covid
Buscar en
Seminarios de la Fundación Española de Reumatología
Toda la web
Inicio Seminarios de la Fundación Española de Reumatología Teriparatida
Journal Information
Vol. 7. Issue 2.
Pages 96-103 (June 2006)
Share
Share
Download PDF
More article options
Vol. 7. Issue 2.
Pages 96-103 (June 2006)
Full text access
Teriparatida
Visits
14493
Xavier Nogués Solán, Monica Payés Peich, Lidia García Gibert
Unitat de Recerca en Fisiopatología Òssia i Articular. Servei de Medicina Interna. Hospital del Mar. Institut Municipal d’Investigació Mèdica. Universitat Autònoma de Barcelona. Barcelona. España
This item has received
Article information
Resumen

La teriparatida es el primer fármaco anabolizante eficaz en el tratamiento de la osteoporosis. La administración intermitente de paratirina (PTH) induce la aparición de pulsos de adenosinmonofosfato cíclico que causan la proliferación y la diferenciación de los osteoprogenitores. La teriparatida, fragmento de la PTH (1-34), ha demostrado en diversos estudios en mujeres posmenopáusicas, osteoporosis del varón y corticoides que es un fármaco eficaz para el tratamiento de la osteoporosis establecida. El riesgo relativo de sufrir una nueva fractura vertebral disminuye entre el 65 y el 69%, con aumentos de masa ósea entre el 9 y el 11%, similares a los que se obtiene con los bisfosfonatos a largo plazo, como el alendronato y el risedronato a 7 años. Además, estudios recientes demuestran que con el tratamiento durante 2 años con bisfosfonatos tras la teriparatida los aumentos de masa ósea llegan al 23,6%. Su indicación en nuestro país se reduce a la osteoporosis posmenopáusica establecida, es decir con fracturas.

Palabras clave:
Teriparatida
PTH
Osteoporosis
Masa ósea
Fracturas
Abstract

Teriparatide is considered the first anabolic drug to treat established osteoporosis. Intermittent administration of Pth leads to cAMP presence that produces proliferation and differentiation of progenitors. Teriparatide, a 1-34 PTH fragment, has demonstrated in several studies in postmenopausal women, men osteoporosis and corticosteroid-induced osteoporosis its efficacy to treat osteoporosis. The risk of having a new vertebral fracture decreases between 65% to 69%, and the increase of bone mass ranges between 9% to 11%. This is similar to the range reached by bisphosphonates as alendronate and risedronate at 7 years of treatment. Moreover, recent studies have shown that a secuential treatment with bisphosphonates and teriparatide the increase of bone mass reaches 23,6%. The prescription of teriparatide in Spain is only for postmenopausal establish osteoporosis, that means with fractures.

