Common Questions
Does teriparatide reduce the risk of fractures?
Teriparatide significantly reduces the risk of both vertebral and nonvertebral fractures in patients at high risk for fractures. At this time, there is no supporting data that it significantly reduces the risk of hip fractures.
There has been only one large randomized placebo control trial of teriparatide (with calcium and vitamin D) in postmenopausal women with prior vertebral fractures (1). This study included 1,637 women (average age 69; average T score of -2.6) that were followed for 2 years. They found that with the 20 ug/day dosing:
- New vertebral fracture risk reduction (RR) was 0.35 (CI 0.22-0.55) and absolute risk reduction (ARR) was 9%.
- Nonvertebral fragility fracture RR was 0.47 (CI 0.25-0.88) and ARR of 3%.
There are studies using PTH (1-84) that have shown similar results (2, 3). All other clinical trials of teriparatide assessing fracture risk reduction have been too small to achieve significance.
- Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster J-Y, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak B. Effect of parathyroid hormone (1-34) on fractures and bone mineral densityu in postmenopausal women with osteoporosis. N Engl J Med 2001; 344: 1434-41.
- Greenspan SL, Bone HG, Ettinger MP, Hanley DA, Lindsay R, Zanchetta JR, Blosch CM, Mathisen AL, Morris SA, Marriott TB. Effect of Recombinant Human Parathyroid Hormone (1-84) on Vertebral Fracture and Bone Mineral Density in Postmenopausal Women with Osteoporosis: A Randomized Trial. Ann Intern Med 2007; 146(5): 326-339.