Combination Osteoporosis Rx Further Improves Bone Density

Combination Osteoporosis Rx Further Improves Bone Density

Teriparatide and denosumab administered together more effective than either therapy alone

WEDNESDAY, May 15 (HealthDay News) -- Combination therapy with teriparatide and denosumab may be most effective in treating postmenopausal women with osteoporosis at risk for fracture, according to a study published online May 15 in The Lancet.

Joy N. Tsai, M.D., from Massachusetts General Hospital in Boston, and colleagues conducted a randomized, controlled trial in which postmenopausal women with osteoporosis were assigned (1:1:1) to receive 20 µg teriparatide daily, 60 mg denosumab every six months, or both. Bone-mineral density (BMD) was measured at zero, three, six, and 12 months.

The researchers found that based on the 94 women (out of 100) who completed at least one study visit following baseline, posterior anterior lumbar spine BMD increased more in the combination group (9.1 percent) at 12 months than in the teriparatide (6.2 percent; P = 0.0139) or denosumab (5.5 percent; P = 0.0005) groups. There was also a larger increase in femoral-neck BMD in the combination group (4.2 percent) than in the teriparatide (0.8 percent; P = 0.0007) and denosumab (2.1 percent; P = 0.0238) groups, as well as in total-hip BMD (combination: 4.9 percent; teriparatide, 0.7 percent [P < 0.0001]; denosumab: 2.5 percent [P = 0.0011]).

"Combined teriparatide and denosumab increased BMD more than either agent alone and more than has been reported with approved therapies," the authors write. "Combination treatment might, therefore, be useful to treat patients at high risk of fracture."

The study was funded in part by Amgen and Eli Lilly; several authors disclosed financial ties to both companies.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60856-9/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60856-9/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60984-8/fulltext )