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 in | Journal of bone and mineral research Vol. 33; no. 11; pp. 1931 - 1939 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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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. |
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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 |
AuthorAffiliation_xml | – name: 2 Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, USA – name: 3 Department of Pathology, College of Physicians & Surgeons, Columbia University, New York, NY, USA – name: 1 Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, NY, USA |
Author_xml | – sequence: 1 givenname: Mishaela R surname: Rubin fullname: Rubin, Mishaela R email: mrr6@columbia.edu organization: Columbia University – sequence: 2 givenname: Hua surname: Zhou fullname: Zhou, Hua organization: Helen Hayes Hospital – sequence: 3 givenname: Natalie E surname: Cusano fullname: Cusano, Natalie E organization: Columbia University – sequence: 4 givenname: Rukshana surname: Majeed fullname: Majeed, Rukshana organization: Columbia University – sequence: 5 givenname: Beatriz surname: Omeragic fullname: Omeragic, Beatriz organization: Columbia University – sequence: 6 givenname: Maximo surname: Gomez fullname: Gomez, Maximo organization: Columbia University – sequence: 7 givenname: Thomas L surname: Nickolas fullname: Nickolas, Thomas L organization: Columbia University – sequence: 8 givenname: David W surname: Dempster fullname: Dempster, David W organization: Columbia University – sequence: 9 givenname: John P surname: Bilezikian fullname: Bilezikian, John P organization: Columbia University |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29972871$$D View this record in MEDLINE/PubMed |
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Keywords | CORTICAL POROSITY TRABECULAR TUNNELING HISTOMORPHOMETRY HYPOPARATHYROIDISM RHPTH(1-84) |
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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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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 |
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