Osteoporosis: teriparatide superior to standard care in reducing vertebral fracture risk

  • Oswald AJ & al.
  • Calcif Tissue Int
  • 21 May 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Teriparatide (TPTD) was superior to standard care in improving bone mineral density (BMD) and reducing the risk for vertebral fracture in women with severe spinal osteoporosis.

Why this matters

  • Current NICE guidelines suggest TPTD is recommended as an alternative treatment option in postmenopausal women for secondary prevention of osteoporotic fractures.
  • Previous study has shown that TPTD was superior to standard care at reducing the risk for vertebral fractures in severe osteoporosis over a 5-year period.

Study design

  • An extended observational study of 724 women with severe osteoporosis who received TPTD treatment (20 μg daily; n=496) following anti-resorptive therapy and standard care treatment (n=228) and followed up over 11.5 years.
  • Changes in BMD and risk for fracture were assessed both during the TPTD therapy and after, following the anti-resorptive therapy.
  • Funding: Eli Lilly.

Key results

  • TPTD group were younger (69.6 vs 74.1 years) and had a lower overall 10-year (25.7% vs 28.6%) and hip fracture risk (12.5% vs 15.9%; P<.001 for both vs standard care.>
  • TPTD group had a significantly greater increase in lumbar spine BMD (7.2% vs 4.4% per year; P=.00) and a lower risk for vertebral fractures (4.8% vs 10.1%; P=.01).
  • No significant difference was observed in femoral neck BMD (1.5% vs 2.0% per year; P=.50) and risk for non-vertebral fractures (21.2% vs 21.5%; P=.92).

Limitations

  • Observational design.
  • Information on side effects not systematically collected.