When treating osteoporosis, does your duration of maintenance bisphosphonate therapy post anabolic therapy with PTH analogue change based on C-telopeptide levels?
How would you approach next treatment step in a patient with osteoporosis treated with Forteo x 18 months then switched to oral bisphosphonate x 3 months, and found to have low C-telopeptide levels?
1 Answer
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Endocrinology · Stanford Health Care
Answered on · Updated on
I have treated many patients with teriparatide and conducted non-clinical studies on PTH/PTHrP receptors. Despite the fact that there are no PTH/PTHrP receptors on osteoclasts, when PTH stimulates osteoblast activity, the normal coupling via osteoprotegerin is intact, and about 4 weeks after one detects an increase in BSAP or P1NP, indicating enhanced osteoblastic bone formation, one typically can detect an increase in urine NTx or serum CTx, demonstrating an increase in osteoclastic bone resorp...
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