Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial
Context: Recent studies on the mechanism of action (MOA) of bone-active drugs have rekindled interest in how to present and interpret dynamic histomorphometric parameters of bone remodeling. Objective: We compared the effects of an established anabolic agent, teriparatide (TPTD), with those of a pro...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2012-08, Vol.97 (8), p.2799-2808 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Dempster, David W Zhou, Hua Recker, Robert R Brown, Jacques P Bolognese, Michael A Recknor, Christopher P Kendler, David L Lewiecki, E. Michael Hanley, David A Rao, D. Sudhaker Miller, Paul D Woodson, Grattan C Lindsay, Robert Binkley, Neil Wan, Xiaohai Ruff, Valerie A Janos, Boris Taylor, Kathleen A |
| description | Context:
Recent studies on the mechanism of action (MOA) of bone-active drugs have rekindled interest in how to present and interpret dynamic histomorphometric parameters of bone remodeling.
Objective:
We compared the effects of an established anabolic agent, teriparatide (TPTD), with those of a prototypical antiresorptive agent, zoledronic acid (ZOL).
Design:
This was a 12-month, randomized, double-blind, active-comparator controlled, cross-sectional biopsy study.
Setting:
The study was conducted at 12 U.S. and Canadian centers.
Subjects:
Healthy postmenopausal women with osteoporosis participated in the study.
Interventions:
Subjects received TPTD 20 μg once daily by sc injection (n = 34) or ZOL 5 mg by iv infusion at baseline (n = 35).
Main Outcome Measures:
The primary end point was mineralizing surface/bone surface (MS/BS), a dynamic measure of bone formation, at month 6. A standard panel of dynamic and static histomorphometric indices was also assessed. When specimens with missing labels were encountered, several methods were used to calculate mineral apposition rate (MAR). Serum markers of bone turnover were also measured.
Results:
Among 58 subjects with evaluable biopsies (TPTD = 28; ZOL = 30), MS/BS was significantly higher in the TPTD group (median: 5.60 vs. 0.16%, P < 0.001). Other bone formation indices, including MAR, were also higher in the TPTD group (P < 0.05). TPTD significantly increased procollagen type 1 N-terminal propeptide (PINP) at months 1, 3, 6, and 12 and carboxyterminal cross-linking telopeptide of collagen type 1 (CTX) from months 3 to 12. ZOL significantly decreased PINP and CTX below baseline at all time points.
Conclusions:
TPTD and ZOL possess fundamentally different mechanisms of action with opposite effects on bone formation based on this analysis of both histomorphometric data and serum markers of bone formation and resorption. An important mechanistic difference was a substantially higher MS/BS in the TPTD group. Overall, these results define the dynamic histomorphometric characteristics of anabolic activity relative to antiresorptive activity after treatment with these two drugs. |
