Teriparatide in osteoporosis

Medically Reviewed By : Dr Sravya, MBBS, MS 


Clinical trials have demonstrated the effectiveness of teriparatide in reducing both vertebral and non-vertebral fractures in post-menopausal and glucocorticoid-induced osteoporosis. With the widespread adoption of teriparatide over the past two decades, there is now a substantial body of real-world experience in routine clinical practice.

However, limited experience has been reported regarding the use of teriparatide in pre-menopausal osteoporosis or in combination with other therapies. Surveillance studies have not identified any safety concerns or signals indicating a possible association between teriparatide and osteosarcoma. Furthermore, this review examines the evidence for predicting response to teriparatide, aiming to provide insights into the optimal utilization of teriparatide within an increasingly diverse range of available treatments for osteoporosis.

teriparatide in osteoporosis

What is teriparatide

Teriparatide is an injection used to treat diseases which effect the bones and results in weakness in bones and break easily a condition called osteoporosis. It is used in both women and men who are in a condition of high risk of bone features and unable to do any other treatments. The formulation of the injection is that it contain a hormone called parathyroid hormone (PTH),it is a natural hormone and it works by causing the body in building new bones and works on increasing bone strength and density (thickness ).

How is the medicine should be used

Precaution taken before having teriparatide injection

Mechanism of action of teriparatide

Parathyroid hormone (PTH) is a naturally occurring hormone that plays a vital role in regulating calcium and phosphate levels in the body, particularly in the bones and kidneys. It influences bone metabolism, the reabsorption of calcium and phosphate in the kidneys, and the absorption of calcium in the intestines. PTH exerts its effects by binding to specific receptors known as PTH receptors. When there is an excess of PTH, such as in conditions like hyperparathyroidism, it can lead to increased activity of osteoclasts and accelerated bone resorption. Interestingly, the effects of PTH on bone depend on the dosage and pattern of exposure. Continuous exposure to PTH promotes bone resorption, while intermittent exposure to low doses of PTH can stimulate bone formation more favorably than resorption.

Likewise, the effects of teriparatide on the skeletal system are influenced by its systemic exposure pattern.

Know side effects

It is uncommon to experience side effects while using teriparatide; however, if they do occur, they are usually temporary and short-lived.

Currently known side effects include joint pain, headache, dizziness, and depression. Please note that as ongoing research progresses, the list of known side effects may be subject to change. For more detailed information on each side effect and suggestions for alleviating symptoms, please refer to the teriparatide factsheet.

It is important to mention that other symptoms and side effects may be listed in your patient information leaflet. These side effects were reported by patients participating in research trials, but it is unclear whether they were directly caused by teriparatide. It is worth noting that some of these side effects were also reported by patients receiving a placebo (inactive treatment).

Teriparatide in Post-Menopausal Osteoporosis

Clinical trials involving post-menopausal women have consistently shown that teriparatide (TPTD) is effective in improving bone mineral density (BMD) and reducing clinical fractures when compared to placebo.

Currently the only comparative study that specifically investigated the incidence of fractures as the primary outcome and confirmed that teriparatide significantly reduces the risk of vertebral fractures in post-menopausal osteoporosis. However, no significant reduction in non-vertebral fractures was observed .

Teriparatide in Pre-Menopausal Osteoporosis

Teriparatide in Men