Contributors to Secondary Osteoporosis in Patients Referred for Treatment with Teriparatide

ABSTRACT

Purpose: Teriparatide is an anabolic agent belonging to a new class of antiosteoporosis drugs. The Turkish Social Security Institution covers teriparatide for patients with osteoporosis who have 2 osteoporotic fractures, are older than 65 years, and have a T-score of less than -4. We evaluated possible secondary contributors to osteoporosis in patients referred for treatment with this agent.
Material and Method: All patients referred to our center for teriparatide treatment over 2 year were evaluated for clinical risk factors for osteoporosis, medical history, and medications.
Results: Sixty-eight patients (63 women and 5 men, mean age:71.3±9.4 (50-89 years) were referred. Twenty-nine patients (42.6%) had received osteoporosis therapy before referral, consisting of bisphosphonate (n=20), strontium ranelate (n=6), calcitonin (n=2), or calcitonin and bisphosphonate (n=1). The mean duration of the previous therapy was 46.4± 38.5 (3-120 months). In all, 50 of the 68 patients (73.5%), including all of the men, had a contributor to secondary osteoporosis. Vitamin D deficiency was the most frequent contributor in 34 patients (52.3%). Other common contributors were hyperthyroidism and hypogonadism. Only 3 of 18 patients with hyperthyroidism and none of the patients with hypogonadism had been diagnosed previously, and 16 of the 24 patients receiving vitamin D supplementation still had deficiency of this vitamin.
Discussion: Most of our patients had a contributor to secondary osteoporosis, which often had not been identified previously. Identifying and correcting such disorders might improve the treatment of osteoporosis and reduce the risk of subsequent fracture.