Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Glucocorticoids, widely used in inflammatory disorders, rapidly increase bone fragility and, therefore, fracture risk. However, common bone densitometry measurements are not sensitive enough to detect these changes. Moreover, densitometry only partially recognizes treatment-induced fracture reductions in osteoporosis. Here, we tested whether the reference point indentation technique could detect bone tissue property changes early after glucocorticoid treatment initiation. After initial laboratory and bone density measurements, patients were allocated into groups receiving calcium + vitamin D (Ca+D) supplements or anti-osteoporotic drugs (risedronate, denosumab, teriparatide). Reference point indentation was performed on the cortical bone layer of the tibia by a handheld device measuring bone material strength index (BMSi). Bone mineral density was measured by dual-energy X-ray absorptiometry (DXA). Although Ca+D-treated patients exhibited substantial and significant deterioration, risedronate-treated patients exhibited no significant change, and both denosumab- and teriparatide-treated participants exhibited significantly improved BMSi 7 weeks after initial treatment compared with baseline; these trends remained stable for 20 weeks. In contrast, no densitometry changes were observed during this study period. In conclusion, our study is the first to our knowledge to demonstrate that reference point indentation is sensitive enough to reflect changes in cortical bone indentation after treatment with osteoporosis therapies in patients newly exposed to glucocorticoids.

Original publication

DOI

10.1002/jbmr.2497

Type

Journal article

Journal

J Bone Miner Res

Publication Date

09/2015

Volume

30

Pages

1651 - 1656

Keywords

ANABOLICS, ANTIRESORPTIVES, BIOMECHANICS, BONE MATERIAL STRENGTH, CORTICOSTEROIDS, REFERENCE POINT INDENTATION, Absorptiometry, Photon, Adult, Aged, Bone Density, Bone Density Conservation Agents, Bone and Bones, Calcium, Denosumab, Densitometry, Female, Fractures, Bone, Glucocorticoids, Humans, Male, Middle Aged, Osteoporosis, Reference Values, Risedronate Sodium, Stress, Mechanical, Teriparatide