Teriparatide in the management of osteoporosis

Figures & data

Figure 1 Teriparatide therapy improves skeletal architecture. Micro-CT scans of iliac crest biopsy specimens at baseline (A) and after 21 months of therapy (B) with teriparatide (20 μg/d). Reproduced with permission from Jiang Y, Zhao JJ, Mitlak BH et al 2003. Recombinant human parathyroid hormone (1–34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res, 18:1932–41. Copyright © 2003 American Society for Bone and Mineral Research.

Figure 2 Effect of teriparitide treatment (20 μg/d, black bar) compared with placebo (gey bar) on A. Risk of one or more new vertebral fracture. B. Risk of one or more new moderate or severe vertebral fractures.

Table 1 Therapeutic clinical trials evaluating fracture risk reduction in women with postmenopausal osteoporosis

Trial	Dose	Mean age	Treatment duration (y)	Relative risk reduction (%)
				vertebral	total nonvertebral	hip
Teriparatide
bNeer	20–40 μg/d	69	1.6	65	34
Risedronate
cVERT-NA	5 mg/d	69	1 3	65 41	39
dVERT-MN	5 mg/d	71	1 3	61 49	33 (NS)
eHIP	2.5–5 mg/d	74	3		20	40
Alendronate
fFIT 1	5–10 mg/d	71	3	47	20 (NS)	51
gFIT 2	5–10 mg/d	68	4	44	12 (NS)	21(NS)
Ibandronate
hBONE	2.5 mg/d	69	3	62	NS*
Raloxifene
iMORE	60 mg/d	67	3	30	NS
Hormone replacement
jWHI	CEE 0.625 mg/d plus progestin	63	5.6	35	25	33
kWHI	CEE 0.625 mg/d	63	6.8	38		39
Calcitonin
lPROOF	200 IU/d	68	5	33	12 (NS)	50 (NS)

^a not significant;

^b (Neer et al 2001);

^c Vertebral Efficacy With Risedronate Therapy North America (Harris et al 1999);

^d Vertebral Efficacy With Risedronate Therapy Multinational (Reginster et al 2000);

^e Hip Intervention Program (McClung et al 2001);

^f Fracture Intervention Trial 1 (Black et al 1996);

^g Fracture Intervention Trial 2 (Cummings et al 1998);

^h Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (Chesnut et al 2004);

ⁱ Multiple Outcomes of Raloxifene Evaluation (Ettinger et al 1999);

^j Women’s Health Initiative (Cauley et al 2003);

^k Women’s Health Initiative (Anderson et al 2004);

^l Prevent Recurrence of Osteoporotic Fractures (Chesnut et al 2000)

JiangYZhaoJJMitlakBH2003Recombinant human parathyroid hormone (1–34) [teriparatide] improves both cortical and cancellous bone structureJ Bone Miner Res1819324114606504

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NeerRMArnaudCDZanchettaJR2001Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. [see comment]N Engl J Med34414344111346808

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