Teriparatide for osteoporosis in patients with sarcoidosis: Report on risk-benefit ratio in four cases - 03/05/16
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Abstract |
Objectives |
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 4patients with histologically documented sarcoidosis who received teriparatide therapy for severe osteoporosis manifesting as a fracture cascade with multilevel vertebral fractures. When teriparatide was started, 1patient was receiving 10mg of prednisone equivalents per day, 1 was progressively tapering glucocorticoid dose, 2 had never received any glucocorticoid treatment.
Results |
In all 4patients, teriparatide was effective in halting the fracture cascade, including in the 2patients who remained on long-term glucocorticoid therapy. None of the patients developed hypercalcemia. During teriparatide therapy, 3patients 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 3patients for several years.
Conclusions |
Even if the implication of teriparatide is unclear, the appearance of adverse events in 3 out of 4patients in this small series suggest caution in the use of teriparatide in patients with sarcoidosis.
Le texte complet de cet article est disponible en PDF.Keywords : Sarcoidosis, Osteoporosis, Teriparatide, Fracture
Plan
Vol 83 - N° 3
P. 344-345 - mai 2016 Retour au numéro
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