Effect of switching administration of alendronate after teriparatide for the prevention of BMD loss around the implant after total hip arthroplasty, 2-year follow-up: a randomized controlled trial.

Morita A, Kobayashi N, Choe H, Ike H, Tezuka T, Higashihira S, Inaba Y

Journal of orthopaedic surgery and research16 Jan 2020Cited by 16 (Europe PMC)

PMID31948455PMCIDPMC6966791DOI10.1186/s13018-020-1547-5PepBankPUB-31948455

Summary

BackgroundStress shielding after total hip arthroplasty (THA) can induce bone mineral density (BMD) loss around the femoral implant. Several studies using drug have described methods to prevent BMD loss around implants following THA. Switching from teriparatide to alendronate was reported to increase lumbar BMD; on the other hands, it is unclear whether switching from teriparatide to alendronate is effective around the implant. The aim of this study is that changes in BMD is compared in patients switched from teriparatide to alendronate, in patients treated with alendronate alone, and in control patients without medication after total hip arthroplasty.Patients and methodsPatients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA. Baseline periprosthetic BMD was measured by dual-energy X-ray absorptiometry (DEXA) 1 week after THA, followed by subsequent measurements at 1 and 2 years postoperatively. Lumbar BMD was also evaluated at preoperatively, 1 and 2 years postoperatively.ResultsTwo years after surgery, BMD (%) at zone 1 was significantly higher in the switch group than in the control group (P = 0.02). BMD (%) at zone 7 was significantly higher in the switch and ALD groups than in the control group (P = 0.01, P = 0.03). Lumbar BMD (%) anterior-posterior (AP) side was significantly higher in the switch group than in the ALD and control groups 2 years after surgery. On the other hand, lumbar BMD (%) lateral side was significantly higher in the switch and ALD groups than control group 2 years after surgery.ConclusionsSwitching therapy had a significant effect on BMD of the lumbar spine and zones 1 and 7 at 2 years postoperatively. At zone 1 in particular, it was found to be more effective than ALD alone.Trial registrationUMIN, registry number UMIN000016158. Registered 8 January 2015.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study5

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone5

In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Teriparatide (PTH 1-34).

01HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
After hip arthroplasty, sequential teriparatide and alendronate produced higher zone 1 BMD than untreated control at two years.
In plain wordsAfter hip replacement, sequential teriparatide and alendronate produced higher zone 1 bone density than untreated control.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseZone 1 periprosthetic BMD
Study
n: not reported in source
Comparator
Untreated control
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
Two years after surgery, BMD (%) at zone 1 was significantly higher in the switch group than in the control group (P = 0.02).
1 context sentence(design, population, supporting numbers)
Summary · context
Patients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3194845501
02HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
After hip arthroplasty, sequential teriparatide and alendronate produced higher zone 7 BMD than untreated control.
In plain wordsAfter hip replacement, sequential teriparatide and alendronate produced higher zone 7 bone density than untreated control.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseZone 7 periprosthetic BMD
Study
n: not reported in source
Comparator
Untreated control
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
BMD (%) at zone 7 was significantly higher in the switch and ALD groups than in the control group (P = 0.01, P = 0.03).
1 context sentence(design, population, supporting numbers)
Summary · context
Patients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3194845502
03HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
After hip arthroplasty, sequential teriparatide and alendronate produced higher anterior-posterior lumbar BMD than alendronate alone at two years.
In plain wordsAfter hip replacement, sequential teriparatide and alendronate produced higher front-view lumbar bone density than alendronate alone.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseAnterior-posterior lumbar BMD
Study
n: not reported in source
Comparator
Alendronate alone
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
Lumbar BMD (%) anterior-posterior (AP) side was significantly higher in the switch group than in the ALD and control groups 2 years after surgery.
1 context sentence(design, population, supporting numbers)
Summary · context
Patients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3194845503
04HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
After hip arthroplasty, sequential teriparatide and alendronate produced higher anterior-posterior lumbar BMD than untreated control at two years.
In plain wordsAfter hip replacement, sequential teriparatide and alendronate produced higher front-view lumbar bone density than untreated control.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseAnterior-posterior lumbar BMD
Study
n: not reported in source
Comparator
Untreated control
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
Lumbar BMD (%) anterior-posterior (AP) side was significantly higher in the switch group than in the ALD and control groups 2 years after surgery.
1 context sentence(design, population, supporting numbers)
Summary · context
Patients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3194845504
05HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
After hip arthroplasty, sequential teriparatide and alendronate produced higher lateral lumbar BMD than untreated control at two years.
In plain wordsAfter hip replacement, sequential teriparatide and alendronate produced higher side-view lumbar bone density than untreated control.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseLateral lumbar BMD
Study
n: not reported in source
Comparator
Untreated control
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
On the other hand, lumbar BMD (%) lateral side was significantly higher in the switch and ALD groups than control group 2 years after surgery.
1 context sentence(design, population, supporting numbers)
Summary · context
Patients were randomized into three groups, those switched to alendronate after teriparatide (switch: n = 17), those receiving continuous alendronate (ALD: n = 15), and control untreated patients (control: n = 16) and followed up for 2 years after THA.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3194845505

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22 Oct 2026, 02:26 UTC
Study results updated
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21 Oct 2026, 18:59 UTC
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