JBMR Online - Journal of Bone and Mineral Research - 20(9):1507

¹Department of Endocrinology and Diabetes and University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Australia;

²Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA;

³Department of Endocrinology, St Olav's University Hospital, Trondheim, Norway;

A follow-up in 1262 women was conducted after the discontinuation of teriparatide. The hazard ratio for combined teriparatide group (20 and 40 μg) for the 50-month period after baseline was 0.57 (p = 0.002), suggesting a sustained effect in reducing the risk of nonvertebral fragility fracture.

Introduction: Treatment with teriparatide [rhPTH(1-34)] 20 and 40 μg once-daily subcutaneous dosing significantly reduced the risk of nonvertebral fragility fractures over a median exposure of 19 months.

Materials and Methods: All participants in the Fracture Prevention Trial were invited to participate in a follow-up study. Prior treatment assignments were revealed, and patients were able to receive osteoporosis treatments without restriction.

Results: Approximately 60% of the 1262 patients received an osteoporosis treatment at some time during follow-up, with greater use in the former placebo group than in the combined former teriparatide group (p < 0.05). The hazard ratios for nonvertebral fragility fractures in each teriparatide group relative to placebo were statistically significant for the 50-month period including treatment and follow-up (p < 0.03). In the follow-up period, the hazard ratio was significantly different between the 40 μg and combined groups versus placebo but not for the 20 μg group versus placebo. However, the 20 and 40 μg groups were not different from each other. Kaplan-Meier analysis of time to fracture showed that the fracture incidence in the former placebo and teriparatide groups diverged during the 50-month period including teriparatide treatment and follow-up (p = 0.009). Total hip and femoral neck BMD decreased in teriparatide-treated patients who had no follow-up treatment; BMD remained stable or further increased in patients who received a bisphosphonate after teriparatide treatment.

Conclusions: While the study design is observational, the results support a sustained effect of teriparatide in reducing the risk of nonvertebral fragility fractures up to 30 months after discontinuation of treatment.

Cited by

John L Vahle, Ulrich Zuehlke, Allen Schmidt, Michael Westmore, Peiqi Chen and Masahiko Sato. (2008) Lack of Bone Neoplasms and Persistence of Bone Efficacy in Cynomolgus Macaques After Long-Term Treatment With Teriparatide [rhPTH(1-34)]. Journal of Bone and Mineral Research 23:12, 2033-2039
Online publication date: 1-Dec-2008.
Abstract | Full Text | Printable PDF (216 KB)

John P Bilezikian. (2008) Chapter 53.

Combination Anabolic and Antiresorptive Therapy for Osteoporosis. Primer 7:1, 252-254
Online publication date: 1-Jan-2008.
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Armen H Tashjian Jr and Robert F Gagel. (2006) Teriparatide [Human PTH(1-34)]: 2.5 Years of Experience on the Use and Safety of the Drug for the Treatment of Osteoporosis. Journal of Bone and Mineral Research 21:3, 388-365
Online publication date: 1-Mar-2006.
Citation | Full Text | Printable PDF (502 KB)

Louis G Ste-Marie, Sherwyn L Schwartz, Anwar Hossain, Durisala Desaiah and Gregory A Gaich. (2006) Effect of Teriparatide [rhPTH(1-34)] on BMD When Given to Postmenopausal Women Receiving Hormone Replacement Therapy. Journal of Bone and Mineral Research 21:2, 283-291
Online publication date: 1-Feb-2006.
Abstract | Full Text | Printable PDF (132 KB)