Aging Clinical and Experimental Research · 9 authors, 6 centres
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This prospective study compared sequential teriparatide followed by alendronate against alendronate alone in 105 osteoporotic women who had undergone percutaneous vertebroplasty, and found that sequential treatment significantly reduced the vertebral refracture rate and improved lumbar bone mineral density over 12 months.
This prospective study enrolled 165 female osteoporosis patients who had undergone percutaneous vertebroplasty, of whom 105 completed the 1-year follow-up (46 in the sequential teriparatide-alendronate group, 59 in the alendronate-alone group). Patients were assigned based on their own choice rather than randomization. The sequential group received teriparatide for the first 6 months followed by alendronate for 6 months, while the comparison group received alendronate throughout. At 12 months, lumbar BMD was significantly higher in the sequential group (0.65 ± 0.10 vs. 0.57 ± 0.07 g/cm², p < 0.001), though femoral neck and total hip BMD did not differ significantly. The vertebral refracture rate was lower in the sequential group (2.2% vs. 13.6%, p < 0.05). Bone turnover markers PINP and CTX both increased during the teriparatide phase and then declined during the alendronate phase. Limitations include the small sample, short follow-up, and lack of randomization. The findings suggest short-sequential teriparatide-alendronate therapy may be more effective than alendronate alone for elevating lumbar BMD and preventing refracture, though the non-randomized design limits the strength of these conclusions.
