The use of parathyroid hormone in the treatment of osteoporosis.
Anabolic skeletal agents have recently broadened our therapeutic options for osteoporosis. By directly stimulating bone formation, they reduce fracture incidence by improving bone qualities in addition to increasing bone mass. Teriparatide [recombinant human parathyroid hormone(1-34)], the only anabolic agent currently approved in the United States for osteoporosis, has emerged as a major therapeutic approach to selected patients with osteoporosis. Teriparatide is approved for both postmenopausal women and men with osteoporosis who are at high risk for fracture. With the use of this anabolic agent, bone density and bone turnover increase, microarchitecture improves, and bone size is beneficially altered. The incidence of vertebral and nonvertebral fractures is reduced with teriparatide use. Combination therapy with parathyroid hormone and an antiresorptive does not appear to offer definitive advantages over the use of PTH or an antiresorptive alone, although recent ideas about combining these agents may offer new insights. In order to maintain increases in bone density acquired during PTH therapy, it is important to follow its use with an antiresorptive agent.
Girotra
Monica
M
Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W. 168th Street, New York, NY 10032, USA.
Rubin
Mishaela R
MR
Bilezikian
John P
JP
D045930:Anabolic Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D019379:Teriparatide / Q000009:adverse effects / Q000627:therapeutic use
D045930:Anabolic Agents; D050071:Bone Density Conservation Agents; C470125:PTH protein, human; D010281:Parathyroid Hormone; D019379:Teriparatide