Benefits of sequential treatment of high risk osteoporosis with teripartide and denosumab: our experience.

Abstract

High risk osteoporosis treatment is a challenge in daily medical practice. We report three patients that attended our institution with severe osteoporosis that were given sequentially teriparatide 20 μg daily for eighteen months followed by twelve months of denosumab, as 60mg every six months. After teriparatide treatment lumbar spine bone mineral density increased 5.86%±1.01% and 1.92%±3.10% in femoral neck, while after denosumab treatment lumbar spine bone mineral density continued increasing reaching a total of 10.45%±1.70% and 9.28%±3.86 in femoral neck. teriparatide treatment increased bone resorption with high serum CTX while after denosumab it fell abruptly, showing the impact of these two drugs in bone turnover. We conclude that sequential treatment with teriparatide and denosumab in approved doses was beneficial for these three patients. More prospective studies are needed.