| doi_str_mv | 10.1210/jc.2012-1262 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1611621779</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1032736660</sourcerecordid><originalsourceid>FETCH-LOGICAL-c502t-222cea7c257de6b47a9a8b9b43ac89e2638655bcdebfedc86169cf12f5b3ee173</originalsourceid><addsrcrecordid>eNqF0c-L1DAUB_Agijuu3jxLLsIKdk1e22TibRjUERYWnAqyl5Imr2xq29QkPYzg_27HGfUieHqXz_vB-xLynLNrDpy96cw1MA4ZBwEPyIqroswkV_IhWTEGPFMSvlyQJzF2jPGiKPPH5AJAMs64XJEf-6_YY9I93bmY_ODDdO8HTOFA3Uj3c9OhSZH6kVYY3KSDTs4i9YHe-R5t8KMzdGOcpdU9Bj0d6NV-d1vdvaL7NNvDW7qhn_Ro_eC-o6VbP6bg-6WRVsHp_il51Oo-4rNzvSSf37-rtrvs5vbDx-3mJjMlg5QBgEEtDZTSomgKqZVeN6opcm3WCkHka1GWjbHYtGjNWnChTMuhLZsckcv8klyd5k7Bf5sxpnpw0WDf6xH9HGsuOBfApVT_pywHmQsh2EJfn6gJPsaAbT0FN-hwWFB9zKbuTH3Mpj5ms_AX58lzM6D9g3-HsYCXZ6Cj0X0b9Ghc_OsEFEr9OjE_OVwea4IbcQoYY935OYzLG_-9_ieLSaiU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1032736660</pqid></control><display><type>article</type><title>Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>Dempster, David W ; Zhou, Hua ; Recker, Robert R ; Brown, Jacques P ; Bolognese, Michael A ; Recknor, Christopher P ; Kendler, David L ; Lewiecki, E. Michael ; Hanley, David A ; Rao, D. Sudhaker ; Miller, Paul D ; Woodson, Grattan C ; Lindsay, Robert ; Binkley, Neil ; Wan, Xiaohai ; Ruff, Valerie A ; Janos, Boris ; Taylor, Kathleen A</creator><creatorcontrib>Dempster, David W ; Zhou, Hua ; Recker, Robert R ; Brown, Jacques P ; Bolognese, Michael A ; Recknor, Christopher P ; Kendler, David L ; Lewiecki, E. Michael ; Hanley, David A ; Rao, D. Sudhaker ; Miller, Paul D ; Woodson, Grattan C ; Lindsay, Robert ; Binkley, Neil ; Wan, Xiaohai ; Ruff, Valerie A ; Janos, Boris ; Taylor, Kathleen A</creatorcontrib><description>Context:
Recent studies on the mechanism of action (MOA) of bone-active drugs have rekindled interest in how to present and interpret dynamic histomorphometric parameters of bone remodeling.
Objective:
We compared the effects of an established anabolic agent, teriparatide (TPTD), with those of a prototypical antiresorptive agent, zoledronic acid (ZOL).
Design:
This was a 12-month, randomized, double-blind, active-comparator controlled, cross-sectional biopsy study.
Setting:
The study was conducted at 12 U.S. and Canadian centers.
Subjects:
Healthy postmenopausal women with osteoporosis participated in the study.
Interventions:
Subjects received TPTD 20 μg once daily by sc injection (n = 34) or ZOL 5 mg by iv infusion at baseline (n = 35).
Main Outcome Measures:
The primary end point was mineralizing surface/bone surface (MS/BS), a dynamic measure of bone formation, at month 6. A standard panel of dynamic and static histomorphometric indices was also assessed. When specimens with missing labels were encountered, several methods were used to calculate mineral apposition rate (MAR). Serum markers of bone turnover were also measured.
Results:
Among 58 subjects with evaluable biopsies (TPTD = 28; ZOL = 30), MS/BS was significantly higher in the TPTD group (median: 5.60 vs. 0.16%, P < 0.001). Other bone formation indices, including MAR, were also higher in the TPTD group (P < 0.05). TPTD significantly increased procollagen type 1 N-terminal propeptide (PINP) at months 1, 3, 6, and 12 and carboxyterminal cross-linking telopeptide of collagen type 1 (CTX) from months 3 to 12. ZOL significantly decreased PINP and CTX below baseline at all time points.
