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Bone Health and Osteoporosis UK

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New fast test for drug modality efficacy, no radiation, simple blood test.

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Just had this test done after being on Prolia nightmare for 2 years, now on Forteo for 1.5 years with great sucess.

This test allows rapid analysis of bone turnover, just had mine done and it proved out the efficacy of my current modality.

disclaimer, I am male, but apparently that is not a factor in the test.

PINP as a biological response marker during teriparatide treatment for osteoporosis

J. H. Krege, N. E. Lane, J. M. Harris, and P. D. Millercorresponding author

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Abstract

Postmenopausal women with severe osteoporosis may require treatment with the bone anabolic drug teriparatide. While changes in bone mineral density (BMD) are one measure of response, BMD changes often require a minimum of one year to observe measureable changes. Biochemical markers of bone turnover change within 1 to 3 months of initiating osteoporosis therapy. Monitoring with a marker such as procollagen type I N propeptide (PINP), an osteoblast-derived protein, during teriparatide treatment may provide clinically useful information for managing patients with osteoporosis. Clinical trials have shown consistent increases in PINP within 3 months of initiating teriparatide, increases that are significantly greater than placebo and significantly different from baseline. Increases in PINP concentrations during teriparatide treatment correlate well with increases in skeletal activity assessed by radioisotope bone scans and quantitative bone histomorphometry parameters. Individuals treated with teriparatide in clinical trials usually experienced an increase in PINP > 10 mcg/L from baseline, while those given placebo usually did not. In the clinical setting, patients experiencing a significant increase in PINP > 10 mcg/L after initiating teriparatide therapy may receive an earlier confirmation of anabolic effect, while those who do not may be assessed for adherence, proper injection technique, or undetected secondary conditions that might mitigate an anabolic response. PINP monitoring may provide information supplemental to BMD monitoring and be a useful aid in managing patients receiving anabolic osteoporosis treatment in the same way that biochemical markers of bone resorption are useful in monitoring antiresorptive therapy. This review examines PINP as a biological response marker during teriparatide treatment for osteoporosis.

Keywords: Anabolics, Biochemical markers of bone turnover, Osteoporosis, PINP, Teriparatide

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2 Replies

I was all set to begin Forteo, after 2 years on Prolia resulting in Osteonecrosis of the jaw, until I read the risk of potential side effects including possible back spasms , depression, and a small chance of bone cancer. - the cancer risk was a deal breaker for me. I decided not to play that game of risks after "winning" the rare side effect of the jaw condition from Prolia.

What risks were you told about, and what side effects are you feeling? I am having my bone reabsorption rate measured about every 6 months, and I it is now too fast (high number in the 90's) I am praying that with controlled exercise, diet, calcium, vit D and time, my body will even out and flush all that "crap" out of my body. So far I have had no fractures - but probably will need a second hip replacement in the future. I am delaying this surgery until it either improves with exercise or gets worse. I also live in fear of needing any tooth surgeries in the future.

Posy-White profile image
Posy-White

Hello Gary1977

So pleased to hear you're doing well on the Forteo, I'm in your footsteps 1.5 years through the Forteo course after the Prolia rebound disaster.

I have had the blood test at the begining of the Forteo treatment just to check bone turnover and then had a scan to get a full picture.

The bone turnover had stablised so felt less worried about more fractures (8 in one go is enough) I thought the blood test was something offered regularly? (I don't think I ask enough questions sometimes!). Interesting to hear from others if they have been offered this.

Can I ask you a question - Have you talked yet about plans for the end of the course of Forteo?

I did ask this and still have my head in the sand, as it was suggested Prolia again, I know I need to start thinking about it - phone the help line in the UK etc. but.... on the one hand no daily injections, hurray on the other??? I keep hoping for something that does not have such side effects. I know I can not go the no medication route because of other issues.

Best Wishes

Posy White

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