Online citations, reference lists, and bibliographies.
← Back to Search

Improvements In Vertebral Body Strength Under Teriparatide Treatment Assessed In Vivo By Finite Element Analysis: Results From The EUROFORS Study

C. Graeff, Y. Chevalier, M. Charlebois, P. Varga, D. Pahr, T. N. Nickelsen, M. Morlock, C. Glüer, P. Zysset
Published 2009 · Medicine, Biology

Cite This
Download PDF
Analyze on Scholarcy
Share
Monitoring of osteoporosis therapy based solely on DXA is insufficient to assess antifracture efficacy. Estimating bone strength as a variable closely linked to fracture risk is therefore of importance. Finite element (FE) analysis–based strength measures were used to monitor a teriparatide therapy and the associated effects on whole bone and local fracture risk. In 44 postmenopausal women with established osteoporosis participating in the EUROFORS study, FE models based on high‐resolution CT (HRCT) of T12 were evaluated after 0, 6, 12, and 24 mo of teriparatide treatment (20 μg/d). FE‐based strength and stiffness calculations for three different load cases (compression, bending, and combined compression and bending) were compared with volumetric BMD (vBMD) and apparent bone volume fraction (app. BV/TV), as well as DXA‐based areal BMD of the lumbar spine. Local damage of the bone tissue was also modeled. Highly significant improvements in all analyzed variables as early as 6 mo after starting teriparatide were found. After 24 mo, bone strength in compression was increased by 28.1 ± 4.7% (SE), in bending by 28.3 ± 4.9%, whereas app. BV/TV was increased by 54.7 ± 8.8%, vBMD by 19.1 ± 4.0%, and areal BMD of L1–L4 by 10.2 ± 1.2%. When comparing standardized increases, FE changes were significantly larger than those of densitometry and not significantly different from app. BV/TV. The size of regions at high risk for local failure was significantly reduced under teriparatide treatment. Treatment with teriparatide leads to bone strength increases for different loading conditions of close to 30%. FE is a suitable tool for monitoring bone anabolic treatment in groups or individual patients and offers additional information about local failure modes. FE variables showed a higher standardized response to changes than BMD measurements, but further studies are needed to show that the higher response represents a more accurate estimate of treatment‐induced fracture risk reduction.
This paper references
10.1016/J.BONE.2003.12.001
The osteoporotic vertebral structure is well adapted to the loads of daily life, but not to infrequent "error" loads.
J. Homminga (2004)
0001 vs. baseline; # p < 0.0001 vs. 6-mo visit. better than quantitative computed tomography
p lt
10.1016/J.JBIOMECH.2007.05.004
Validation of a voxel-based FE method for prediction of the uniaxial apparent modulus of human trabecular bone using macroscopic mechanical tests and nanoindentation.
Y. Chevalier (2007)
10.1359/jbmr.070728
Structural Determinants of Vertebral Fracture Risk
L. J. Melton (2007)
10.1359/jbmr.1999.14.11.1952
Monitoring Skeletal Changes by Radiological Techniques
C. Glüer (1999)
10.1056/NEJM200105103441904
Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.
R. Neer (2001)
10.1359/jbmr.060802
Change in Lumbar Spine BMD and Vertebral Fracture Risk Reduction in Teriparatide‐Treated Postmenopausal Women With Osteoporosis
P. Chen (2006)
10.1097/BRS.0b013e31815e3993
In Vivo Assessment of Lumbar Vertebral Strength in Elderly Women Using Computed Tomography-Based Nonlinear Finite Element Model
K. Imai (2008)
10.1385/JCD:7:2:153
Image-based micro-finite-element modeling for improved distal radius strength diagnosis: moving from bench to bedside.
W. Pistoia (2004)
10.1016/J.BONE.2006.01.147
Time-lapsed investigation of three-dimensional failure and damage accumulation in trabecular bone using synchrotron light.
P. Thurner (2006)
10.1359/jbmr.2002.17.1.1
Relationships Between Bone Mineral Density and Incident Vertebral Fracture Risk with Raloxifene Therapy
S. Sarkar (2002)
10.1359/jbmr.070603
Monitoring Teriparatide‐Associated Changes in Vertebral Microstructure by High‐Resolution CT In Vivo: Results From the EUROFORS Study
C. Graeff (2007)
10.1016/J.BONE.2007.05.017
Locations of bone tissue at high risk of initial failure during compressive loading of the human vertebral body.
S. Eswaran (2007)
10.1016/S0002-9343(01)01124-X
Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.
S. Cummings (2002)
10.1001/ARCHINTE.165.15.1762
Opposite bone remodeling effects of teriparatide and alendronate in increasing bone mass.
M. Mcclung (2005)
10.1007/s10237-008-0125-2
A three-dimensional elastic plastic damage constitutive law for bone tissue
D. García (2009)
10.1080/10255840802078022
A patient-specific finite element methodology to predict damage accumulation in vertebral bodies under axial compression, sagittal flexion and combined loads
Y. Chevalier (2008)
10.1016/S0021-9290(99)00099-8
Femoral strength is better predicted by finite element models than QCT and DXA.
D. Cody (1999)
Curnier A 2009 A threedimensional elastic plastic damage constitutive law for bone tissue
D Garcia (2009)
10.1615/CRITREVBIOMEDENG.V23.I5-6.20
Finite element methods in spine biomechanics research.
L. Gilbertson (1995)
10.1359/jbmr.061011
Effects of Teriparatide and Alendronate on Vertebral Strength as Assessed by Finite Element Modeling of QCT Scans in Women With Osteoporosis
T. M. Keaveny (2007)
Comparison of 3 sequential treatment regimens of teriparatide: Final results from the EUROFORS study
R. Eastell (2006)
10.1016/S8756-3282(03)00210-2
Finite element models predict in vitro vertebral body compressive strength better than quantitative computed tomography.
R. Crawford (2003)
using synchrotron light
SK Eswaran (2007)
Comparison of the effects of teriparatide and alendronate on parameters of total hip strength as assessed by finite element analysis: Results from the Forteo and Alendronate Comparison Trial
TM Keaveny (2007)



