Teriparatide [parathyroid hormone (1-34)] and dentistry

Yıl 2015, Cilt: 32 Sayı: 3, 165 - 70, 15.07.2015

Aydın Keskinrüzgar , Saim Yanık , Mutan Aras , Sedat Çetiner

https://doi.org/10.17214/aot.74775

Cited By: 1

Öz

Teriparatide is a new synthetic parathyroid hormone recently used with a purpose to improve the thickness and the quality of bone. Parathyroid hormone regulates the metabolism of calcium and phosphate and is responsible for bone formation. Teriparatide is a new antiosteoporosis drug and is known to prevent bone resorption in cases where mineral density is low or the quality of bone is inferior. Unlike other antiresorptive agents it possesses an anabolic effect on bone. In its mechanism of action, when bone resorption starts with osteoclast stimulation, osteoblasts are stimulated at the same time, resulting in the aforementioned anabolic effect. This effect has tempted researches to use this agent in cases of biphosphonate related osteonecrosis and periodontal bone defects. Research reveals no serious clinical side effects associated with this agent; however, a risk of osteosarcoma due to its anabolic effect on bone should be considered. Yet, no case of osteosarcoma related to the teriparatide use has been reported so far. In the literature, there exists only few case reports that has used teriparatide. Prospective randomized studies are needed to evaluate the long-term effectiveness of this drug.

Anahtar Kelimeler

Bisphosphonate-associated osteonecrosis of the jaw, osteoporosis, parathyroid hormone, teriparatide

Teriparatid [paratiroid hormon (1-34)] ve diş hekimliği

Öz

Teriparatid kemik kalitesini ve kemik yoğunluğunu arttırmak amacıyla paratiroid hormunundan elde edilen yeni bir ajandır. Paratiroid hormon, kalsiyum ve fosfat metabolizmasını düzenleyererek kemik yapımından sorumlu tutulmaktadır. Teriparatidin osteoporoz hastalarında antirezorptif ajanlara alternatif bir tedavi olması güncel bir konudur. Kemik mineral dansitesinin düşük veya kemik kitlesinin kalitesiz olduğu durumlarda kemik yıkımını engelleyen bu ajanın diğer antirezorptif ajanlardan farklı olarak kemik üzerindeki anabolik etkisi belirtilmiştir. Teriparatidin mekanizmasında, osteoklastlar uyarılarak kemik yıkımının başlatıldığı, diğer bir taraftan ise osteoblastların uyarıldığı belirtilmiştir. Teriparatidin bu özelliği bazı araştırmacıları bu ajanı osteoporoz dışındaki bifosfonat ile ilişkili osteonekroz vakalarında ve periodontal kemik defektlerinde kullanmaya yöneltmiştir. Yapılan araştırmalarda teriparatidin klinik olarak ciddi bir yan etkisinin rapor edilmemesine rağmen kemik üzerindeki anabolik etkisinden dolayı osteosarkom riski vurgulanmıştır. Buna karşın, yapılan klinik araştırmalarda böyle bir durum bildirilmemiştir. Literatürde, yeni bir ajan olan teriparatid ile ilgili az sayıda vaka mevcuttur. Bu ilacın uzun dönem etkilerini belirleyebilmek için bu konuda daha çok prospektif randomize çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Çenenin bifosfonat ilişkili osteonekrozu, osteoporoz, paratiroid hormonu, teriparatid

