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Teriparatide for severe osteoporosis
Kimberly A Cappuzzo1, Jeffrey C Delafuente
1Department of Pharmacy and the Geriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298-0533, USA. kcappuzzo@vcu.edu
The Annals of Pharmacotherapy
|January 27, 2004
Summary
Teriparatide, a parathyroid hormone analog, effectively treats osteoporosis by increasing bone density and reducing fracture risk. Long-term safety and comparative efficacy require further investigation.
Area of Science:
- Endocrinology
- Pharmacology
- Bone Metabolism
Background:
- Osteoporosis poses a significant fracture risk, particularly in postmenopausal women and men with specific conditions.
- Current treatments aim to slow bone loss, but anabolic agents offer a new therapeutic approach.
Purpose of the Study:
- To comprehensively review teriparatide (recombinant human parathyroid hormone [1-34]), an anabolic agent for osteoporosis.
- To evaluate its pharmacology, pharmacokinetics, efficacy, safety, and clinical use.
Main Methods:
- A systematic literature search of MEDLINE (1966-May 2003) and bibliographies was performed.
- Key search terms included parathyroid hormone, osteoporosis, fracture, and teriparatide.
- Unpublished clinical trial data were also obtained from the manufacturer.
Main Results:
- Teriparatide significantly increases spine and hip bone mineral density (BMD) in patients with osteoporosis.
- It reduces the incidence of both vertebral and non-vertebral fractures.
- Common side effects include nausea, headache, dizziness, and arthralgias; a black box warning exists due to osteosarcoma risk in rats.
Conclusions:
- Teriparatide offers substantial BMD increases and fracture reduction, especially in severe osteoporosis.
- Further comparative trials are needed to establish its role versus other osteoporosis therapies.
- Long-term safety and efficacy data remain limited.