Parathyroid hormone and teriparatide for the treatment of osteoporosis

A review of the evidence and suggested guidelines for its use

Anthony B. Hodsman, Douglas C. Bauer, David W. Dempster, Larry Dian, David A. Hanley, Steven T. Harris, David L. Kendler, Michael R. McClung, Paul D. Miller, Wojciech P. Olszynski, Eric Orwoll, Kin Yuen Chui

Research output: Contribution to journalArticle

475 Citations (Scopus)

Abstract

All therapies currently recommended for the management of osteoporosis act mainly to inhibit bone resorption and reduce bone remodeling. PTH and its analog, teriparatide [recombinant human PTH(1-34)], represent a new class of anabolic therapies for the treatment of severe osteoporosis, having the potential to improve skeletal microarchitecture. Significant reductions in both vertebral and appendicular fracture rates have been demonstrated in the phase III trial of teriparatide, involving elderly women with at least one prevalent vertebral fracture before the onset of therapy. However, there is as yet no evidence that the antifracture efficacy of PTH will be superior to the bisphosphonates, whereas cost-utility estimates suggest that teriparatide is significantly more expensive. Teriparatide should be considered as treatment for postmenopausal women and men with severe osteoporosis, as well as for patients with established glucocorticoid-induced osteoporosis who require long-term steroid treatment. Teriparatide should also be considered for the management of individuals at particularly high risk for fractures, including subjects who are younger than age 65 and who have particularly low bone mineral density measurements (T scores <3.5). Teriparatide therapy is not recommended for more than 2 yr, based, in part, on the induction of osteosarcoma in a rat model of carcinogenicity. Total daily calcium intake from both supplements and dietary sources should be limited to 1500 mg together with adequate vitamin D intake (

Original languageEnglish (US)
Pages (from-to)688-703
Number of pages16
JournalEndocrine Reviews
Volume26
Issue number5
DOIs
StatePublished - Aug 2005

Fingerprint

Teriparatide
Parathyroid Hormone
Osteoporosis
Guidelines
Therapeutics
Bone Remodeling
Diphosphonates
Osteosarcoma
Bone Resorption
Dietary Supplements
Vitamin D
Bone Density
Glucocorticoids
Steroids
Calcium
Costs and Cost Analysis

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Hodsman, A. B., Bauer, D. C., Dempster, D. W., Dian, L., Hanley, D. A., Harris, S. T., ... Chui, K. Y. (2005). Parathyroid hormone and teriparatide for the treatment of osteoporosis: A review of the evidence and suggested guidelines for its use. Endocrine Reviews, 26(5), 688-703. https://doi.org/10.1210/er.2004-0006

Parathyroid hormone and teriparatide for the treatment of osteoporosis : A review of the evidence and suggested guidelines for its use. / Hodsman, Anthony B.; Bauer, Douglas C.; Dempster, David W.; Dian, Larry; Hanley, David A.; Harris, Steven T.; Kendler, David L.; McClung, Michael R.; Miller, Paul D.; Olszynski, Wojciech P.; Orwoll, Eric; Chui, Kin Yuen.

In: Endocrine Reviews, Vol. 26, No. 5, 08.2005, p. 688-703.

Research output: Contribution to journalArticle

Hodsman, AB, Bauer, DC, Dempster, DW, Dian, L, Hanley, DA, Harris, ST, Kendler, DL, McClung, MR, Miller, PD, Olszynski, WP, Orwoll, E & Chui, KY 2005, 'Parathyroid hormone and teriparatide for the treatment of osteoporosis: A review of the evidence and suggested guidelines for its use', Endocrine Reviews, vol. 26, no. 5, pp. 688-703. https://doi.org/10.1210/er.2004-0006
Hodsman, Anthony B. ; Bauer, Douglas C. ; Dempster, David W. ; Dian, Larry ; Hanley, David A. ; Harris, Steven T. ; Kendler, David L. ; McClung, Michael R. ; Miller, Paul D. ; Olszynski, Wojciech P. ; Orwoll, Eric ; Chui, Kin Yuen. / Parathyroid hormone and teriparatide for the treatment of osteoporosis : A review of the evidence and suggested guidelines for its use. In: Endocrine Reviews. 2005 ; Vol. 26, No. 5. pp. 688-703.
@article{b5d5471ee08c49a0accd02268c10a779,
title = "Parathyroid hormone and teriparatide for the treatment of osteoporosis: A review of the evidence and suggested guidelines for its use",
abstract = "All therapies currently recommended for the management of osteoporosis act mainly to inhibit bone resorption and reduce bone remodeling. PTH and its analog, teriparatide [recombinant human PTH(1-34)], represent a new class of anabolic therapies for the treatment of severe osteoporosis, having the potential to improve skeletal microarchitecture. Significant reductions in both vertebral and appendicular fracture rates have been demonstrated in the phase III trial of teriparatide, involving elderly women with at least one prevalent vertebral fracture before the onset of therapy. However, there is as yet no evidence that the antifracture efficacy of PTH will be superior to the bisphosphonates, whereas cost-utility estimates suggest that teriparatide is significantly more expensive. Teriparatide should be considered as treatment for postmenopausal women and men with severe osteoporosis, as well as for patients with established glucocorticoid-induced osteoporosis who require long-term steroid treatment. Teriparatide should also be considered for the management of individuals at particularly high risk for fractures, including subjects who are younger than age 65 and who have particularly low bone mineral density measurements (T scores <3.5). Teriparatide therapy is not recommended for more than 2 yr, based, in part, on the induction of osteosarcoma in a rat model of carcinogenicity. Total daily calcium intake from both supplements and dietary sources should be limited to 1500 mg together with adequate vitamin D intake (",
author = "Hodsman, {Anthony B.} and Bauer, {Douglas C.} and Dempster, {David W.} and Larry Dian and Hanley, {David A.} and Harris, {Steven T.} and Kendler, {David L.} and McClung, {Michael R.} and Miller, {Paul D.} and Olszynski, {Wojciech P.} and Eric Orwoll and Chui, {Kin Yuen}",
year = "2005",
month = "8",
doi = "10.1210/er.2004-0006",
language = "English (US)",
volume = "26",
pages = "688--703",
journal = "Endocrine Reviews",
issn = "0163-769X",
publisher = "The Endocrine Society",
number = "5",

}

TY - JOUR

T1 - Parathyroid hormone and teriparatide for the treatment of osteoporosis

T2 - A review of the evidence and suggested guidelines for its use

AU - Hodsman, Anthony B.

AU - Bauer, Douglas C.

AU - Dempster, David W.

AU - Dian, Larry

AU - Hanley, David A.

AU - Harris, Steven T.

AU - Kendler, David L.

AU - McClung, Michael R.

AU - Miller, Paul D.

AU - Olszynski, Wojciech P.

AU - Orwoll, Eric

AU - Chui, Kin Yuen

PY - 2005/8

Y1 - 2005/8

N2 - All therapies currently recommended for the management of osteoporosis act mainly to inhibit bone resorption and reduce bone remodeling. PTH and its analog, teriparatide [recombinant human PTH(1-34)], represent a new class of anabolic therapies for the treatment of severe osteoporosis, having the potential to improve skeletal microarchitecture. Significant reductions in both vertebral and appendicular fracture rates have been demonstrated in the phase III trial of teriparatide, involving elderly women with at least one prevalent vertebral fracture before the onset of therapy. However, there is as yet no evidence that the antifracture efficacy of PTH will be superior to the bisphosphonates, whereas cost-utility estimates suggest that teriparatide is significantly more expensive. Teriparatide should be considered as treatment for postmenopausal women and men with severe osteoporosis, as well as for patients with established glucocorticoid-induced osteoporosis who require long-term steroid treatment. Teriparatide should also be considered for the management of individuals at particularly high risk for fractures, including subjects who are younger than age 65 and who have particularly low bone mineral density measurements (T scores <3.5). Teriparatide therapy is not recommended for more than 2 yr, based, in part, on the induction of osteosarcoma in a rat model of carcinogenicity. Total daily calcium intake from both supplements and dietary sources should be limited to 1500 mg together with adequate vitamin D intake (

AB - All therapies currently recommended for the management of osteoporosis act mainly to inhibit bone resorption and reduce bone remodeling. PTH and its analog, teriparatide [recombinant human PTH(1-34)], represent a new class of anabolic therapies for the treatment of severe osteoporosis, having the potential to improve skeletal microarchitecture. Significant reductions in both vertebral and appendicular fracture rates have been demonstrated in the phase III trial of teriparatide, involving elderly women with at least one prevalent vertebral fracture before the onset of therapy. However, there is as yet no evidence that the antifracture efficacy of PTH will be superior to the bisphosphonates, whereas cost-utility estimates suggest that teriparatide is significantly more expensive. Teriparatide should be considered as treatment for postmenopausal women and men with severe osteoporosis, as well as for patients with established glucocorticoid-induced osteoporosis who require long-term steroid treatment. Teriparatide should also be considered for the management of individuals at particularly high risk for fractures, including subjects who are younger than age 65 and who have particularly low bone mineral density measurements (T scores <3.5). Teriparatide therapy is not recommended for more than 2 yr, based, in part, on the induction of osteosarcoma in a rat model of carcinogenicity. Total daily calcium intake from both supplements and dietary sources should be limited to 1500 mg together with adequate vitamin D intake (

UR - http://www.scopus.com/inward/record.url?scp=21344454577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21344454577&partnerID=8YFLogxK

U2 - 10.1210/er.2004-0006

DO - 10.1210/er.2004-0006

M3 - Article

VL - 26

SP - 688

EP - 703

JO - Endocrine Reviews

JF - Endocrine Reviews

SN - 0163-769X

IS - 5

ER -