CLINICAL IMPROVEMENT AFTER 18 MONTH OF THERAPY WITH TERIPARATIDE IN PATIENTS AFFECTED BY OSTEOPOROTIC VERTEBRAL FRACTURE: OUR EXPERIENCE IN THIRTY WOMEN TREATED

Introduction: Vertebral fractures are the most common osteoporotic fracture and may result in back pain with functional limitations and diminished quality of life. Teriparatide [rhPTH (1–34)] has been shown to increase bone mass and reduce the risk
of vertebral and other osteoporotic fractures.
Materials and Methods: From January 2006 to January 2008 thirty women (mean age 72.3) with osteoporotic compression vertebral fractures (VCF) have been treated with a daily subcutaneous administration of teriparatide (20 μg/day) and supplementation with calcium and vitamin D. All patients underwent a preliminary
clinical (VAS, Oswestry Disability Index) and instrumental evaluation (Plain X-ray with vertebral morphometry and DXA).
Inclusion criteria were: persistent back pain non responsive to drugs, postmenopausal osteoporosis, a minimum of one year
previous antiresorptive therapy. Results: The mean pre-treatment VAS and ODI scores were 8.3 and 78% respectively. In all patients plain X-rays have shown at least one severe vertebral fracture (>40%) with a mean (Bone Mineral Density) T-score of -3.8 at lumbar spine. Clinical and instrumental evaluation was performed at 6, 12 and 18 months. The mean VAS score was 4.2, 4 and 4.4 respectively as well as the ODI score with 55, 50 and 50%. No statistically significative T-score improvement was observed in any patients at every step of follow up.Conclusion: Chronic back pain associated with vertebral fracture provides a great challenge to physicians and patients. A daily
administration of teriparatide is a valid a reliable treatment of severe osteoporosis with VCF. Despite a dramatic improvement in VAS and ODI score no significative BMD modification was observed during follow up.