Effectiveness of Teriparatide in Treating Osteoporotic Vertebral Compression Fractures: A Systematic Review

This systematic review aims to evaluate teriparatide's effectiveness in treating osteoporotic vertebral compression fracture (OVCF). The study focuses on teriparatide's impact on bone mineral density, fracture union rates, and nonunion rates. Comparison of teriparatide with alternate medications and treatments including bisphosphonates, denosumab, and vertebroplasty, were also analyzed.

A PubMed and Embase search using PRISMA criteria yielded seven studies that examined the impact of teriparatide on OVCF and compared its efficacy with bisphosphonates, vertebroplasty, and denosumab. Relevant search terms produced 119 unique results, of which seven were deemed eligible for this study.

Union rates in TPD-treated groups ranged from 74 to 100%, significantly higher than BP groups (61%-97%). BMD improvements were also greater in TPD groups, with increases of up to 5.3% over six months compared to 4.9% in BP groups (p < 0.05). Combination therapy of TPD with vertebroplasty showed even higher union rates (91.4% at three months, p < 0.05) and reduced kyphosis progression compared to TPD alone. Some studies suggest that prior bisphosphonate use may delay the effects of teriparatide on fracture healing, though results were not always statistically significant (p > 0.05).

Teriparatide shows notable improvements in fracture healing, making it a promising treatment for OVCF. Despite its benefits, further research is required to determine the optimal treatment duration and to assess the long-term effects of teriparatide and its combination with vertebroplasty.