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- W1833748982 abstract "BACKGROUND: Stress fractures are one of the more severe overuse injuries and occur more frequently in women than men. Location and severity of stress fractures vary according to the sport and intensity of physical activity and most commonly involve the lower extremities. The treatment period may extend beyond 12 weeks based on the severity of the stress fracture and physical activity of the patient. Although data are sparse, there is an evolving interest in using systemic medical interventions to potentially improve or accelerate stress fracture repair. Intermittent administration of human recombinant parathyroid hormone (PTH) (1-34) (Teriparatide) is a FDA-approved anabolic treatment used to treat osteoporosis in men and women and reduce fracture risk in postmenopausal women. Although there may be potential benefits of systemic v teriparatide therapy to hasten the healing of fractures, there only a few randomized, controlled studies at present. OBJECTIVES: To determine in this randomized, placebo-controlled study whether teriparatide can increase the anabolic window in premenopausal women with lower extremity stress fractures and can hasten the healing process, as assessed by Magnetic Resonance Imaging (MRI). Specifically, we will evaluate: 1) Whether bone formation markers increases more rapidly than resorption markers in response to daily teriparatide (20 μg) at 4 and 8 weeks and of the anabolic window, using the area under the curve between percent changes in biomarkers of formation over resorption over time, and 2) whether there is acceleration of the stress fracture healing, as assessed by MRI images. METHODS: Among 101 women screened for this study, 13 women were enrolled and randomized to receive teriparatide (20 μg) (n=6) or placebo (n=7) for 8 weeks in a double-blinded trial. Lab evaluations were completed at each visit (i.e. baseline, 4 weeks and 8 weeks) for 25-hydroxyvitamin D (25(OH)D), serum and urinary calcium, PTH, thyroid-stimulating hormone (TSH), and alkaline phosphate as well as BTM; amino-terminal propeptide of type I collagen (P1NP) and osteocalcin (OC) for bone formation and serum type I collagen c-telopeptides (CTX) and urinary type I collagen-telopeptides for bone resorption. To assess fracture healing, MRI images were reviewed by a radiologist specializing in MRI imaging and who was blinded to the treatment interventions. MRI images were obtained at baseline and 8 weeks and graded on a 0 to 4 scale. Grade 4" @default.
- W1833748982 created "2016-06-24" @default.
- W1833748982 creator A5054587371 @default.
- W1833748982 date "2013-01-01" @default.
- W1833748982 modified "2023-09-26" @default.
- W1833748982 title "Effects of recombinant human parathyroid hormone on the anabolic window and acceleration of lower extremity stress fracture healing" @default.
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