Teriparatide for treatment of patients with bisphosphonate-associated atypical fracture of the femur.
Osteoporos Int
; 29(2): 501-506, 2018 02.
Article
in En
| MEDLINE
| ID: mdl-29085957
ABSTRACT
The Fracture Improvement with Teriparatide (Fix-IT) study randomized 13 women with an atypical femur fracture to immediate vs delayed teriparatide therapy; all were followed for 12 months. Results suggested a trend for superior healing and lesser bone mineral density declines in the immediate vs delayed group with no differences in adverse events. PURPOSE:
Little clinical data are available on the use of teriparatide for the treatment of bisphosphonate-associated atypical femur fractures (AFF). The goal of the Fix-IT study was to determine if immediate therapy with teriparatide was superior for fracture healing after an AFF compared to a 6-month delay in teriparatide therapy.METHODS:
This randomized pilot clinical trial included 13 women with an AFF who were randomized to immediate teriparatide vs a delay of 6 months. All were followed for 12 months on teriparatide. The primary outcomes included individual and composite measures of radiologic bone healing (scored 1 point [no healing] to 4 points [complete healing]) at 6 and 12 months. Secondary outcomes included bone mineral density of the unfractured contralateral hip, spine, 1/3 distal radius, and adverse events.RESULTS:
We found there was a trend for superior healing with the composite score (12.6 vs 11.2 at 6 months and 15.4 vs 13.2 at 12 months), and lesser bone mineral density declines at the 1/3 distal radius (12-month change - 1.9 vs - 6.1%) in the immediate vs the delayed group. There were no differences in adverse events. There was one implant failure in the delayed group.CONCLUSIONS:
There is a preliminary signal for greater improvements with immediate teriparatide therapy vs delayed therapy. However, because an AFF is a rare event, and only a small number of patients were included, the results must be interpreted with caution.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Teriparatide
/
Diphosphonates
/
Bone Density Conservation Agents
/
Femoral Fractures
/
Fractures, Spontaneous
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
Osteoporos Int
Journal subject:
METABOLISMO
/
ORTOPEDIA
Year:
2018
Document type:
Article
Affiliation country:
United States