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Effect of transdermal teriparatide administration on bone mineral density in postmenopausal women
Felicia Cosman1, Nancy E Lane, Michael A Bolognese
1Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, New York 10993, USA. cosmanf@helenhayeshosp.com
Context:
Treatment of osteoporosis with an anabolic agent, teriparatide [human PTH 1-34 (TPTD)], is effective in reducing incident fractures, but patient resistance to daily sc injections has limited its use. A novel transdermal patch, providing a rapid, pulse delivery of TPTD, may provide a desirable alternative.
Objective:
The aim of the study was to determine the safety and efficacy of a novel transdermal TPTD patch compared to placebo patch and sc TPTD 20-microg injection in postmenopausal women with osteoporosis.
Design:
Our study consisted of 6-month, randomized, placebo-controlled, positive control, multidose daily administration.
Patients:
We enrolled 165 postmenopausal women (mean age, 64 yr) with osteoporosis.
Interventions:
A TPTD patch with a 20-, 30-, or 40-microg dose or a placebo patch was self-administered daily for 30-min wear time, or 20 microg of TPTD was injected daily.
Outcomes:
The primary efficacy measure was mean percentage change in lumbar spine bone mineral density (BMD) from baseline at 6 months.
Results:
TPTD delivered by transdermal patch significantly increased lumbar spine BMD vs. placebo patch in a dose-dependent manner at 6 months (P < 0.001). TPTD 40-microg patch increased total hip BMD compared to both placebo patch and TPTD injection (P < 0.05). Bone turnover markers (procollagen type I N-terminal propeptide and C-terminal cross-linked telopeptide of type I collagen) increased from baseline in a dose-dependent manner in all treatment groups and were all significantly different from placebo patch (P < 0.001). All treatments were well tolerated, and no prolonged hypercalcemia was observed.
Conclusion:
Transdermal patch delivery of TPTD in postmenopausal women with osteoporosis for 6 months is safe and effective in increasing lumbar spine and total hip BMD.
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