Determinants associated with bone mineral density increase in response to daily teriparatide treatment in patients with osteoporosis

- We examine baseline factors related to lumbar spine BMD increase to teriparatide use.
- Bisphosphonate use, lower BMD, and higher PINP were related by univariate analyses.
- Higher PINP and lower BMD were associated with BMD increase by multivariate analyses.
- Bisphosphonate use lost its correlation in multivariate analyses.
- Baseline higher PINP and lower BMD were a predictor of lumbar spine BMD increase.

IntroductionSeveral factors associated with bone mineral density (BMD) increase are reported with daily teriparatide treatment, but there has been no systematic analysis to summarize these associations. The purpose of this study was to investigate the clinical determinants associated with BMD increase to daily teriparatide treatment.MethodsThis was a retrospective study. We performed an analysis of 306 patients diagnosed with osteoporosis. Teriparatide was administered at 20 μg/day for 12 months. The primary efficacy measure was a change in lumbar spine (LS) BMD from baseline at 12 months. To determine the response variables of BMD changes, we investigated the clinical determinants using univariate and multivariate analyses.ResultsThere was a 9.8 ± 8.2% increase in LS BMD after 12 months. Prior bisphosphonate treatment and baseline procollagen type I N-terminal propeptide (PINP) concentration were significantly associated with LS BMD absolute response by univariate analyses. In the multiple regression model, patients with higher baseline PINP concentration had a significantly greater LS BMD absolute increase. Prior bisphosphonate use lost its correlation in the multiple regression models.ConclusionOur results showed that baseline PINP concentration was a useful predictor of LS BMD absolute increase regardless of prior treatment.