Teriparatide for Bone Formation in Hip Fractures

(©Muratart,Shutterstock.com)

Teriparatide, a recombinant human parathyroid hormone analog [rhPTH(1-34)] approved for women and men with osteoporosis, has been shown to renew bone tissue in patients with femoral neck fractures of the hip, according to research presented at the American Society for Bone and Mineral Research (ASBMR) annual meeting which was held this week.

Previously, teriparatide (Forteo, Lilly) was not shown to have a significant effect on reducing hip fractures.

"This study is reassuring to both patients and doctors that teriparatide has an immediate positive effect on bone formation at this, the most serious sites of osteoporosis-related fractures,” said David Dempster, Ph.D., of Columbia University in New York, who presented the results on September 12. “This is the first histological study to look at the effects of any osteoporosis drug on the human femur.”

This was a double-blind trial of 35 patients undergoing total hip replacement for osteoarthritis. Participants were randomized to receive teriparatide daily or a placebo for an average of six weeks before surgery.

In cancellous and endocortical bone tissue, remodeling-based bone formation was significantly higher in patients treated with teriparatide than in the placebo group. In the intracortical and periosteal tissue sections, no significant differences were observed in any parameter. These findings are similar to those seen with early teriparatide in the iliac crest.

“Teriparatide rapidly stimulates bone formation in the human femoral neck. Formation occurs primarily in and around existing remodeling units but there is also stimulation of modeling based formation (i.e. formation without resorption), which is a very efficient way to build bone mass,” Dr. Dempster said.

_______________

REFERENCE

[1039] Effects of Teriparatide on Modeling-based and Remodeling-based Bone Formation in the Human Femoral Neck. David Dempster. September 12. ASMBR 2020 Annual Meeting Virtual Event.