[Morphologic study of iliac crest spongiosa in patients with osteoporosis treated with combination therapy of pulsatile administration of parathyroid hormone (1-38 hPTH) and sequential addition of calcitonin nasal spray]

Abstract

Seven patients with clinically and histologically proven osteoporosis were treated with intermittent doses of parathyroid hormone fragment (hPTH 1-38) in combination with sequential administration of calcitonin by nasal spray. Iliac crest bone biopsies were taken before and after 14 month of treatment. Under treatment we found a moderate increase in the number of osteoclasts without signs of an increased depth of resorption lacunae.No loss of complete trabeculae due to osteoclastic perforation could be demonstrated. In contrast, we found a drastic increase in the layers of osteoblasts covering osteoid tissue by about 100%. Mineralisation defects or endosteal fibrosis were not present in any case. Mean bone volume (BV/TV) increased under treatment from 12.1% to 16.8% (relative increase of 38%) and was due to a thickening of the individual trabeculae in all seven cases. Considering the small number of patients analysed, the described treatment regimen seems to be efficient on a histological point of view.