Authors: Kathryn M Ryder S Bobo Tanner Laura Carbone John E Williams Henry M Taylor Andrew Bush Victorina Pintea Mitchell A Watsky
Publish Date: 2009/10/06
Volume: 28, Issue: 2, Pages: 233-239
Abstract
Institutionalized adults with severe developmental disabilities have a high rate of minimal trauma and appendicular fracture There is little information about osteoporosis treatment in this population In this efficacy and safety study men and women with severe developmental disabilities and osteoporosis received 20 mcg teriparatide subcutaneously daily for 18–24 months Markers of bone formation procollagen type 1 intact Nterminal propeptide P1NP and resorption Ctelopeptide CTx were measured at threemonth intervals Serum calcium was measured at twoweek intervals for 12 weeks and thereafter at threemonth intervals Twentyseven individuals received at least one injection The incidence of hypercalcemia was 111 but was persistent and led to medication discontinuation in only one participant Biomarkers of bone formation increased rapidly doubling by three months At 12 months P1NP and CTx remained elevated from baseline P1NP had risen from 6695 ± 8371 μg/l mean ± SD to 14242 ± 11385 μg/l P = 005 and CTx had increased from 0377 ± 0253 to 1016 ± 1048 ng/ml P = 001 The majority of participants had an increase in P1NP of over 10 μg/l In conclusion teriparatide is safe and effective in developmentally disabled institutionalized adults Serial calcium measurements are warranted particularly during the first three months of therapy
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