Teriparatide for osteoporosis in patients with sarcoidosis: Report on risk-benefit ratio in four cases

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• 作者：Salima Challal^a ; Luca Semerano^a ; ^b ; ^c ; Hilario Nunes^d ; Dominique Valeyre^d ; Marie-Christophe Boissier^a ; ^b ; ^c ; Nathalie Saidenberg-Kermanac&rsquo ; h^a ; ^c ; ^{nathalie.saidenberg@avc.aphp.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sarcoidosis ; Osteoporosis ; Teriparatide ; Fracture
• 刊名：Joint Bone Spine
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：83
• 期：3
• 页码：344-345
• 全文大小：323 K

文摘

For patients with sarcoidosis, no consensus exists about the management of osteoporosis, whether related or unrelated to glucocorticoid therapy.

Methods

We report the first series of 4 patients with histologically documented sarcoidosis who received teriparatide therapy for severe osteoporosis manifesting as a fracture cascade with multilevel vertebral fractures. When teriparatide was started, 1 patient was receiving 10 mg of prednisone equivalents per day, 1 was progressively tapering glucocorticoid dose, 2 had never received any glucocorticoid treatment.

Results

In all 4 patients, teriparatide was effective in halting the fracture cascade, including in the 2 patients who remained on long-term glucocorticoid therapy. None of the patients developed hypercalcemia. During teriparatide therapy, 3 patients underwent a flare or a complication of sarcoidosis. Only the patient on stable glucocorticoid treatment did not present any adverse event. Before teriparatide initiation, sarcoidosis had been well controlled in all 3 patients for several years.

Conclusions

Even if the implication of teriparatide is unclear, the appearance of adverse events in 3 out of 4 patients in this small series suggest caution in the use of teriparatide in patients with sarcoidosis.