Comparative effects of teriparatide and risedronate in glucocorticoid-induced osteoporosis in men: 18-month results of the EuroGIOPs trial
Open accessAbstract
Data on treatment of glucocorticoid-induced osteoporosis (GIO) in men are scarce. We performed a randomized, open-label trial in men who have taken glucocorticoids (GC) for ≥3 months, and had an areal bone mineral density (aBMD) T-score ≤ -1.5 standard deviations. Subjects received 20 μg/d teriparatide (n = 45) or 35 mg/week risedronate (n = 47) for 18 months. Primary objective was to compare lumbar spine (L1 -L3 ) BMD measured by quantitative computed tomography (QCT). Secondary outcomes included BMD and microstructure measured by high-resolution QCT (HRQCT) at the 12th thoracic vertebra, biomechanical effects for axial compression, anterior bending, and axial torsion evaluated by finite element (FE) analysis from HRQCT data, aBMD by dual X-ray absorptiometry, biochemical markers, and safety. Computed tomography scans were performed at 0, 6, and 18 months. A mixed model repeated measures analysis was performed to compare changes from baseline between groups. Mean age was 56.3 years. Median GC dose and duration were 8.8 mg/d and 6.4 years, respectively; 39.1% of subjects had a prevalent fracture, and 32.6% received prior bisphosphonate treatment. At 18 months, trabecular BMD had significantly increased for both treatments, with significantly greater increases with teriparatide (16.3% versus 3.8%; p = 0.004). HRQCT trabecular and cortical variables significantly increased for both treatments with significantly larger improvements for teriparatide for integral and trabecular BMD and bone surface to volume ratio (BS/BV) as a microstructural measure. Vertebral strength increases at 18 months were significant in both groups (teriparatide: 26.0% to 34.0%; risedronate: 4.2% to 6.7%), with significantly higher increases in the teriparatide group for all loading modes (0.005 < p < 0.015). Adverse events were similar between groups. None of the patients on teriparatide but five (10.6%) on risedronate developed new clinical fractures (p = 0.056). In conclusion, in this 18-month trial in men with GIO, teriparatide showed larger improvements in spinal BMD, microstructure, and FE-derived strength than risedronate.
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The anabolic agent hPTH (1-34) is superior to bisphosphonates in increasing spine and hip BMD and reduces the incidence of new vertebral fractures in glucocorticoid-induced osteoporosis populations for both men and women.
“In support of this notion, it is reported that anabolic agent, hPTH (1-34), is superior to bisphosphonates in increasing spine and hip BMD and reduces the incidence of new vertebral fractures in glucocorticoid-induced osteoporosis (GIOP) populations for both men and women [11, 47-49].”
From Prevention of glucocorticoid induced bone changes with beta-ecdysone (2015) · cites this paper as [48]
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- Authors
- Glüer, C.-C., Marin, F., Ringe, J. D., Hawkins, F., Möricke, R., Papaioannu, N., Farahmand, P., Minisola, S., Martínez, G., Nolla, J. M., Niedhart, C., Guañabens, N., Nuti, R., Martín-Mola, E., Thomasius, F., Kapetanos, G., Peña, J., Graeff, C., Petto, H., Sanz, B., Reisinger, A., & Zysset, P. K.
- Affiliations
- University Hospital Schleswig-Holstein (DE)
- Lilly Research CenterWindleshamUK
- Klinikum Leverkusen (DE)
- Hospital Universitario 12 De Octubre (ES)
- Institut für Präventive Medizin & Klinische ForschungMagdeburgGermany
- National and Kapodistrian University of Athens (GR)
- Policlinico Umberto I (IT)
- Hospital BellvitgeBarcelonaSpain
- GemeinschaftspraxisHeinsbergGermany
- Hospital Clinic and Center of Network Biomedical Research in Hepatic and Digestive DiseasesBarcelonaSpain
- Policlinico Le ScotteSienaItaly
- Hospital Universitario La Paz (ES)
- Osteoporose StudiengesellschaftFrankfurtGermany
- Aristotle University of Thessaloniki (GR)
- Lilly Research CenterViennaAustria
- Institute for Lightweight Design and Structural BiomechanicsViennaAustria
- University of Bern (CH)
- Corresponding author
- Glüer, Claus-C
- ORCID
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-15
- Volume
- 28
- Issue
- 6
- Pages
- 1355-1368
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- PMC
- PMC3708101
- OpenAlex
- W1920107567
- Cited by
- 171
- References
- 49
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 8 · 2023: 6 · 2022: 11 · 2021: 17 · 2020: 20 · 2019: 12 · 2018: 17 · 2017: 11 · 2016: 12 · 2015: 20 · 2014: 17 · 2013: 10
- FWCI
- 20.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion, other-oa)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- glucocorticoid-induced osteoporosis, teriparatide, risedronate, men, bone mineral density, trabecular bone microarchitecture, vertebral strength, finite element analysis, bone turnover markers, fracture prevention, bisphosphonates, adverse events, quantitative computed tomography
- MeSH terms
- Risedronic Acid, Adult, Aged, Aged, 80 and over, Europe, Female, Follow-Up Studies, Glucocorticoids, Humans, Lumbar Vertebrae, Middle Aged, Osteoporosis, Radiography, Etidronic Acid, Bone Density, Spinal Fractures, Teriparatide, Bone Density Conservation Agents
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