12-Month Teriparatide Treatment Reduces New Vertebral Compression Fractures Incidence And Back Pain And Improves Quality Of Life After Percutaneous Kyphoplasty In Osteoporotic Women
Received 25 July 2019
Accepted for publication 15 September 2019
Published 1 October 2019 Volume 2019:14 Pages 1693—1703
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Zhi-Ying Wu
Meng Kong, 1, 2 Chuanli Zhou, 1 Kai Zhu, 1 Yiran Zhang, 1 Mengxiong Song, 1 Hao Zhang, 1 Qihao Tu, 1 Xuexiao Ma 1, 2
1Department of Spinal Surgery, Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province 266000, China; 2Department of Medicine, Qingdao University, Qing’dao, Shandong Province 266000, China
Correspondence: Xuexiao Ma
Department of Spinal Surgery, Affiliated Hospital of Qingdao University, No. 59, Hai Er Road, Qing’dao, Shandong Province 266000, People’s Republic of China
Tel +86 532 18661807895
Purpose: Define the effectiveness of teriparatide (TPTD) treatment on reducing the incidence of new vertebral compression fractures (NVCFs) and back pain and improving quality of life after percutaneous kyphoplasty (PKP).
Methods: Two years of clinical follow-up data from primary osteoporotic women who had experienced initial osteoporotic vertebral compression fractures (OVCFs) and received PKP plus 12-month TPTD (n=113) or basic treatment (BT) of calcium and vitamin D supplements (n=208) were retrospectively collected. The risk of NVCFs over each 6-month period in the TPTD group was evaluated and compared with the BT group using a logistic regression. Health-related quality of life (HRQoL, EQ-5D questionnaire), back pain [100 mm visual analog scale (VAS)] and bone mineral density (BMD) of the spine were analyzed using linear mixed models for repeated measures (LMMRM).
Results: Logistic regression analysis adjusting for baseline characteristics showed that patients in the TPTD group had a lower risk of NVCFs compared with those receiving BT during the final three observation intervals (6– 12 months, OR=0.189, 95% CI=0.030– 0.681, p=0.046; 12– 18 months, OR=0.009, 95% CI=0.0001– 0.111, p=0.001; 18– 24 months, OR=0.024, 95% CI=0.0009– 0.264, p=0.009, respectively). Significant improvements in adjusted EQ-5D and back pain VAS scores were identified in the TPTD group compared with the BT group, and this improvement was sustained for at least 12 months after teriparatide treatment was discontinued (both p< 0.001). The BMD of the spine also showed a higher T-value in the TPTD group compared with the BT group (p< 0.001).
Conclusion: In routine clinical practice, for patients with OVCFs who receive the PKP procedure, TPTD treatment may be a preferable subsequent therapy because of its ability to reduce the incidence of NVCFs and sustain a high quality of life and back pain alleviation.
Keywords: teriparatide, osteoporosis vertebral fractures, quality of life, back pain, PKP
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