Journal of Bone and Mineral Metabolism

, Volume 32, Issue 4, pp 441–446

Once-weekly teriparatide reduces the risk of vertebral fracture in patients with various fracture risks: subgroup analysis of the Teriparatide Once-Weekly Efficacy Research (TOWER) trial


    • Tamana Central Hospital
  • Masataka Shiraki
    • Research Institute and Practice for Involutional Diseases
  • Toshitsugu Sugimoto
    • Internal Medicine 1Shimane University Faculty of Medicine
  • Hideaki Kishimoto
    • Nojima Hospital
  • Masako Ito
    • Medical Work-Life-Balance CenterNagasaki University Hospital
  • Masao Fukunaga
    • Kawasaki Medical School
  • Hiroshi Hagino
    • School of Health Science and Rehabilitation Division, Faculty of MedicineTottori University
  • Teruki Sone
    • Department of Nuclear MedicineKawasaki Medical School
  • Tatsuhiko Kuroda
    • Project for Bone Metabolic DiseaseAsahi Kasei Pharma Corporation
  • Toshitaka Nakamura
    • National Center for Global Health and Medicine
Original Article

DOI: 10.1007/s00774-013-0505-2

Cite this article as:
Nakano, T., Shiraki, M., Sugimoto, T. et al. J Bone Miner Metab (2014) 32: 441. doi:10.1007/s00774-013-0505-2


Once-weekly teriparatide (human parathyroid hormone [1–34]) (56.5 μg for 72 weeks) injections provided a vertebral fracture risk reduction in Japanese osteoporotic patients evaluated in the Teriparatide Once-Weekly Efficacy Research (TOWER) trial. Using data from the TOWER trial, a subgroup analysis was performed to study the efficacy of once-weekly teriparatide for a variety of baseline clinical risk factors in placebo (n = 281) and teriparatide (n = 261) groups. Significant fracture risk reductions were observed in the subgroups of individuals aged <75 years [relative risk (RR) 0.06, p = 0.007] and ≥75 years (RR 0.32, p = 0.015). A significant risk reduction was observed among patients with prevalent vertebral fracture in the subgroup with 1 (RR 0.08, p = 0.015) or ≥2 (RR 0.29, p = 0.009) prevalent vertebral fractures, and in those with grade 3 deformity (RR 0.26, p = 0.003). Significant risk reduction was observed in the subgroup with lumbar bone mineral density (BMD) < −2.5 SD (RR 0.25, p = 0.035). In the teriparatide group, no incident fracture was observed in the subgroups with a prevalent vertebral fracture number of 0, with grade 0–2 vertebral deformity, or with lumbar BMD ≥2.5 SD. Significant risk reduction was observed in all of the bone turnover marker and estimated glomerular filtration rate subgroups. In conclusion, once-weekly 56.5 μg teriparatide injection reduced the vertebral fracture risk in patients with varying degrees of fracture risk, age, vertebral fracture number and grade, bone turnover level, and renal function.


TeriparatideOnce-weekly injectionOsteoporosisVertebral fracture

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013