Parathyroid hormone for osteoporosis treatment

Osteoporosis may cause disastrous fractures and is a great threat to old people. Different medicines, including calcitonin, selective estrogen receptor modulators (SERM) and bisphosphonates, have been developed to treat the condition. In contrast to these bone resorption antagonists, parathyroid hormone (teriparatide) which works through the regulation of calcium and phosphate metabolism can increase bone deposition. Patients given teriparatide (20 μg) daily for 2 years experienced a significant increase in hip bone bone mineral density (BMD) of 3.5% and 3.9% after 1 and 2 years, respectively, as well as a significant increase in vertebra BMD of 7.2% and 10.9% after 1 and 2 years, respectively. Teriparatide treatment also reduced the risk of one or more new vertebral fractures in postmenopausal women with osteoporosis by 65% and the risk of multiple new vertebral fractures by 77%. Furthermore, teriparatide resulted in a 53% decrease in the risk for nonvertebral osteoporotic fractures and a 90% decrease in moderate or severe new nonvertebral fractures. Compared to alendronate, 12-month treatment with teriparatide resulted in greater increases in femoral neck and total hip BMD. Also, patients treated with teriparatide tended to be at lower risk of nonvertebral fractures, 4.1% in the teriparatide group versus 13.7% in the alendronate group. If there is a need to switch from bisphosponates to teriparatide, a 6-month interval is recommended to prevent interference with the osteogenic effects of teriparatide. Other effects of teriparatide, including stimulation of bone healing and osteoconduction in porous joint replacement materials that may be extensively applied to orthopedic clinical practice, warrant further studies and confirmation.