Anabolic therapy for osteoporosis: Parathyroid hormone

被引：14

作者：

Cosman F. ^{[1
]}

机构：

[1] Regional Bone Center, Helen Hayes Hospital, New York, NY 10993, Route 9W, West Haverstraw

来源：

Current Rheumatology Reports | 2006年 / 8卷 / 1期

关键词：

Osteoporosis; Vertebral Fracture; Alendronate; Raloxifene; Teriparatide;

D O I：

10.1007/s11926-006-0028-0

中图分类号：

学科分类号：

摘要：

Recombinant human parathyroid hormone (PTH 1-34) is the only anabolic agent currently approved for the treatment of osteoporosis. The term anabolic is based on mechanism of action. PTH stimulates bone formation, in contrast to antiresorptive agents, which reduce bone resorption and formation. Recent investigations involving the PTH(1-34) and PTH(1-84) peptides, alone and in combination or sequential regimens with antiresorptive agents, have provided a greater understanding of the place of PTH in the armamentarium against osteoporosis. These studies indicate that adding a bisphosphonate to PTH in previously untreated individuals does not produce additional bone benefit; however, sequential use of PTH followed-up by an antiresorptive agent is highly effective at increasing bone mineral density. Adding PTH after an antiresorptive agent also produces substantial bone density increments, though the magnitude of bone density increase may differ for different antiresorptive agents. PTH can repair underlying micro-architectural defects in bone, improve bone mass substantially, and perhaps change macro-architecture and geometry of bone. There are still many unanswered questions regarding PTH treatment of osteoporosis, including the optimal duration of treatment, optimal dosing regimen, mechanism of resistance to its effect after 18-24 months, and the effect of subsequent rechallenge. Copyright © 2006 by Current Science Inc.

引用

页码：63 / 69

页数：6

共 44 条

[21]

Greenspan S.L., Marriott T.B., Hanley D.A., Et al., Full-length PTH prevents first vertebral fracture in postmenopausal women with osteoporosis: Results from the TOP study, Amer College Rheumatol, SUPPL., (2004)

[22]

Greenspan S.L., Bone H.G., Marriott T.B., Et al., Preventing the first vertebral fracture in postmenopausal women with low bone mass using PTH(1-84): Results from the TOP study, J Bone Miner Res, 20, SUPPL. 1, (2005)

[23]

Black D.M., Rosen C.M., Greenspan S., Et al., The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis, N Engl J Med, 349, pp. 1207-1215, (2003)

[24]

Neer R.M., Hayes A., Rao A., Et al., Effects of parathyroid hormone, alendronate, or both on bone density in osteoporotic postmenopausal women, J Bone Miner Res, 17, SUPPL. 1, (2002)

[25]

Cosman F., Nieves J., Woelfert L., Et al., Alendronate does not block the anabolic effect of PTH in postmenopausal osteoporotic women, J Bone Miner Res, 13, pp. 1051-1055, (1998)

[26]

Cosman F., Nieves J., Zaion M., Et al., Daily and Cylcic parathyroid hormone in women receiving alendronate, N Eng J Med, 353, pp. 566-575, (2005)

[27]

Ettinger B., San Martin J., Crans G., Pavo I., Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate, J Bone Miner Res, 19, pp. 745-751, (2004)

[28]

Lindsay R., Nieves J., Formica C., Et al., Randomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis, Lancet, 350, pp. 550-555, (1997)

[29]

Cosman F., Nieves J., Woelfert L., Et al., Parathyroid hormone added to established hormone therapy: Effects on vertebral fracture and maintenance of bone mass after parathyroid hormone withdrawal, J Bone Miner Res, 16, pp. 925-931, (2001)

[30]

Roe E.B., Sanchez S.D., Del Puerto G.A., Et al., Parathyroid hormone 1-34 (hPTH 1-34) and estrogen produce dramatic bone density increases in postmenopausal osteoporosis - Results from a placebo-controlled randomized trial, J Bone Miner Res, 12, SUPPL. 1, (1999)

← 1 2 3 4 5 →