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Konings V, Laurent MR, Janssens S, Dupont J, Gielen E, Dejaeger M. Skeletal response to teriparatide in real-life setting: effects of age, baseline bone density and prior denosumab use. Acta Clin Belg 2023; 78:446-451. [PMID: 37466144 DOI: 10.1080/17843286.2023.2238375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Teriparatide (TPD) is an osteoanabolic agent used in patients with high osteoporotic fracture risk. Predictors of therapeutic response to TPD in real-life setting are not well characterised. This study investigated the influence of previous antiresorptive therapy, age and other patient characteristics on the skeletal response to TPD. METHODS Retrospective study at the metabolic bone clinic, University Hospitals Leuven, Belgium. Patients with osteoporosis and a high fracture burden received TPD for 9-18 months. Bone mineral density (BMD) was measured at baseline, 9 and 18 months at lumbar spine (LS), femoral neck (FN) and total hip (TH). RESULTS BMD at LS increased at 9 months (change mean (standard error) 6.8 % (0.7) p < 0.001) and at 18 months (8.0 % (0.9) p < 0.001), while BMD at FN and TH did not change significantly. Non-response in BMD change at the LS was seen with prior denosumab use (odds ratio 0.21, 95% confidence interval (CI) 0.049-0.912, p = 0.037). Changes in BMD at TH were significantly greater in younger patients and in patients with a lower baseline BMD. CONCLUSION TPD-induced changes in BMD at TH might depend on age and baseline BMD and at LS on prior denosumab use. The results suggest that these factors may be relevant for clinical decision making when initiating TPD treatment, although larger studies are needed to confirm these findings.
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Affiliation(s)
- Valerie Konings
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
| | - Michaël R Laurent
- Department of Geriatrics, Imelda Hospital, Bonheiden, Belgium
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Sigrid Janssens
- Department of Public Health and Primary Care, Laboratory of Gerontology and Geriatrics, KULeuven, Leuven, Belgium
| | - Jolan Dupont
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Laboratory of Gerontology and Geriatrics, KULeuven, Leuven, Belgium
| | - Evelien Gielen
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Laboratory of Gerontology and Geriatrics, KULeuven, Leuven, Belgium
| | - Marian Dejaeger
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Laboratory of Gerontology and Geriatrics, KULeuven, Leuven, Belgium
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Li J, Yao Z, Liu X, Duan R, Yi X, Ayoub A, Sanders JO, Mesfin A, Xing L, Boyce BF. TGFβ1 +CCR5 + neutrophil subset increases in bone marrow and causes age-related osteoporosis in male mice. Nat Commun 2023; 14:159. [PMID: 36631487 PMCID: PMC9834218 DOI: 10.1038/s41467-023-35801-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 01/03/2023] [Indexed: 01/13/2023] Open
Abstract
TGFβ1 induces age-related bone loss by promoting degradation of TNF receptor-associated factor 3 (TRAF3), levels of which decrease in murine and human bone during aging. We report that a subset of neutrophils (TGFβ1+CCR5+) is the major source of TGFβ1 in murine bone. Their numbers are increased in bone marrow (BM) of aged wild-type mice and adult mice with TRAF3 conditionally deleted in mesenchymal progenitor cells (MPCs), associated with increased expression in BM of the chemokine, CCL5, suggesting that TRAF3 in MPCs limits TGFβ1+CCR5+ neutrophil numbers in BM of young mice. During aging, TGFβ1-induced TRAF3 degradation in MPCs promotes NF-κB-mediated expression of CCL5 by MPCs, associated with higher TGFβ1+CCR5+ neutrophil numbers in BM where they induce bone loss. TGFβ1+CCR5+ neutrophils decreased bone mass in male mice. The FDA-approved CCR5 antagonist, maraviroc, reduced TGFβ1+CCR5+ neutrophil numbers in BM and increased bone mass in aged mice. 15-mon-old mice with TGFβRII specifically deleted in MPCs had lower numbers of TGFβ1+CCR5+ neutrophils in BM and higher bone volume than wild-type littermates. We propose that pharmacologic reduction of TGFβ1+CCR5+ neutrophil numbers in BM could treat or prevent age-related osteoporosis.
