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首页> 外文期刊>Journal of Clinical & Translational Endocrinology >Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study
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Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study

机译：特立帕肽与安慰剂对下肢应力性骨折女性的骨生物标志物，结构和骨折愈合的短期影响：一项初步研究

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Highlights ? Teriparatide (TPTD) and fracture healing studies in premenopausal women is limited. ? Brief TPTD administration showed a greater anabolic window compared to placebo. ? Bone formation markers increased in TPTD- vs. placebo-treated group (both p?≤?0.01). ? TPTD (83.3%) vs. placebo (57.1%) showed improved stress fractures on MRI (p?=?0.18). Abstract Aims In this pilot, placebo-controlled study, we evaluated whether brief administration of teriparatide (TPTD) in premenopausal women with lower-extremity stress fractures would increase markers of bone formation in advance of bone resorption, improve bone structure, and hasten fracture healing according to magnetic resonance imaging (MRI). Methods Premenopausal women with acute lower-extremity stress fractures were randomized to injection of TPTD 20-μg subcutaneous (s.c.) (n?=?6) or placebo s.c. (n?=?7) for 8 weeks. Biomarkers for bone formation N-terminal propeptide of type I procollagen (P1NP) and osteocalcin (OC) and resorption collagen type-1 cross-linked C-telopeptide (CTX) and collagen type 1 cross-linked N-telopeptide (NTX) were measured at baseline, 4 and 8 weeks. The area between the percent change of P1NP and CTX over study duration is defined as the anabolic window. To assess structural changes, peripheral quantitative computed topography (pQCT) was measured at baseline, 8 and 12 weeks at the unaffected tibia and distal radius. The MRI of the affected bone assessed stress fracture healing at baseline and 8 weeks. Results After 8 weeks of treatment, bone biomarkers P1NP and OC increased more in the TPTD- versus placebo-treated group (both p?≤?0.01), resulting in a marked anabolic window (p?≤?0.05). Results from pQCT demonstrated that TPTD-treated women showed a larger cortical area and thickness compared to placebo at the weight bearing tibial site, while placebo-treated women had a greater total tibia and cortical density. No changes at the radial sites were observed between groups. According to MRI, 83.3% of the TPTD- and 57.1% of the placebo-treated group had improved or healed stress fractures (p?=?0.18). Conclusions In this randomized, pilot study, brief administration of TPTD showed anabolic effects that TPTD may help hasten fracture healing in premenopausal women with lower-extremity stress fractures. Larger prospective studies are warranted to determine the effects of TPTD treatment on stress fracture healing in premenopausal women.
机译：强调 ？绝经前妇女的特立帕肽（TPTD）和骨折愈合研究非常有限。 ？与安慰剂相比，简短的TPTD给药显示出更大的合成代谢窗口。 ？与安慰剂治疗组相比，TPTD-治疗组的骨形成标记增加（均p≤≤0.01）。 ？ TPTD（83.3％）vs.安慰剂（57.1％）在MRI上显示出改善的应力性骨折（p≤0.18）。摘要目的在这项试验性安慰剂对照研究中，我们评估了在绝经前下肢应力性骨折的女性中短暂使用特立帕肽（TPTD）是否会增加骨吸收之前的骨形成标记，改善骨结构并加速骨折愈合。根据磁共振成像（MRI）。方法将绝经前下肢急性下肢骨折的妇女随机分为皮下注射TPTD 20μg（s.c.）（n？=？6）或安慰剂s.c。 （n？=？7）8周。测量了I型胶原蛋白（P1NP）和骨钙素（OC）的骨形成N末端前肽以及1型胶原交联的C-端肽（CTX）和1型胶原交联的N-端肽（NTX）的骨形成的生物标志物。在基线的第4周和第8周。在研究期间P1NP和CTX的百分比变化之间的区域被定义为合成代谢窗口。为了评估结构变化，在基线，第8周和第12周未受影响的胫骨和distal骨远端测量了外周定量计算机地形图（pQCT）。受影响骨的MRI在基线和第8周评估了应力性骨折的愈合情况。结果治疗8周后，与安慰剂治疗组相比，TPTD治疗组的骨生物标志物P1NP和OC升高更多（均p≤≤0.01），导致明显的合成代谢窗口（p≤≤0.05）。 pQCT的结果表明，在负重胫骨部位，与安慰剂相比，TPTD治疗的女性显示出更大的皮质面积和厚度，而安慰剂治疗的女性具有更大的总胫骨和皮质密度。各组之间the骨部位未见变化。根据MRI，TPTD组的83.3％和安慰剂治疗组的57.1％的应力性骨折得到改善或治愈（p = 0.18）。结论在这项随机的，初步的研究中，短暂施用TPTD表现出同化作用，即TPTD可能有助于加速具有下肢应力性骨折的绝经前女性的骨折愈合。有必要进行更大规模的前瞻性研究来确定TPTD治疗对绝经前女性压力性骨折愈合的影响。

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