Conclusions:
TPTD and ZOL possess fundamentally different mechanisms of action with opposite effects on bone formation based on this analysis of both histomorphometric data and serum markers of bone formation and resorption. An important mechanistic difference was a substantially higher MS/BS in the TPTD group. Overall, these results define the dynamic histomorphometric characteristics of anabolic activity relative to antiresorptive activity after treatment with these two drugs.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2012-1262</identifier><identifier>PMID: 22701017</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Bone and Bones - drug effects ; Bone and Bones - pathology ; Bone Density Conservation Agents - pharmacology ; Bone Remodeling ; Cross-Sectional Studies ; Diphosphonates - adverse effects ; Diphosphonates - pharmacology ; Double-Blind Method ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Imidazoles - adverse effects ; Imidazoles - pharmacology ; Medical sciences ; Middle Aged ; Osteogenesis - drug effects ; Teriparatide - adverse effects ; Teriparatide - pharmacology ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>The journal of clinical endocrinology and metabolism, 2012-08, Vol.97 (8), p.2799-2808</ispartof><rights>Copyright © 2012 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-222cea7c257de6b47a9a8b9b43ac89e2638655bcdebfedc86169cf12f5b3ee173</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26249979$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22701017$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dempster, David W</creatorcontrib><creatorcontrib>Zhou, Hua</creatorcontrib><creatorcontrib>Recker, Robert R</creatorcontrib><creatorcontrib>Brown, Jacques P</creatorcontrib><creatorcontrib>Bolognese, Michael A</creatorcontrib><creatorcontrib>Recknor, Christopher P</creatorcontrib><creatorcontrib>Kendler, David L</creatorcontrib><creatorcontrib>Lewiecki, E. Michael</creatorcontrib><creatorcontrib>Hanley, David A</creatorcontrib><creatorcontrib>Rao, D. Sudhaker</creatorcontrib><creatorcontrib>Miller, Paul D</creatorcontrib><creatorcontrib>Woodson, Grattan C</creatorcontrib><creatorcontrib>Lindsay, Robert</creatorcontrib><creatorcontrib>Binkley, Neil</creatorcontrib><creatorcontrib>Wan, Xiaohai</creatorcontrib><creatorcontrib>Ruff, Valerie A</creatorcontrib><creatorcontrib>Janos, Boris</creatorcontrib><creatorcontrib>Taylor, Kathleen A</creatorcontrib><title>Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Context:
Recent studies on the mechanism of action (MOA) of bone-active drugs have rekindled interest in how to present and interpret dynamic histomorphometric parameters of bone remodeling.
Objective:
We compared the effects of an established anabolic agent, teriparatide (TPTD), with those of a prototypical antiresorptive agent, zoledronic acid (ZOL).
Design:
This was a 12-month, randomized, double-blind, active-comparator controlled, cross-sectional biopsy study.
Setting:
The study was conducted at 12 U.S. and Canadian centers.
Subjects:
Healthy postmenopausal women with osteoporosis participated in the study.
Interventions:
Subjects received TPTD 20 μg once daily by sc injection (n = 34) or ZOL 5 mg by iv infusion at baseline (n = 35).
Main Outcome Measures:
The primary end point was mineralizing surface/bone surface (MS/BS), a dynamic measure of bone formation, at month 6. A standard panel of dynamic and static histomorphometric indices was also assessed. When specimens with missing labels were encountered, several methods were used to calculate mineral apposition rate (MAR). Serum markers of bone turnover were also measured.
Results:
Among 58 subjects with evaluable biopsies (TPTD = 28; ZOL = 30), MS/BS was significantly higher in the TPTD group (median: 5.60 vs. 0.16%, P < 0.001). Other bone formation indices, including MAR, were also higher in the TPTD group (P < 0.05). TPTD significantly increased procollagen type 1 N-terminal propeptide (PINP) at months 1, 3, 6, and 12 and carboxyterminal cross-linking telopeptide of collagen type 1 (CTX) from months 3 to 12. ZOL significantly decreased PINP and CTX below baseline at all time points.
