone mineral density within the first 12 months after str A longitudinal study. Osteoporos Int 2000;11:381-387. Go to original source...
    31. Raška Jr I, Týblová M, Rašková M, Michalská D, Havrdová E, Zikán V. Omezená schopnost chůze významně přispívá k úbytku kostní denzity v proximálním femuru u premenopauzálních i postmenopauzálních žen s roztroušenou sklerózou. Osteol Bull 2012;17(4):128-135.
    32. Bakker A, Klein-Nulend J, Burger E. Shear stress inhibits while di osteocyte apoptosis. Biochem Biophys Res Commun 2004;320(4):1163-1168. Go to original source...
    33. Sims NA, Vrahnas C. Regulation of cortical and trabecular bone mass by com nication between osteoblasts, osteocytes and osteoclasts. Arch Biochem Biophys 2014;561:22-28. Go to original source...
    34. Walker MD, Cusano NE, Sliney J Jr, Romano M, Zhang C, McMahon DJ, Bilezikian JP. Combination therapy with r teoporosis. Endocrine 2013;44(1):237-246. Go to original source...
    35. Vegger JB, Nielsen ES, Bruel A, Thomsen JS. Additive effect of PTH (1-34) and zoledronate in the prevention of disuse osteopenia in rats. Bone 2014;66:287-295. Go to original source...

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