The Effects of Long‐term Administration of rhPTH(1‐84) in Hypoparathyroidism by Bone Histomorphometry

ABSTRACT Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in short‐term studies has beneficial skeletal effects. Although rhPTH(1‐84) will likely be used indefinitely, long‐term effects on skeletal micr...

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Published inJournal of bone and mineral research Vol. 33; no. 11; pp. 1931 - 1939
Main Authors Rubin, Mishaela R, Zhou, Hua, Cusano, Natalie E, Majeed, Rukshana, Omeragic, Beatriz, Gomez, Maximo, Nickolas, Thomas L, Dempster, David W, Bilezikian, John P
Format Journal Article
LanguageEnglish
Published United States Oxford University Press 01.11.2018
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Abstract ABSTRACT Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in short‐term studies has beneficial skeletal effects. Although rhPTH(1‐84) will likely be used indefinitely, long‐term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1‐84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1‐84), skeletal remodeling indices were markedly suppressed. With long‐term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26‐fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15‐fold (0.003 ± 0.01 to 0.047 ± 0.05 μm2/μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.
AbstractList Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1–84) [rhPTH(1–84)] in short-term studies has beneficial skeletal effects. Although rhPTH(1–84) will likely be used indefinitely, long-term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3±1 years of rhPTH(1–84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1–84), skeletal remodeling indices were markedly suppressed. With long-term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26-fold (0.3±1 to 7.9±7%, p =0.003), bone formation rate increased by 15-fold (0.003±0.01 to 0.047±0.05 µm 2 /µm/day, p =0.007), osteoid width doubled (1.9±1 to 4.3±1 lamellae, p =0.017), and osteoid surface tripled (3.3±3 to 10.8±6%, p =0.011). Bone resorption as measured by eroded surface increased (4.6±2 to 7.5±3%, p =0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6±5 to 29.1±11%, p =0.017) and trabecular number (1.8±1 to 2.5±1 #/mm, p =0.025). Cortical porosity tended to increase (6.3±5 to 9.5±3%, p =0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism.
ABSTRACT Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in short‐term studies has beneficial skeletal effects. Although rhPTH(1‐84) will likely be used indefinitely, long‐term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1‐84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1‐84), skeletal remodeling indices were markedly suppressed. With long‐term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26‐fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15‐fold (0.003 ± 0.01 to 0.047 ± 0.05 μm2/μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] in short-term studies has beneficial skeletal effects. Although rhPTH(1-84) will likely be used indefinitely, long-term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1-84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1-84), skeletal remodeling indices were markedly suppressed. With long-term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26-fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15-fold (0.003 ± 0.01 to 0.047 ± 0.05 μm /μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in short‐term studies has beneficial skeletal effects. Although rhPTH(1‐84) will likely be used indefinitely, long‐term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1‐84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1‐84), skeletal remodeling indices were markedly suppressed. With long‐term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26‐fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15‐fold (0.003 ± 0.01 to 0.047 ± 0.05 μm2/μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] in short-term studies has beneficial skeletal effects. Although rhPTH(1-84) will likely be used indefinitely, long-term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1-84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1-84), skeletal remodeling indices were markedly suppressed. With long-term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26-fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15-fold (0.003 ± 0.01 to 0.047 ± 0.05 μm2 /μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] in short-term studies has beneficial skeletal effects. Although rhPTH(1-84) will likely be used indefinitely, long-term effects on skeletal microstructure are unknown. We therefore studied histomorphometric changes with transiliac crest bone biopsies before and after 8.3 ± 1 years of rhPTH(1-84) in 13 hypoparathyroid subjects compared with 45 controls. Before institution of rhPTH(1-84), skeletal remodeling indices were markedly suppressed. With long-term treatment, indices of bone remodeling increased. Mineralizing surface increased by 26-fold (0.3 ± 1 to 7.9 ± 7%, p = 0.003), bone formation rate increased by 15-fold (0.003 ± 0.01 to 0.047 ± 0.05 μm2 /μm/day, p = 0.007), osteoid width doubled (1.9 ± 1 to 4.3 ± 1 lamellae, p = 0.017), and osteoid surface tripled (3.3 ± 3 to 10.8 ± 6%, p = 0.011). Bone resorption as measured by eroded surface increased (4.6 ± 2 to 7.5 ± 3%, p = 0.021). Structural changes demonstrated intratrabecular tunneling, with increases in cancellous bone volume (19.6 ± 5 to 29.1 ± 11%, p = 0.017) and trabecular number (1.8 ± 1 to 2.5 ± 1 #/mm, p = 0.025). Cortical porosity tended to increase (6.3 ± 5 to 9.5 ± 3%, p = 0.07). Mineralizing surface, osteoid surface, and eroded surface surpassed control levels, as did cancellous bone volume, trabecular number, and cortical porosity. These data, the first to reflect such long exposure of any PTH for any disease, illustrate that PTH establishes and maintains a new skeletal state for at least 8 years in hypoparathyroidism. © 2018 American Society for Bone and Mineral Research.
Author Rubin, Mishaela R
Majeed, Rukshana
Zhou, Hua
Bilezikian, John P
Dempster, David W
Gomez, Maximo
Omeragic, Beatriz
Cusano, Natalie E
Nickolas, Thomas L
AuthorAffiliation 3 Department of Pathology, College of Physicians & Surgeons, Columbia University, New York, NY, USA
2 Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, USA
1 Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, NY, USA
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2018 American Society for Bone and Mineral Research.
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Issue 11
Keywords CORTICAL POROSITY
TRABECULAR TUNNELING
HISTOMORPHOMETRY
HYPOPARATHYROIDISM
RHPTH(1-84)
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PublicationDate November 2018
PublicationDateYYYYMMDD 2018-11-01
PublicationDate_xml – month: 11
  year: 2018
  text: November 2018
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
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PublicationTitle Journal of bone and mineral research
PublicationTitleAlternate J Bone Miner Res
PublicationYear 2018
Publisher Oxford University Press
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  article-title: PTH(1-84) administration reverses abnormal bone-remodeling dynamics and structure in hypoparathyroidism
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Snippet ABSTRACT Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in...
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] in...
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1‐84) [rhPTH(1‐84)] in...
Hypoparathyroidism is a rare disorder that is associated with abnormal bone properties. Recombinant human parathyroid hormone (1–84) [rhPTH(1–84)] in...
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SourceType Open Access Repository
Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage 1931
SubjectTerms Adult
Aged
Bone and Bones - pathology
Bone growth
Bone histomorphometry
Bone remodeling
Bone resorption
Cancellous bone
Case-Control Studies
Cohort Studies
CORTICAL POROSITY
Female
HISTOMORPHOMETRY
Humans
HYPOPARATHYROIDISM
Hypoparathyroidism - drug therapy
Lamellae
Long-term effects
Male
Middle Aged
Osteogenesis
Osteoid
Parathyroid
Parathyroid hormone
Parathyroid Hormone - administration & dosage
Parathyroid Hormone - pharmacology
Parathyroid Hormone - therapeutic use
Porosity
Recombinant Proteins - administration & dosage
Recombinant Proteins - pharmacology
Recombinant Proteins - therapeutic use
RHPTH(1‐84)
Time Factors
TRABECULAR TUNNELING
Title The Effects of Long‐term Administration of rhPTH(1‐84) in Hypoparathyroidism by Bone Histomorphometry
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fjbmr.3543
https://www.ncbi.nlm.nih.gov/pubmed/29972871
https://www.proquest.com/docview/2129534154
https://www.proquest.com/docview/2064774948
https://pubmed.ncbi.nlm.nih.gov/PMC6546298
Volume 33
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