2022, Vol. 26 ›› Issue (35): 5685-5692

Effect of teriparatide combined with risedronate sodium on bone metabolism in patients with osteoporotic vertebral compression fractures

Zhai Xiao1, Yang Xinming2, Liu Fanghong3, Sun Jianwei3   

Abstract: BACKGROUND: Osteoporotic vertebral compression fracture can lead to an increase in the rate of recurrence of adjacent vertebrae fractures after vertebroplasty. Osteoporosis is an independent risk factor leading to recurrence of fractures, so it is a clinical hot issue to select anti-osteoporotic drugs with better curative effects for postoperative treatment.
OBJECTIVE: To explore the effect of teriparatide combined with risedronate sodium after vertebroplasty in patients with osteoporotic vertebral compression fractures.
METHODS: 151 patients with osteoporotic vertebral compression fractures, aged 50-75 years, were enrolled from the Handan Branch, Fengfeng General Hospital of North China Healthcare Group from September 2018 to October 2020. All the patients were randomly divided into four groups according to the random number table method, namely control group (n=28; oral calcium), risedronate sodium group (n=41; oral calcium+oral risedronate sodium), teriparatide group (n=41; oral calcium+subcutaneous injection of teriparatide) and combination therapy group (n=41; oral calcium+oral risedronate sodium+subcutaneous injection of teriparatide). After 6 months of treatment, visual analog scale score, Oswestry dysfunction index, bone mineral density, and serum bone metabolism indexes were evaluated. Adverse reactions and incidence of refractures were recorded.
RESULTS AND CONCLUSION: Compared with baseline data, the visual analog scale score, Oswestry dysfunction index, serum bone metabolism level, and bone mineral density were significantly improved in the four groups after treatment (P < 0.05). After 6 months of treatment, the combination therapy group achieved the best therapeutic effects and had lower visual analog scale score and Oswestry dysfunction index, higher bone mineral density, and lower β-degradation product level at the carboxyl end of type I collagen than the other three groups (all P < 0.05). The combination therapy showed significantly better therapeutic effects than the other three groups at different age stages. There was no significant difference in the therapeutic effect between men and women under the same medication method. There was also no significant difference among the four groups within the same fracture time. Both teriparatide and risedronate sodium only caused mild or moderate symptoms, such as vomiting, palpitations, headache or dizziness, in a small number of patients, and 151 patients showed no obvious abnormality in liver and kidney functions. Incidence of refractures was 7.14% in the control group, 7.32% in the risedronate sodium group, 7.32% in the teriparatide group, and 4.88% in the combination therapy group, and there was no significant difference between the four groups (P > 0.05). For patients with osteoporotic vertebral compression fractures, therefore, the combined use of teriparatide and risedronate sodium is highly safe that can effectively improve patients’ quality of life and bone metabolism, reduce pain, and improve bone mineral density.
Key words: teriparatide, risedronate sodium, osteoporotic vertebral compression bone, vertebroplasty, osteoporosis, bone mineral density