Impact of Teriparatide and Denosumab on Clinical and Radiographic Outcomes in Osteoporotic Vertebral Compression Fractures
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Patient Selection
2.2. Clinical Outcomes
2.3. Radiographic Assessment
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. BMD and Radiographic Outcomes
3.3. Clinical Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Teriparatide (n = 35) | Denosumab (n = 43) | p-Value |
---|---|---|---|
Age | 77.6 (6.1) | 76.2 (6.5) | 0.32 |
Sex (M:F), No. (%) | 2 (6%):33 (94%) | 10 (23%):33 (77%) | 0.033 |
BMI | 23.4 (3.3) | 23.8 (3.4) | 0.65 |
Extent of levels, No. (%) | 0.32 | ||
1 | 25 (71%) | 34 (79%) | |
2 | 7 (20%) | 6 (14%) | |
3 | 0 (0%) | 2 (5%) | |
>3 | 3 (9%) | 1 (2%) | |
Locations, No. (%) | 0.44 | ||
L | 18 (51%) | 27 (63%) | |
T | 13 (37%) | 13 (32%) | |
T and L | 4 (12%) | 3 (7%) | |
DEXA | |||
Lumbar (T-score) | −3.7 (1.1) | −2.5 (0.9) | <0.001 |
BMD of lumbar (g/cm2) | 0.722 (0.144) | 0.854 (0.134) | <0.001 |
BMD of femur neck (g/cm2) | 0.503 (0.114) | 0.610 (0.109) | <0.001 |
BMD of total hip (g/cm2) | 0.609 (0.108) | 0.741 (0.108) | <0.001 |
Medical comorbidity, No. (%) | |||
Diabetes | 6 (17%) | 7 (16.3%) | >0.99 |
Hypertension | 16 (46%) | 14 (33%) | 0.34 |
Cerebrovascular disease | 6 (17%) | 4 (9%) | 0.49 |
Chronic kidney disease | 1 (3%) | 4 (9%) | 0.49 |
Characteristics | Teriparatide (n = 35) | Denosumab (n = 43) | p-Value |
---|---|---|---|
DEXA at 12-month | |||
Lumbar (T-score) | −3.5 (1.0) | −2.2 (0.9) | <0.001 |
BMD of lumbar (g/cm2) | 0.776 [0.708–0.881] | 0.915 [0.841–0.974] | <0.001 |
BMD of femur neck (g/cm2) | 0.500 (0.101) | 0.628 (0.115) | <0.001 |
BMD of total hip (g/cm2) | 0.613 (0.098) | 0.753 (0.113) | <0.001 |
DEXA, absolute change * | |||
Lumbar (T-score) | 0.3 (0.5) | 0.3 (0.3) | 0.86 |
BMD of lumbar (g/cm2) | 0.065 (0.191) | 0.061 (0.075) | 0.91 |
BMD of femur neck (g/cm2) | −0.001 (0.046) | 0.014 (0.065) | 0.28 |
BMD of total hip (g/cm2) | 0.009 (0.043) | 0.013 (0.035) | 0.66 |
DEXA, relative change (%) † | |||
Lumbar (T-score) | 6.8(13.8) | 14.6(21.3) | 0.088 |
BMD of lumbar | 11.3 (21.6) | 7.9 (8.8) | 0.38 |
BMD of femur neck | 0.3 (9.0) | 2.8 (10.5) | 0.32 |
BMD of total hip | 1.8 (8.2) | 1.8 (4.8) | 0.96 |
Radiographics | |||
Compression rate (initial, %) | 22.8 [15.0–27.4] | 21.6 [10.4–35.6] | 0.94 |
Compression rate (final, %) | 34.1 [28.8–47.1] | 38.5 [33.9–46.0] | 0.38 |
Wedge angle (initial, degree) | 7.0 (3.9) | 7.7 (3.9) | 0.44 |
Wedge angle (final, degree) | 9.6 (5.5) | 9.9 (4.6) | 0.82 |
Union, No. (%) | 26 (74%) | 35 (81%) | 0.45 |
Newly onset vertebral fracture, No. (%) | 3 (9%) | 4 (9%) | >0.99 |
Variables | Teriparatide (n = 35) | Denosumab (n = 43) | p-Value |
---|---|---|---|
VAS back pain | |||
Initial | 52.7 (16.6) | 49.0 (16.4) | |
6 months | 37.7 (23.1) | 37.0 (18.5) | |
12 months | 38.7 (22.8) | 38.1 (17.8) | 0.011 † |
Overall group effect * | NA | NA | 0.755 |
ODI | |||
Initial | 69.7 (26.7) | 63.5 (23.1) | |
6 months | 30.3 (23.1) | 31.4 (24.3) | |
12 months | 32.6 (27.3) | 24.2 (19.8) | <0.001 † |
Overall group effect * | NA | NA | 0.056 |
EQ-5D | |||
Initial | 0.444 (0.191) | 0.497 (0.219) | |
6 months | 0.669 (0.249) | 0.665 (0.202) | |
12 months | 0.647 (0.257) | 0.656 (0.230) | 0.001 † |
Overall group effect * | NA | NA | 0.259 |
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Kwon, B.-T.; Ham, D.-W.; Park, S.-M.; Kim, H.-J.; Yeom, J.S. Impact of Teriparatide and Denosumab on Clinical and Radiographic Outcomes in Osteoporotic Vertebral Compression Fractures. Medicina 2024, 60, 1314. https://doi.org/10.3390/medicina60081314
Kwon B-T, Ham D-W, Park S-M, Kim H-J, Yeom JS. Impact of Teriparatide and Denosumab on Clinical and Radiographic Outcomes in Osteoporotic Vertebral Compression Fractures. Medicina. 2024; 60(8):1314. https://doi.org/10.3390/medicina60081314
Chicago/Turabian StyleKwon, Byung-Taek, Dae-Woong Ham, Sang-Min Park, Ho-Joong Kim, and Jin S. Yeom. 2024. "Impact of Teriparatide and Denosumab on Clinical and Radiographic Outcomes in Osteoporotic Vertebral Compression Fractures" Medicina 60, no. 8: 1314. https://doi.org/10.3390/medicina60081314