Comparison of the effect of teriparatide and risedronate on bone loss in postmenopausal women with multiple sclerosis treated with low-dose glucocorticoids
Abstract
The aim of the study was to compare changes in bone mineral density (BMD) and bone turnover markers (BTM) in postmenopausal women with multiple sclerosis (MS) treated with teriparatide (TPTD) or risedronate. The study involved 71 MS women treated with low-dose glucocorticoids (GC).
Motor function was evaluated using the Kurtzke Expanded Disability Status Scale (EDSS). At 12 months, the BMD of the lumbar spine significantly increased from baseline in both treatment groups (p < 0.001) without significant differences between them (+7.4 +- 8 % and +2.8 +- 2.9 % for TPTD and risedronate, respectively, p = 0.09).
There were no significant changes from baseline in total hip or femoral neck BMD in either treatment group. At 6 months, PINP and CTX levels decreased in the risedronate group (p < 0.001) and increased in the TPTD group (p < 0.001).
Our results confirmed a significant inverse relationship between baseline EDSS and baseline total hip or femoral neck BMD. Conclusion: In postmenopausal women with MS treated with low-dose GC, TPTD as well as risedronate treatment resulted in a significant increase in BMD at the lumbar spine, but not at the hip.
Limited walking ability in MS contributes to loss of BMD at the hip. Further studies should evaluate whether combined or sequential treatment with TPTD and risedronate is effective in preventing bone loss at the hip