This paper is referenced by
10.1007/s12020-012-9691-2
New advances in imaging osteoporosis and its complications
J. Griffith (2012)
10.1016/j.jocd.2015.06.011
Clinical Use of Quantitative Computed Tomography-Based Finite Element Analysis of the Hip and Spine in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part II.
P. Zysset (2015)
10.1016/B978-0-12-374602-3.00045-6
Advanced Structural Assessment of Bone Using CT and MRI
X. E. Guo (2010)
10.1002/jbmr.1870
Comparative Effects of Teriparatide and Risedronate in Glucocorticoid-Induced Osteoporosis in Men: 18-Month Results of the EuroGIOPs Trial
C. Glueer (2013)
10.1007/s00198-010-1379-y
Early changes in biochemical markers of bone turnover and their relationship with bone mineral density changes after 24 months of treatment with teriparatide
A. Blumsohn (2010)
10.1007/978-3-319-30412-0_13
What’s Next in the Field of Bone Health in Pediatrics? Research Considerations
Sharmila Majumdar (2016)
10.1016/j.rbre.2017.01.001
Treatment of postmenopausal osteoporosis: a literature-based algorithm for use in the public health care system.
Ellen Luz Pereira Caires (2017)
10.1007/S12018-009-9066-2
Clinical Tools to Evaluate Bone Strength
S. Manske (2010)
10.1097/BOR.0000000000000405
Skeletal assessment with finite element analysis: relevance, pitfalls and interpretation
Graeme M Campbell (2017)
10.1002/9781118453926.CH31
Quantitative Computed Tomography in Children and Adults
C. Glüer (2013)
10.1002/jbmr.2924
Assessment of Bone Fragility in Patients With Multiple Myeloma Using QCT‐Based Finite Element Modeling
G. Campbell (2017)
10.1115/1.3212097
The role of cortical shell and trabecular fabric in finite element analysis of the human vertebral body.
Y. Chevalier (2009)
10.1016/j.berh.2009.09.008
Quantifying the material and structural determinants of bone strength.
M. Bouxsein (2009)
10.1016/B978-0-12-802792-9.00002-1
Bone Biology and Effects of Pharmaceutical Intervention on Bone Quality
Susan M. Ott (2017)
10.1186/s40842-018-0062-7
The challenges of diagnosing osteoporosis and the limitations of currently available tools
P. Choksi (2018)
10.1016/j.jocd.2015.06.012
Clinical Use of Quantitative Computed Tomography (QCT) of the Hip in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part I.
K. Engelke (2015)
10.3999/JSCPT.44.395
The Effect of the Concomitant Administration of Active Vitamin D on the Safety of Once-a-Day Subcutaneous Injection of Teriparatide 20 μg/day
Masako Nakano (2013)
10.1016/B978-0-12-801238-3.65349-7
Osteoporosis Treatment: Bone-Forming Agents
Bente Lomholt Langdahl (2014)
10.1080/14728222.2020.1726889
Emerging therapeutic targets for osteoporosis
L. Gennari (2020)
10.1016/j.bone.2012.02.635
Changes in vitamin D metabolites during teriparatide treatment.
F. Cosman (2012)
10.1016/j.jmbbm.2012.11.018
Clinical versus pre-clinical FE models for vertebral body strength predictions.
D. Pahr (2014)
10.1007/s00198-013-2379-5
Early changes in biochemical markers of bone formation during teriparatide therapy correlate with improvements in vertebral strength in men with glucocorticoid-induced osteoporosis
P. Farahmand (2013)
Nichtinvasive Bestimmung von Knochenmikrostruktur und -festigkeit
Glüer Cg (2011)
10.1016/j.bone.2011.01.004
Increased bone strength is associated with improved bone microarchitecture in intact female rats treated with strontium ranelate: a finite element analysis study.
S. Boyd (2011)
10.1118/1.4950874
Bone-marrow densitometry: Assessment of marrow space of human vertebrae by single energy high resolution-quantitative computed tomography.
J. Peña (2016)
10.1097/MED.0b013e32835a2609
Assessment of bone quality and strength with new technologies
K. Engelke (2012)
10.1038/s41598-020-65921-1
PTH(1–34) treatment and/or mechanical loading have different osteogenic effects on the trabecular and cortical bone in the ovariectomized C57BL/6 mouse
Bryant C. Roberts (2020)
Neue Horizonte für die In-vivo-Bestimmung wesentlicher Aspekte der Knochenqualität
Claus Christian Glüer (2013)
10.1007/s00198-018-4445-5
Teriparatide treatment exerts differential effects on the central and peripheral skeleton: results from the MOAT study
M. Paggiosi (2018)
10.1111/j.1749-6632.2011.06282.x
Noninvasive imaging of bone microarchitecture
J. Patsch (2011)
10.1007/s11914-013-0141-8
Finite Element Analysis of the Hip and Spine Based on Quantitative Computed Tomography
R. D. Carpenter (2013)
10.1007/s00198-014-2646-0
PINP as a biological response marker during teriparatide treatment for osteoporosis
J. Krege (2014)
See more
Semantic Scholar Logo Some data provided by SemanticScholar