Key words:
Teriparatide
PTH
Osteoporosis
Bone mass
Fracture
Full text is only aviable in PDF
Bibliografía
[1.]
A.M. Parfitt, A.R. Villanueva, J. Foldes, et al.
Relations between histologic indices of bone formation. Implications for the pathogenesis of spinal osteoporosis.
J Bone Miner Res, 10 (1995), pp. 466-473
[2.]
L.G. Raisz.
Physiology and pathophysiology of bone remodelling.
Clin Chem, 45 (1999), pp. 1353-1358
[3.]
L.G. Raisz, G.A. Rodan.
Pathogenesis of osteoporosis.
Endocrinol Metab Clin North Am, 32 (2003), pp. 15-24
[4.]
H. Juppner, H.M. Kronenberg, et al.
Parathyroid hormone.
Primer on the metabolic bone diseases and disorders of mineral metabolism, 5.ª ed., pp. 117-124
[5.]
J.M. Hock, J.E. Onyia, B. Miller, et al.
Anabolic PTH targets proliferating cells of the primary spongiosa in young rats, and increases the number differentiating into osteoblasts.
J Bone Miner Res, 9 (1994), pp. S412
[6.]
C. Deal.
The use of intermittent human parathyroid hormone as a treatment for osteoporosis.
Curr Rheumatol Rep, 6 (2004), pp. 49-58
[7.]
J.E. Onyia, J. Bidwell, J. Herring, J. Hulman, J.M. Hock.
In vivo, human parathyroid hormone fragment (hPTH 1-34) transiently stimulates immediate early response gene expression, but not proliferation, in trabecular bone cells of young rats.
Bone, 17 (1995), pp. 479-484
[8.]
H. Dobnig, R.T. Turner.
Evidence that intermittent treatment with parathyroid hormone increases bone formation in adult rats by activation of bone lining cells.
Endocrinology, 136 (1995), pp. 3632-3638
[9.]
T. Komori, H. Yagi, S. Nomura, et al.
Targeted disruption of CbFa1 results in a complete lack of bone formation owing to maturational arrest of osteoblast.
Cell, 89 (1997), pp. 755-764
[10.]
R.M. Neer, C.D. Arnaud, J.R. Zanchetta, et al.
Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.
N Engl J Med, 344 (2001), pp. 1434-1441
[11.]
R.D. Wasnich, P.D. Miller.
Antifracture efficacy of antiresorptive agents are related to changes in bone density.
J Clin Endocrinol Metab, 85 (2000), pp. 231-236
[12.]
P.N. Sambrook, J.P. Rodríguez, R.D. Wasnich, et al.
Alendronate in the prevention of osteoporosis: 7-year follow-up.
Osteoporos Int, 15 (2004), pp. 483-488
[13.]
H.G. Bone, D. Hosking, J.P. Devogelaer, Alendronate Phase III Osteoporosis Treatment Study Group, et al.
Ten years’ experience with alendronate for osteoporosis in postmenopausal women.
N Engl J Med, 350 (2004), pp. 1189-1199
[14.]
D.D. Mellstrom, O.H. Sorensen, S. Goemaere, et al.
Seven years of treatment with risedronate in women with postmenopausal osteoporosis.
Calcif Tissue Int, 75 (2004), pp. 462-468
[15.]
N.E. Lane, S. Sánchez, H.K. Genant, et al.
Short-term increases in bone turnover markers predict parathyroid hormone-induced spinal bone mineral density gains in postmenopausal women with glucocorticoid-induced osteoporosis.
Osteoporos Int, 11 (2000), pp. 434-442
[16.]
D.M. Black, S.L. Greenspan, K.E. Ensrud, PaTH Study Investigators, et al.
The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis.
N Engl J Med, 349 (2003), pp. 1207-1215
[17.]
D.W. Dempster, F. Cosman, E.S. Kurland, et al.
Effects of daily treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: a paired biopsy study.
J Bone Miner Res, 16 (2001), pp. 1846-1853
[18.]
Y. Jiang, J.J. Zhao, B.H. Mitlak, et al.
Recombinant human parathyroid hormone (1-34) [teriparatide] improves both cortical and cancellous bone structure.
J Bone Miner Res, 18 (2003), pp. 1932-1941
[19.]
M. Sato, M. Westmore, Y.L. Ma, et al.
Teriparatide [PTH (1-34)] strengthens the proximal femur of ovariectomized nonhuman primates despite increasing porosity.
J Bone Miner Res, 19 (2004), pp. 623-629
[20.]
J.S. Finkelstein, A. Hayes, J.L. Hunzelman, et al.
The effects of parathyroid hormone, alendronate, or both in men with osteoporosis.
N Engl J Med, 349 (2003), pp. 1216-1226
[21.]
E.S. Kurland, S.L. Heller, B. Diamond, et al.
The importance of bisphosphonate therapy in maintaining bone mass in men after therapy with teriparatide [human parathyroid hormone(1-34)].
Osteoporosis Int, 15 (2004), pp. 992-997
[22.]
B. Ettinger, J. San Martin, G. Crans, et al.
Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate.
J Bone Miner Res, 19 (2004), pp. 745-751
[23.]
J.L. Vahle, M. Sato, G.G. Long, et al.
Skeletal changes in rats given daily subcutaneous injections of recombinant human parathyroid hormone (1-34) for 2 years and relevance to human safety.
Toxicol Pathol, 30 (2002), pp. 312-321
[24.]
J.L. Vahle, G.G. Long, G. Sandusky, et al.
Bone neoplasms in F344 rats given teriparatide [rhPTH(1-34)] are dependent on duration of treatment and dose.
Toxicol Pathol, 32 (2004), pp. 426-438
[26.]
E.S. Orwoll, W.H. Scheele, S. Paul, et al.
The effect of teriparatide [human parathyroid hormone (1-34)] therapy on bone density in men with osteoporosis.
J Bone Miner Res, 18 (2003), pp. 9-17
[27.]
I.R. Reid.
Glucocorticoid-induced osteoporosis: assessment and treatment.
J Clin Densitom, 1 (1998), pp. 65-73
[28.]
E. Canalis, J.P. Bilezikian, A. Angeli, et al.
Perspectives on glucocorticoid-induced osteoporosis.
[29.]
Q. Rehman, T.F. Lang, C.D. Arnaud, et al.
Daily treatment with parathyroid hormone is associated with an increase in vertebral cross-sectional area in postmenopausal women with glucocorticoid-induced osteoporosis.
Osteoporosis Int, 14 (2003), pp. 77-81
Copyright © 2006. Sociedad Española de Reumatología
Download PDF
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos