Update on the safety and efficacy of teriparatide in the treatment of osteoporosis

Minisola, Salvatore; Cipriani, Cristiana; Grotta, Giada Della; Colangelo, Luciano; Occhiuto, Marco; Biondi, Piergianni; Sonato, Chiara; Vigna, Evelina; Cilli, M.; Pepe, Jessica

doi:10.1177/1759720x19877994

Cited by 64 publications

(35 citation statements)

References 66 publications

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“…Other common side effects include nausea, arthralgia, fatigue, headache, and hypertension [32,33]. A previous study reported that these side effects usually start in the early treatment period and rarely occur after 3 months of treatment [17]. This report is consistent with the results of the present study in which side effects occurred in the early treatment period and were relieved with conservative treatment.…”

Section: Discussionsupporting

confidence: 92%

“…PTH is a bone forming agent that signi cantly reduces the risk of osteoporotic vertebral fracture and treats it effectively, especially in multiple level fractures [6,15,16]. While previous studies reported that conversion to anti-resorptive agents is necessary after 2 years of PTH administration for the treatment of osteoporosis, there is no standard duration of PTH administration established for acute osteoporotic vertebral fractures [17][18][19]. This study compared the conservative treatment group (Group C) and the intervention treatment group (Group I).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Parathyroid Hormone Injection Versus Vertebroplasty in the Treatment of Osteoporotic Vertebral Fracture in Old Age: A Retrospective Study of 58 Female Patients

Kook

Kang

Park

2020

Preprint

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Background: While the indications of parathyroid hormone (PTH) in osteoporosis prevention and management have been established, its indications in the treatment of osteoporotic vertebral fractures remain unknown. This study aimed to compare the effects of intervention (percutaneous vertebroplasty followed by anti-resorptive agents) and conservative treatment (PTH administration) in patients with osteoporotic vertebral fractures, as well as to investigate the optimal duration of PTH administration. Methods: A retrospective study was conducted using data of patients treated for osteoporotic vertebral fractures between January 2015 and November 2019. Treatment was selected based on the patient’s age, comorbidities, and patient’s preference after explaining the expected advantages and disadvantages of each treatment. Group C was administered PTH injections once weekly, whereas Group I underwent vertebroplasty followed by the administration of anti-resorptive agents. Radiological and clinical parameters were analyzed between two groups.Results: This study enrolled 58 patients (77 vertebrae). Group C included 24 patients (38 vertebrae) with average age of 77.50 ± 7.19 years (range, 65–85 years), average bone mineral density (BMD) of −3.39 ± 0.86 (range, −2.5 to −5.8), average follow-up period of 27.47 ± 7.60 weeks (range, 12–49 weeks). Group I included 34 patients (39 vertebrae) with an average age of 76.20 ± 8.67 years (range, 65–92 years), average BMD of −3.35 ± 0.91 (range, −2.5 to −5.1), average follow-up period of 30.82 ± 10.95 weeks (range, 16–59 weeks). There was no significant difference between the two groups in initial demographic, clinical and radiographic parameters. Group I showed significantly better clinical and radiological outcome during the last follow-up. Regarding side effects in Group C, two cases of dizziness (8.3%), nausea and vomiting (8.3%) were reported. In Group I, cement leakage was found in 26 vertebrae (66.7%), and cement leakage complications were observed in four patients (11.8%). Conclusion: Conservative treatment using PTH injection demonstrated slower pain relief and lesser suppression of vertebral height loss than vertebroplasty. However, PTH injection demonstrated a lower risk of procedure-related complications. The patient’s age, preference, and general condition with respect to the procedure’s risk should be considered when determining treatment options for osteoporotic vertebral fracture in old age.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Parathyroid Hormone Injection Versus Vertebroplasty in the Treatment of Osteoporotic Vertebral Fracture in Old Age: A Retrospective Study of 58 Female Patients