Conclusions:
TPTD and ZOL possess fundamentally different mechanisms of action with opposite effects on bone formation based on this analysis of both histomorphometric data and serum markers of bone formation and resorption. An important mechanistic difference was a substantially higher MS/BS in the TPTD group. Overall, these results define the dynamic histomorphometric characteristics of anabolic activity relative to antiresorptive activity after treatment with these two drugs.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Bone and Bones - drug effects</subject><subject>Bone and Bones - pathology</subject><subject>Bone Density Conservation Agents - pharmacology</subject><subject>Bone Remodeling</subject><subject>Cross-Sectional Studies</subject><subject>Diphosphonates - adverse effects</subject><subject>Diphosphonates - pharmacology</subject><subject>Double-Blind Method</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Imidazoles - adverse effects</subject><subject>Imidazoles - pharmacology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Osteogenesis - drug effects</subject><subject>Teriparatide - adverse effects</subject><subject>Teriparatide - pharmacology</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0c-L1DAUB_Agijuu3jxLLsIKdk1e22TibRjUERYWnAqyl5Imr2xq29QkPYzg_27HGfUieHqXz_vB-xLynLNrDpy96cw1MA4ZBwEPyIqroswkV_IhWTEGPFMSvlyQJzF2jPGiKPPH5AJAMs64XJEf-6_YY9I93bmY_ODDdO8HTOFA3Uj3c9OhSZH6kVYY3KSDTs4i9YHe-R5t8KMzdGOcpdU9Bj0d6NV-d1vdvaL7NNvDW7qhn_Ro_eC-o6VbP6bg-6WRVsHp_il51Oo-4rNzvSSf37-rtrvs5vbDx-3mJjMlg5QBgEEtDZTSomgKqZVeN6opcm3WCkHka1GWjbHYtGjNWnChTMuhLZsckcv8klyd5k7Bf5sxpnpw0WDf6xH9HGsuOBfApVT_pywHmQsh2EJfn6gJPsaAbT0FN-hwWFB9zKbuTH3Mpj5ms_AX58lzM6D9g3-HsYCXZ6Cj0X0b9Ghc_OsEFEr9OjE_OVwea4IbcQoYY935OYzLG_-9_ieLSaiU</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Dempster, David W</creator><creator>Zhou, Hua</creator><creator>Recker, Robert R</creator><creator>Brown, Jacques P</creator><creator>Bolognese, Michael A</creator><creator>Recknor, Christopher P</creator><creator>Kendler, David L</creator><creator>Lewiecki, E. Michael</creator><creator>Hanley, David A</creator><creator>Rao, D. Sudhaker</creator><creator>Miller, Paul D</creator><creator>Woodson, Grattan C</creator><creator>Lindsay, Robert</creator><creator>Binkley, Neil</creator><creator>Wan, Xiaohai</creator><creator>Ruff, Valerie A</creator><creator>Janos, Boris</creator><creator>Taylor, Kathleen A</creator><general>Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QP</scope></search><sort><creationdate>20120801</creationdate><title>Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial</title><author>Dempster, David W ; Zhou, Hua ; Recker, Robert R ; Brown, Jacques P ; Bolognese, Michael A ; Recknor, Christopher P ; Kendler, David L ; Lewiecki, E. Michael ; Hanley, David A ; Rao, D. Sudhaker ; Miller, Paul D ; Woodson, Grattan C ; Lindsay, Robert ; Binkley, Neil ; Wan, Xiaohai ; Ruff, Valerie A ; Janos, Boris ; Taylor, Kathleen A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c502t-222cea7c257de6b47a9a8b9b43ac89e2638655bcdebfedc86169cf12f5b3ee173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Bone and Bones - drug effects</topic><topic>Bone and Bones - pathology</topic><topic>Bone Density Conservation Agents - pharmacology</topic><topic>Bone Remodeling</topic><topic>Cross-Sectional Studies</topic><topic>Diphosphonates - adverse effects</topic><topic>Diphosphonates - pharmacology</topic><topic>Double-Blind Method</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Imidazoles - adverse effects</topic><topic>Imidazoles - pharmacology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Osteogenesis - drug effects</topic><topic>Teriparatide - adverse effects</topic><topic>Teriparatide - pharmacology</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dempster, David W</creatorcontrib><creatorcontrib>Zhou, Hua</creatorcontrib><creatorcontrib>Recker, Robert R</creatorcontrib><creatorcontrib>Brown, Jacques P</creatorcontrib><creatorcontrib>Bolognese, Michael A</creatorcontrib><creatorcontrib>Recknor, Christopher P</creatorcontrib><creatorcontrib>Kendler, David L</creatorcontrib><creatorcontrib>Lewiecki, E. Michael</creatorcontrib><creatorcontrib>Hanley, David A</creatorcontrib><creatorcontrib>Rao, D. Sudhaker</creatorcontrib><creatorcontrib>Miller, Paul