Abstract
Purpose of review: The prevention and treatment of osteoporosis has traditionally involved the use of antiresorptive therapies. The introduction of parathyroid hormone, an anabolic agent that enhances bone formation, has been accompanied by new treatment strategies. This article reviews combination and sequential therapy approaches with parathyroid hormone and antiresorptive agents to optimize efficacy outcomes. Recent findings: The distinguishing features of the anabolic and antiresorptive therapies for the treatment of osteoporosis has led to the hypothesis that the appropriate use of both agents, either in sequence or in combination, may result in superior fracture protection compared with either anabolic or antiresorptive treatment alone. This enthusiasm has been tempered by the observations that the transition from daily bisphosphonate therapy may blunt the efficacy of teriparatide. By contrast, more recent studies suggest that once-weekly bisphosphonate therapy may provide a better option with parathyroid hormone either in combination or in sequence. These considerations are critical to understanding the benefits of sequential treatment (parathyroid hormone followed by an antiresorptive agent), which aims to maintain or build on the large gains in efficacy from short-term therapy with parathyroid hormone. Because patients may require an additional treatment course of parathyroid hormone in the future, the choice of antiresorptive agent should be carefully considered. In addition, more recent evidence suggests that the forms of parathyroid hormone may have important differences in action that influence combination and sequence outcomes. Summary: Combination and sequential therapy with parathyroid hormone offers new options to maximize efficacy in patients at risk for osteoporotic fracture.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 467-474 |
| Number of pages | 8 |
| Journal | Current Opinion in Rheumatology |
| Volume | 17 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 2005 |
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Keywords
- Anabolic agent
- Antiresorptive agent
- Combination therapy
- Parathyroid hormone
- Sequential therapy
ASJC Scopus subject areas
- Rheumatology
- Immunology
Cite this
New perspectives on parathyroid hormone therapy. / Lane, Nancy E; Morris, Stephen.
In: Current Opinion in Rheumatology, Vol. 17, No. 4, 07.2005, p. 467-474.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - New perspectives on parathyroid hormone therapy
AU - Lane, Nancy E
AU - Morris, Stephen
PY - 2005/7
Y1 - 2005/7
N2 - Purpose of review: The prevention and treatment of osteoporosis has traditionally involved the use of antiresorptive therapies. The introduction of parathyroid hormone, an anabolic agent that enhances bone formation, has been accompanied by new treatment strategies. This article reviews combination and sequential therapy approaches with parathyroid hormone and antiresorptive agents to optimize efficacy outcomes. Recent findings: The distinguishing features of the anabolic and antiresorptive therapies for the treatment of osteoporosis has led to the hypothesis that the appropriate use of both agents, either in sequence or in combination, may result in superior fracture protection compared with either anabolic or antiresorptive treatment alone. This enthusiasm has been tempered by the observations that the transition from daily bisphosphonate therapy may blunt the efficacy of teriparatide. By contrast, more recent studies suggest that once-weekly bisphosphonate therapy may provide a better option with parathyroid hormone either in combination or in sequence. These considerations are critical to understanding the benefits of sequential treatment (parathyroid hormone followed by an antiresorptive agent), which aims to maintain or build on the large gains in efficacy from short-term therapy with parathyroid hormone. Because patients may require an additional treatment course of parathyroid hormone in the future, the choice of antiresorptive agent should be carefully considered. In addition, more recent evidence suggests that the forms of parathyroid hormone may have important differences in action that influence combination and sequence outcomes. Summary: Combination and sequential therapy with parathyroid hormone offers new options to maximize efficacy in patients at risk for osteoporotic fracture.
AB - Purpose of review: The prevention and treatment of osteoporosis has traditionally involved the use of antiresorptive therapies. The introduction of parathyroid hormone, an anabolic agent that enhances bone formation, has been accompanied by new treatment strategies. This article reviews combination and sequential therapy approaches with parathyroid hormone and antiresorptive agents to optimize efficacy outcomes. Recent findings: The distinguishing features of the anabolic and antiresorptive therapies for the treatment of osteoporosis has led to the hypothesis that the appropriate use of both agents, either in sequence or in combination, may result in superior fracture protection compared with either anabolic or antiresorptive treatment alone. This enthusiasm has been tempered by the observations that the transition from daily bisphosphonate therapy may blunt the efficacy of teriparatide. By contrast, more recent studies suggest that once-weekly bisphosphonate therapy may provide a better option with parathyroid hormone either in combination or in sequence. These considerations are critical to understanding the benefits of sequential treatment (parathyroid hormone followed by an antiresorptive agent), which aims to maintain or build on the large gains in efficacy from short-term therapy with parathyroid hormone. Because patients may require an additional treatment course of parathyroid hormone in the future, the choice of antiresorptive agent should be carefully considered. In addition, more recent evidence suggests that the forms of parathyroid hormone may have important differences in action that influence combination and sequence outcomes. Summary: Combination and sequential therapy with parathyroid hormone offers new options to maximize efficacy in patients at risk for osteoporotic fracture.
KW - Anabolic agent
KW - Antiresorptive agent
KW - Combination therapy
KW - Parathyroid hormone
KW - Sequential therapy
UR - http://www.scopus.com/inward/record.url?scp=23044507489&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23044507489&partnerID=8YFLogxK
U2 - 10.1097/01.bor.0000166383.73153.cf
DO - 10.1097/01.bor.0000166383.73153.cf
M3 - Article
C2 - 15956845
AN - SCOPUS:23044507489
VL - 17
SP - 467
EP - 474
JO - Current Opinion in Rheumatology
JF - Current Opinion in Rheumatology
SN - 1040-8711
IS - 4
ER -