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Osteologie 2012; 21(01): 29-32
DOI: 10.1055/s-0037-1621663
Der interessante Fall
Schattauer GmbH

Teriparatid-Gabe zur medikamentösen Behandlung von Pseudarthrosen: Vorstellung von drei Fällen

K. M. Peters
1   Orthopädie und Osteologie, Dr. Becker Rhein-Sieg-Klinik, Nümbrecht
,
D. Bungart
1   Orthopädie und Osteologie, Dr. Becker Rhein-Sieg-Klinik, Nümbrecht
› Author Affiliations
Further Information

Publication History

eingereicht: 06 October 2011

angenommen: 25 October 2011

Publication Date:
04 January 2018 (online)

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Zusammenfassung

Teriparatid ist ein Medikament zur Behandlung der Osteoporose, welches identisch ist mit der Sequenz der 34 N-terminalen Aminosäuren des endogenen humanen Parathormons. Die tägliche subkutane Gabe induziert die Formierung neuen Knochens durch direkte Wirkung auf die Osteoblasten.

Im Rahmen eines „Compassionate Use” wurden drei Patienten mit Pseud-arthrosenbildung über mehrere Monate einmal täglich subkutan mit Teriparatid (Forsteo®) behandelt. Hierdurch konnte die Knochenstruktur verbessert und die Pseud-arthrosen zur Abheilung gebracht werden. Somit kann der osteoanabole Effekt dieses Medikaments nicht nur in der Osteoporosebehandlung genutzt werden, sondern auch zur Therapie von Pseudarthrosen.

 

  • Literatur

  • 1 Andreassen TT, Ejersted C, Oxlund H. Intermittent parathyriod hormone (1–34) increases callus formation and mechanical strength of healing rat fractures. J Bone Mineral Res 1999; 14: 960-968.
    CrossrefPubMedGoogle Scholar
  • 2 Aspenberg P, Genant HK, Johansson T. et al. Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radius fractures. J Bone Miner Res 2010; 25 (02) 404-414.
    CrossrefPubMedGoogle Scholar
  • 3 Bukata SV, Puzas JE. Orthopedic uses of teriparatide. Curr Osteoporos Res 2010; 8: 28-33.
    Google Scholar
  • 4 Canalis E, Mazziotti G, Giustina A, Bilezikian JP. Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos Int 2007; 18: 1319-1328.
    CrossrefPubMedGoogle Scholar
  • 5 Compston JE. Review. Skeletal actions of intermittant parathyroid hormone. Effects on bone remodelling and structure. Bone 2007; 40: 1447-1452.
    CrossrefPubMedGoogle Scholar
  • 6 Fox J. Developments in parathyroid hormone and related peptides as bone-formation agents. Current Opinion in Pharmacology 2002; 2: 338-344.
    CrossrefPubMedGoogle Scholar
  • 7 Graeff C, Chevalier Y, Charlebois M. et al. Improvements in vertebral body strength under teriparatide treatment assessed in vivo by finite element analysis: results from the EUROFORS study. J Bone Mineral Res 2009; 24: 1672-1680.
    CrossrefPubMedGoogle Scholar
  • 8 Graeff C, Timm W, Nickelsen TN. et al. Monitoring teriparatide-associated changes in vertebral microstructure by high-resolution CT in vivo: results from the EUROFORS study. J Bone Mineral Res 2007; 22: 1426-1433.
    CrossrefPubMedGoogle Scholar
  • 9 Jilka RL. Review. Molecular and cellular mechanisms of the anabolic effect of intermittent PTH. Bone 2007; 40: 1434-1446.
    CrossrefPubMedGoogle Scholar
  • 10 Keaveny T, Donley DW, Hoffmann PF. et al. Effects of Teriparatide and Alendronate on vertebral strength as assessed by Finite Element Modeling of QCT Scans in women with osteoporosis. J Bone Mineral Res 2007; 21: 149-157.
    Google Scholar
  • 11 Knabe A. Veränderung der Knochendichte bei postmenopausalen Frauen nach Umstellung auf Teriparatid (hTPH[1–34]) bei Versagen einer Bisphosphonat-Therapie. Doktorarbeit 2009 Gießen.
    Google Scholar
  • 12 Lane NE, Sanchez S, Modin GW. et al. Parathyroid hormone treatment can reverse corticosteroid-induced osteoporosis. Results from a randomized controlled clinical trial. J Clin Invest 1998; 102: 1627-1633.
    CrossrefPubMedGoogle Scholar
  • 13 Lindsay R, Nieves J, Formica C. et al. Randomized contolled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis. Lancet 1997; 350: 500-555.
    Google Scholar
  • 14 Manabe T, Mori S, Mashiba T. et al. Human parathyoid hormone (1–34) accelerates natural fracture healing process in the femoral osteotomy model of cynomolgus monkeys. Bone 2007; 40: 1475-1482.
    CrossrefPubMedGoogle Scholar
  • 15 McClung M, San Martin J, Miller PD. et al. Opposite bone remodelling effects of Teriparatide and Alendronate in increasing bone mass. JAMA 2005; 294: 1762-1767.
    CrossrefGoogle Scholar
  • 16 Neer RM, Arnaud CD, Zanchetta JR. 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: 1434-1441.
    CrossrefPubMedGoogle Scholar
  • 17 Obermayer-Pietsch B, Marin F, McCloskey EV. et al. Effects of two years of daily teriparatide treatment on BMD in postmenopausal women with severe osteoporosis with and without prior antiresorptive treatment. JBMR 2008; 23: 1591-1600.
    CrossrefPubMedGoogle Scholar
  • 18 O´Loughlin PF, Cunningham ME, Bukata SV. et al. Parathyroid hormone (1–34) augments spinal fusion, fusion mass volume, and fusion mass quality in a rabbit spinal fusion model. Spine 2009; 34: 121-130.
    CrossrefPubMedGoogle Scholar
  • 19 Rehman Q, Lang TF, Arnaud CD. et al. Daily treatment with parathyroid hormone is associated with an increase in vertebral cross-section area in postmenopausal women with glucocorticoid-induced osteoporosis. Osteoporos Int 2003; 14: 77-81.
    CrossrefPubMedGoogle Scholar