Pregnancy- and lactation-associated osteoporosis (PLO) is a rare
disease, presenting in most cases with severe back pain due to low
energy vertebral fractures (VFs). Our purpose was to assess the effect
of teriparatide (TPTD) vs. conventional management on areal bone mineral
density (aBMD) and trabecular bone score (TBS) in patients with PLO. A
multicenter retrospective cohort study concerning premenopausal women
with PLO. Nineteen women were treated with TPTD (20 mu g/day) (group A)
plus calcium and vitamin D and eight women with calcium and vitamin D
only (group B) for up to 24 months. The primary end-point was between
group differences in lumbar spine (LS) and total hip (TH) aBMD, and TBS
at 12 and 24 months. Patients in group A had sustained a median of 4.0
VFs (3-9) vs. 2.5 VFs (1-10) in group B (p = 0.02). At 12 months,
patients on TPTD vs. controls achieved a mean aBMD increase of 20.9 +/-
11.9% vs. 6.2 +/- 4.8% at the LS (p < 0.001), 10.0 +/- 11.6% vs. 5.8
+/- 2.8% at the TH (p = 0.43), and 6.7 +/- 6.9% vs. 0.9 +/- 3.7% in
TBS (p = 0.09), respectively. At 24 months, seven patients on TPTD and
six controls achieved a mean LS aBMD increase of 32.9 +/- 13.4% vs.
12.2 +/- 4.2% (p = 0.001). P1NP levels during the first month of TPTD
treatment were positively correlated with the 1-year LS aBMD change (r =
0.68, p = 0.03). No new clinical fractures occurred while on-treatment.
In patients with PLO, TPTD treatment resulted in significantly greater
increases in LS aBMD compared with calcium and vitamin D supplementation
at 12 and 24 months