The Poor Osteoblastic Functions Can Correct by Teriparatide
Narong Bunyaratavej MD*
Affiliation : * Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
A study of stimulation of poor osteoblastic function by teriparatide and monitored by bone markers. Eighty-one cases were enrolled with poor osteoblastic functions, which were classified with the values of both markers: NMID Osteocalcin was less than 10.81 ng/ml and the PINP was less than 15.88 ng/ml. Most CTx were below 0.1 ng/ml or at any level. Every case took oral bisphosphanates for at least 2 years. Average age was 68 years old; 79 cases are female the others male .The base line of bone markers: NMID osteocalcin, PINP and CTx are 9.3, 14.3 and 0.08 ng/ml, respectively. The duration of Teriparatide injections was 6 months, dose 20 microgram subcutaneous per day. The blood calcium, uric acid and renal profile were monitored too. The results of 98 percent of cases showed that dramatic increase of osteoblastic products and at the second month; all markers increased above the normal values that are indicators of osteoblastic resumes and their activities. The hypercalcemia can occur during treatment (22.2%) and hyperuricemia 12.34%; therefore, blood chemistry and bone markers should be monitored every month as a precaution.
Keywords : Teriparatide, Parathyroid hormone, Osteoblastic function, Treatment of poor function of osteoblast
