Four-Year Teriparatide Followed by Denosumab vs. Continuous Denosumab in Glucocorticoid-Induced Osteoporosis Patients With Prior Bisphosphonate Treatment

Objectives In our previous 24-month study, we observed that teriparatide had some advantages over denosumab for bone mineral density (BMD) in glucocorticoid-induced osteoporosis (GIO) patients with prior bisphosphonate treatment. We conducted this extension study to investigate whether the advantage of teriparatide obtained in the first 2 years would be maintained after the switch to denosumab. Materials and Methods We switched patients who had completed 24-month daily teriparatide treatment to denosumab (switch group, n=18) and compared their BMD every 6 months up to 48 months with the group who continued to receive denosumab (denosumab group, n=16). Results At 48 months, the lumbar spine BMD was significantly increased from baseline in both groups (denosumab: 10.4 +/- 8.7%, p<0.001; switch: 14.2 +/- 6.8%, p<0.001). However, a significant increase in femoral neck BMD from baseline occurred only in the switch group (11.2 +/- 14.6%, p<0.05); denosumab (4.1 +/- 10.8%). The total hip BMD increased significantly from baseline in both groups (denosumab: 4.60 +/- 7.4%, p<0.05; switch: 7.2 +/- 6.9%, p<0.01). Femoral neck BMD was significantly increased in the switch versus the denosumab group (p<0.05). Conclusion In GIO patients with prior bisphosphonate treatment, the advantage of teriparatide may be maintained after the treatment period. A continuous increase in BMD can be expected with teriparatide followed by denosumab.

Automated summary

In patients with GIO and prior bisphosphonate treatment, the advantage of teriparatide may be maintained after switching to denosumab, leading to a continuous increase in BMD.