Kook

Kang

Park

2020

Preprint

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“…Currently, the treatment of osteoporosis is currently mainly aimed at osteoclasts ( Ensrud and Crandall, 2017 ; Roux and Briot, 2018 ), and the new therapy with teriparatide has shown a more curative effect in osteoporosis ( Minisola et al, 2019 ), which suggests that treatment options directed at osteoblasts are of great significance. Adenoviruses containing lncRNAs were used to treat mice and showed a significant therapeutic effect in many diseases, including ischemic myocardial injury ( Cai et al, 2019 ) and cardiac regeneration ( Ponnusamy et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

GAS5 protects against osteoporosis by targeting UPF1/SMAD7 axis in osteoblast differentiation

Xie

et al. 2020

eLife

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Osteoporosis is a common systemic skeletal disorder resulting in bone fragility and increased fracture risk. It is still necessary to explore its detailed mechanisms and identify novel targets for the treatment of osteoporosis. Previously, we found that a lncRNA named GAS5 in human could negatively regulate the lipoblast/adipocyte differentiation. However, it is still unclear whether GAS5 affects osteoblast differentiation and whether GAS5 is associated with osteoporosis. Our current research found that GAS5 was decreased in the bones and BMSCs, a major origin of osteoblast, of osteoporosis patients. Mechanistically, GAS5 promotes the osteoblast differentiation by interacting with UPF1 to degrade SMAD7 mRNA. Moreover, a decreased bone mass and impaired bone repair ability were observed in Gas5 heterozygous mice, manifesting in osteoporosis. The systemic supplement of Gas5-overexpressing adenoviruses significantly ameliorated bone loss in an osteoporosis mouse model. In conclusion, GAS5 promotes osteoblast differentiation by targeting the UPF1/SMAD7 axis and protects against osteoporosis.

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“…After 18 months of treatment, TPTD results in a larger increase in spinal BMD and improved microstructure compared with Risedronate [ 41 ]. In many countries TPTD has not been approved for use for men and hence observational data is correspondingly limited [ 42 ]. In the large registry studies (JFOS, exFOS), approximately 10% of patients were men (see Table 1 ) and the number was generally too small to allow sub-analysis of fracture data.…”

Section: Teriparatide Data In Various Patient Groupsmentioning

confidence: 99%

Review of Current Real-World Experience with Teriparatide as Treatment of Osteoporosis in Different Patient Groups

Hauser

Alonso

Riches

2021

JCM

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Teriparatide has proven effective in reducing both vertebral and non-vertebral fractures in clinical trials of post-menopausal and glucocorticoid-induced osteoporosis. Widespread adoption of Teriparatide over the last two decades means that there is now substantial experience of its use in routine clinical practice, which is summarized in this paper. Extensive real-world experience of Teriparatide in post-menopausal osteoporosis confirms the fracture and bone density benefits seen in clinical trials, with similar outcomes identified also in male and glucocorticoid-induced osteoporosis. Conversely, very limited experience has been reported in pre-menopausal osteoporosis or in the use of Teriparatide in combination with other therapies. Surveillance studies have identified no safety signals relating to the possible association of Teriparatide with osteosarcoma. We also review the evidence for predicting response to Teriparatide in order to inform the debate on where best to use Teriparatide in an increasingly crowded therapeutic landscape.

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Update on the safety and efficacy of teriparatide in the treatment of osteoporosis

Cited by 64 publications

References 66 publications

Parathyroid Hormone Injection Versus Vertebroplasty in the Treatment of Osteoporotic Vertebral Fracture in Old Age: A Retrospective Study of 58 Female Patients

Parathyroid Hormone Injection Versus Vertebroplasty in the Treatment of Osteoporotic Vertebral Fracture in Old Age: A Retrospective Study of 58 Female Patients

GAS5 protects against osteoporosis by targeting UPF1/SMAD7 axis in osteoblast differentiation

Review of Current Real-World Experience with Teriparatide as Treatment of Osteoporosis in Different Patient Groups

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