Kaynakça

• Forteo® (teriparatid injection) package insert. Indianapolis, IN: Eli Lilly and Company; November 2002.
• Cosman F. Parathyroid hormone treatment for osteoporosis. Curr Opin Endocrinol Diabetes Obes 2008;15:495-501.
• Honeywell M, Phillips S, Branch III E, Vo KA, Marks EI, Thompson M. Teriparatid for osteoporosis: a clinical review. P&T 2003;28:713-6.
• Magno AL, Ward BK, Ratajczak T. The calcium-sensing receptor: a molecular perspective. Endocr Rev 2011;32:3-30.
• Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol 2010;1:S23-30.
• Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001;344:1434-41.
• Inderjeeth CA, Chan K, Glendenning P. Teriparatid: its use in the tre- atment of osteoporosis. Clin Med Insights Ther 2011;3:67-80.
• Dayisoylu EH, Şenel FÇ, Üngör C, Tosun E, Çankaya M, Ersöz S, et al. The effects of adjunctive parathyroid hormone injection on bisp- hosphonate-related osteonecrosis of the jaws: an animal study. Int J Oral Maxillofac Surg 2013;42:1475-80.
• Türkiye Endokrinoloji ve Metabolizma Hastalıkları Derneği, Osteo- poroz ve Diğer Metabolik Kemik Hastalıkları Çalışma Grubu. Metabo- lik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. 1. Baskı. İstanbul: Özgün Ofset Tic. Ltd. Şti; 2012.
• Body JJ, Gaich GA, Scheele WH, Kulkarni PM, Miller PD, Peretz A, et al. A randomized, double-blind trial to compare the efficacy of teripa- ratid [recombinant human parathyroid hormone (1-34)] with alendronate in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 2002;87:4528-35.
• Horwitz MJ, Tedesco MB, Gundberg C, Garcia-Ocana A, Stewart AF. Short-term, high-dose parathyroid hormone–related protein as a skeletal anabolic agent for the treatment of postmenopausal osteopo- rosis. J Clin Endocrinol Metab 2003;88:569-75.
• Kurland ES, Cosman F, McMahon DJ, Rosen CJ, Lindsay R, Bile- zikian JP. Parathyroid hormone as a therapy for idiopathic osteoporosis in men. J Clin Endocrinol Metab 2000;85:3069-76.
• Rittmaster RS, Bolognese M, Ettinger M, Hanley DA, Hodsman AB, Kendler DL, et al. Enhancement of bone mass in osteoporotic women with parathyroid hormone followed by alendronate. J Clin Endocrinol Metab 2000;85:2129-34.
• Finkelstein JS, Klibanski A, Arnold AL, Toth TL, Hornstein MD, Neer RM. Prevention of estrogen deficiency related bone loss with human pa- rathyroid hormone (1-34): a randomized controlled trial. JAMA 1998;280:1067-73.
• Russell RG, Watts NB, Ebetino FH, Rogers MJ. Mechanisms of ac- tion of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int 2008;19:733-59.
• Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61:1115-7.
• Lee JJ, Cheng SJ, Jeng JH, Chiang CP, Lau HP, Kok SH. Suc- cessful treatment of advanced bisphosphonate-related osteonecrosis of the mandible with adjunctive e therapy. Head Neck 2011;33:1366-71. 20. Biasotto M, Chiandussi S, Zacchigna S, Moimas S, Dore F, Pozzato G, et al. A novel animal model to study non-spontaneous bisphospho- nates osteonecrosis of jaw. J Oral Pathol Med 2010;39:390-6.
• Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A re- view of the literature on osteonecrosis of the jaw in patients with osteo- porosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther 2007;29:1548-58.
• Rizzoli R, Burlet N, Cahall D, Delmas PD, Eriksen EF, Felsenberg D, et al. Osteonecrosis of the jaw and bisphosphonate treatment for os- teoporosis. Bone 2008;42:841-7.
• Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Meh- rotra B, et al; American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate related osteonecrosis of the jaws-2009 update. J Oral Maxillofac Surg 2009;67:2-12.
• Farrugia MC, Summerlin DJ, Krowiak E, Huntley T, Freeman S, Bor- rowdale R, et al. Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope 2006;116:115-20.
• Shimura K, Shimazaki C, Taniguchi K, Akamatsu S, Okamoto M, Uchida R, et al. Hyperbaric oxygen in addition to antibiotic therapy is ef- fective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma. Int J Hematol 2006;84:343-5.
• Freiberger JJ, Padilla-Burgos R, Chhoeu AH, Kraft KH, Boneta O, Moon RE, et al. Hyperbaric oxygen treatment and bisphosphonatein- duced osteonecrosis of the jaw: a case series. J Oral Maxillofac Surg 2007;65:1321-7.
• Cheung A, Seeman E. Teriparatid therapy for alendronate-associa- ted osteonecrosis of the jaw. N Engl J Med 2010;363:2473-4.
• Lau AN, Adachi JD. Resolution of osteonecrosis of the jaw after te- riparatid [recombinant human PTH-(1-34)] therapy. J Rheumatol 2009;36:1835-7.
• Harper RP, Fung E. Resolution of bisphosphonate-associated os- teonecrosis of the mandible: possible application for intermittent low- dose parathyroid hormone [rhPTH (1-34)]. J Oral Maxillofac Surg 2007;65:573-80.
• Bashutski JD, Eber RM, Kinney JS, Benavides E, Maitra S, Braun TM, et al. Teriparatid and osseous regeneration in the oral cavity. N Engl J Med 2010;363:2396-405.
• Miyauchi A, Matsumoto T, Shigeta H, Tsujimoto M, Thiebaud D, Na- kamura T. Effect of teriparatide on bone mineral density and biochemi- cal markers in Japanese women with postmenopausal osteoporosis: a 6 month dose response study. J Bone Miner Metab 2008;26:624-34.
• Sethi BK, Chadha M, Modi KD, Kumar KM, Mehrotra R, Sriram U. Efficacy of teriparatid in increasing bone mineral density in postmeno- pausal women with osteoporosis--an Indian experience. J Assoc Physi- cians India 2008;56:418-24.
• Anastasilakis AD, Goulis DG, Polyzos SA, Gerou S, Koukoulis GN, Efstathiadou Z, et al. Head-to-head comparison of risedronate vs. teri- paratid on bone turnover markers in women with postmenopausal os- teoporosis: a randomised trial. Int J Clin Pract 2008;62:919-24.
• Okimoto N, Tsurukami H, Okazaki, Nishida S, Sakai A, Ohnishi H, et al. Effects of a weekly injection of human parathyroid hormone (1-34) and withdrawal on bone mass, strength, and turnover in mature ovari- ectomized rats. Bone 1998;22:523-31.
• Kneissel M, Boyde A, Gasser JA. Bone tissue and its mineralization in aged estrogen-depleted rats after long-term intermittent treatment with parathyroid hormone (PTH) analog SDZ PTS 893 or human PTH (1-34). Bone 2001;28:237-50.
• Pleiner-Duxneuner J, Zwettler E, Paschalis E, Roschger P, Nell-Dux- neuner V, Klaushofer K. Treatment of osteoporosis with parathyroid hor- mone and teriparatide. Calcif Tissue Int 2009;84:159-70.
• Girotra M, Rubin MR, Bilezikian JP. The use of parathyroid hormone in the treatment of osteoporosis. Rev Endocr Metab Disord 2006;7:113- 21.