D</creatorcontrib><creatorcontrib>Woodson, Grattan C</creatorcontrib><creatorcontrib>Lindsay, Robert</creatorcontrib><creatorcontrib>Binkley, Neil</creatorcontrib><creatorcontrib>Wan, Xiaohai</creatorcontrib><creatorcontrib>Ruff, Valerie A</creatorcontrib><creatorcontrib>Janos, Boris</creatorcontrib><creatorcontrib>Taylor, Kathleen A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dempster, David W</au><au>Zhou, Hua</au><au>Recker, Robert R</au><au>Brown, Jacques P</au><au>Bolognese, Michael A</au><au>Recknor, Christopher P</au><au>Kendler, David L</au><au>Lewiecki, E. Michael</au><au>Hanley, David A</au><au>Rao, D. Sudhaker</au><au>Miller, Paul D</au><au>Woodson, Grattan C</au><au>Lindsay, Robert</au><au>Binkley, Neil</au><au>Wan, Xiaohai</au><au>Ruff, Valerie A</au><au>Janos, Boris</au><au>Taylor, Kathleen A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>97</volume><issue>8</issue><spage>2799</spage><epage>2808</epage><pages>2799-2808</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Context:
Recent studies on the mechanism of action (MOA) of bone-active drugs have rekindled interest in how to present and interpret dynamic histomorphometric parameters of bone remodeling.
Objective:
We compared the effects of an established anabolic agent, teriparatide (TPTD), with those of a prototypical antiresorptive agent, zoledronic acid (ZOL).
Design:
This was a 12-month, randomized, double-blind, active-comparator controlled, cross-sectional biopsy study.
Setting:
The study was conducted at 12 U.S. and Canadian centers.
Subjects:
Healthy postmenopausal women with osteoporosis participated in the study.
Interventions:
Subjects received TPTD 20 μg once daily by sc injection (n = 34) or ZOL 5 mg by iv infusion at baseline (n = 35).
Main Outcome Measures:
The primary end point was mineralizing surface/bone surface (MS/BS), a dynamic measure of bone formation, at month 6. A standard panel of dynamic and static histomorphometric indices was also assessed. When specimens with missing labels were encountered, several methods were used to calculate mineral apposition rate (MAR). Serum markers of bone turnover were also measured.
Results:
Among 58 subjects with evaluable biopsies (TPTD = 28; ZOL = 30), MS/BS was significantly higher in the TPTD group (median: 5.60 vs. 0.16%, P < 0.001). Other bone formation indices, including MAR, were also higher in the TPTD group (P < 0.05). TPTD significantly increased procollagen type 1 N-terminal propeptide (PINP) at months 1, 3, 6, and 12 and carboxyterminal cross-linking telopeptide of collagen type 1 (CTX) from months 3 to 12. ZOL significantly decreased PINP and CTX below baseline at all time points.
Conclusions:
TPTD and ZOL possess fundamentally different mechanisms of action with opposite effects on bone formation based on this analysis of both histomorphometric data and serum markers of bone formation and resorption. An important mechanistic difference was a substantially higher MS/BS in the TPTD group. Overall, these results define the dynamic histomorphometric characteristics of anabolic activity relative to antiresorptive activity after treatment with these two drugs.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>22701017</pmid><doi>10.1210/jc.2012-1262</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2012-08, Vol.97 (8), p.2799-2808 |
| issn | 0021-972X 1945-7197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1611621779 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Aged Aged, 80 and over Biological and medical sciences Bone and Bones - drug effects Bone and Bones - pathology Bone Density Conservation Agents - pharmacology Bone Remodeling Cross-Sectional Studies Diphosphonates - adverse effects Diphosphonates - pharmacology Double-Blind Method Endocrinopathies Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Humans Imidazoles - adverse effects Imidazoles - pharmacology Medical sciences Middle Aged Osteogenesis - drug effects Teriparatide - adverse effects Teriparatide - pharmacology Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Skeletal Histomorphometry in Subjects on Teriparatide or Zoledronic Acid Therapy (SHOTZ) Study: A Randomized Controlled Trial |
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