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Affiliation(s)
- Jinbo Li
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA.
- Institute of Health and Medical Research, Hebei Medical University, Shijiazhuang, Hebei, 050017, China.
| | - Zhenqiang Yao
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Xin Liu
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Rong Duan
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Xiangjiao Yi
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Akram Ayoub
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Leica Biosystems, Deer Park, IL, 60010, USA
| | - James O Sanders
- Department of Orthopaedics and Rehabilitation Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - Addisu Mesfin
- Department of Orthopaedics and Rehabilitation Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Lianping Xing
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Brendan F Boyce
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA.
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA.
- Department of Orthopaedics and Rehabilitation Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA.
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Mok J, Brown C, Moore AEB, Min SS, Hampson G. Skeletal response to treatment with teriparatide (TPD) after bisphosphonate in post-menopausal women with osteoporosis and a high prevalence of secondary risk factors in real-life setting of a metabolic bone clinic; effect of age and vitamin D status. Endocr Res 2018; 43:195-202. [PMID: 29652557 DOI: 10.1080/07435800.2018.1454461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE Teriparatide (TPD) is a skeletal anabolic agent used in patients with severe post-menopausal osteoporosis (PMO) and steroid-induced osteoporosis who are at hish risk of fracture. Predictors of therapeutic response to teriparatide in real-life setting are not well characterised. We investigated potential factors associated with teriparatide response in post-menopausal women with established osteoporosis. METHODS We carried out a retrospective survey of 48 women, aged 73.2 [7.5] years with severe osteoporosis and prevalent fractures treated with TPD according to the NICE criteria. BMD was measured at baseline, 6-12 and 18-24 months at the lumbar spine (LS), total hip (TH) and femoral neck (FN). Bone turnover markers, serum 25 (OH)vitamin D were determined at 3-12 and 12-24 months. RESULTS BMD increased at 6-12 months (% change mean [SEM] 6.5 [1.1] p = 0.004) and 18-24 months (8.45 % [1.2] p<0.001) at the LS. A significant increase in BMD was observed at FN (3.1 [1.3] % p = 0.02). Changes in BMD at the TH was higher in patients younger than 73 years compared to older women (% change in BMD 4.13 [1.64] % v/s -1.7 [1.1] p = 0.007). Baseline 25 (OH) vitamin D correlated with change in P1NP at 3-12 months (r = 0.45 p = 0.049). CONCLUSIONS TPD-induced changes in BMD at the TH appears may be dependent on age. Vitamin D status may influence the early anabolic effect to TPD. Our data suggest that these factors may be important considerations when initiating and optimising treatment with TPD, although further larger studies are needed to confirm these findings.
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Affiliation(s)
- J Mok
- a Department of Chemical Pathology and Metabolic Medicine , St Thomas' Hospital , London , UK
- b Metabolic Bone Clinic, Department of Rheumatology , Guy's Hospital , London , UK
| | - C Brown
- a Department of Chemical Pathology and Metabolic Medicine , St Thomas' Hospital , London , UK
- b Metabolic Bone Clinic, Department of Rheumatology , Guy's Hospital , London , UK
| | - A E B Moore
- c Osteoporosis Unit, Division of Imaging Sciences (Kings College London) , Guy's Hospital , London , UK
| | - S S Min
- a Department of Chemical Pathology and Metabolic Medicine , St Thomas' Hospital , London , UK
- b Metabolic Bone Clinic, Department of Rheumatology , Guy's Hospital , London , UK
| | - G Hampson
- a Department of Chemical Pathology and Metabolic Medicine , St Thomas' Hospital , London , UK
- b Metabolic Bone Clinic, Department of Rheumatology , Guy's Hospital , London , UK
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Sugiyama T, Oda H. Osteoporosis Therapy: Bone Modeling during Growth and Aging. Front Endocrinol (Lausanne) 2017; 8:46. [PMID: 28337176 PMCID: PMC5343005 DOI: 10.3389/fendo.2017.00046] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 02/24/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Toshihiro Sugiyama
- Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
- *Correspondence: Toshihiro Sugiyama,
| | - Hiromi Oda
- Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
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