Study summary · research use only
Teriparatide in the treatment of osteoporosis
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This review discusses teriparatide (recombinant human parathyroid hormone) for osteoporosis in humans, examining efficacy, safety, and cost. The authors note osteoporosis is a leading cause of fractures in women and men but is underdiagnosed and undertreated, and that antiresorptive therapies have historically been used. They describe teriparatide as an anabolic agent labeled for postmenopausal women and men at high fracture risk, and state that clinical trials indicate it increases predominantly trabecular bone in the lumbar spine and femoral neck, with less effect at cortical sites. They report that combining teriparatide with antiresorptive agents provided no greater benefit than teriparatide monotherapy. Common adverse effects listed include injection-site pain, nausea, headaches, leg cramps, and dizziness. After a maximum of two years, the authors state teriparatide should be discontinued and antiresorptive therapy begun.
Abstract
The efficacy, safety, and cost of teriparatide in the treatment of osteoporosis are reviewed. Osteoporosis is a leading cause of fractures in women and men but is underdiagnosed and undertreated. Antiresorptive therapies (calcitonin, estrogen, bisphosphonates, and selective estrogen-receptor modulators) have historically been used to treat this condition. Teriparatide (recombinant human parathyroid hormone) is an anabolic agent labeled for use in postmenopausal women and men with osteoporosis who are at high risk for fractures. Clinical trials indicate that teriparatide increases predominantly trabecular bone in the lumbar spine and femoral neck; it has less significant effects at cortical sites. The combination of teriparatide with antiresorptive agents is not more effective than teriparatide monotherapy. The most common adverse effects associated with teriparatide include injection-site pain, nausea, headaches, leg cramps, and dizziness. After a maximum of two years of teriparatide therapy, the drug should be discontinued and antiresorptive therapy begun to maintain bone mineral density. Teriparatide is expensive but may be cost-effective in selected patients. Teriparatide offers a therapeutic option for patients at high risk of an osteoporotic fracture and for patients who are intolerant of or unresponsive to antiresorptive therapy.
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