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The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration

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Abstract

Summary

We compared the effectiveness of promoting bone healing between two teriparatide preparations for atypical femoral fracture (AFF). A total of 45 AFFs were included in this study, and we compared the duration of bone union. Teriparatide administered by daily injection enhanced bone union more than weekly administration in complete AFFs.

Introduction

The efficacy of teriparatide for atypical femoral fracture (AFF) has been recently reported. Although two different teriparatide preparations can be used to treat osteoporosis in Japan, daily or weekly injection, all previous reports on the effectiveness of teriparatide for AFF only examined daily injection formulations. Therefore, we compared the promotion of bone healing between the two teriparatide preparations for AFF.

Methods

A total of 45 consecutive AFFs in 43 Japanese patients were included in this study. They received either a daily 20-μg teriparatide injection (daily group; n = 32) or a once-a-week 56.5-μg teriparatide injection (weekly group; n = 13). We compared the clinical background and duration of bone union between these two groups.

Results

When all patents were included, the fracture healing time was not significantly different between the two groups. Only patients with complete AFFs had significantly fewer daily bisphosphonate or denosumab injections than the weekly group (P < 0.05). The fracture healing time in the daily group (6.1 ± 4.1 months) was significantly shorter than that in the weekly group (10.1 ± 4.2 months) (P < 0.05). Even if the influence of bisphosphonate or denosumab usage was excluded, a similar significant difference was observed in the fracture healing time (P < 0.05). There was no significant difference between the two groups among patients with incomplete AFFs.

Conclusions

Daily teriparatide injections enhance bone union more than weekly injections in complete AFF patients.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    H. Tsuchie, N. Miyakoshi, Y. Kasukawa, K. Nozaka & Y. Shimada

  2. Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan

    K. Iba, T. Dohke, I. Kosukegawa & T. Yamashita

  3. Department of Orthopedic Surgery, Northern Akita Municipal Hospital, 16-29 Shimosugi aza Kamishimizusawa, Kitaakita, 018-4221, Japan

    T. Aizawa

  4. Department of Orthopedic Surgery, Ogachi Central Hospital, 25 Yamada aza Isamigaoka, Yuzawa, 012-0055, Japan

    S. Maekawa

  5. Department of Orthopedic Surgery, Ugo Municipal Hospital, 44-5 Otomichi, Nishomonai, Ugo, 012-1131, Japan

    H. Abe

  6. Department of Orthopedic Surgery, Honjyo Daiichi Hospital, 111 Iwabuchishita, Yurihonjyo, 015-8567, Japan

    M. Takeshima

  7. Department of Orthopedic Surgery, Japanese Red Cross Akita Hospital, 222-1 Saruta aza Inawashirosawa, Kamikitate, Akita, 010-1495, Japan

    T. Tomite

  8. Department of Orthopedic Surgery, Akita City Hospital, 4-30 Matsuokamachi, Kawamoto, Akita, 010-0933, Japan

    T. Segawa

  9. Department of Orthopedic Surgery, Yokote Municipal Hospital, 5-31 Negishimachi, Yokote, 013-8602, Japan

    K. Ouchi

  10. Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima, Nishifukuro, Akita, 011-0948, Japan

    H. Kinoshita

  11. Department of Orthopedic Surgery, Yuri Kumiai General Hospital, Kawaguchi aza Yaushiro, Yurihonjyo, 015-8511, Japan

    M. Suzuki

Authors
  1. H. Tsuchie
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  2. N. Miyakoshi
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  3. K. Iba
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  4. Y. Kasukawa
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  5. K. Nozaka
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  6. T. Dohke
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  7. I. Kosukegawa
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  8. T. Aizawa
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  9. S. Maekawa
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  10. H. Abe
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  11. M. Takeshima
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  12. T. Tomite
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  13. T. Segawa
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  14. K. Ouchi
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  15. H. Kinoshita
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  16. M. Suzuki
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  17. T. Yamashita
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  18. Y. Shimada
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Corresponding author

Correspondence to H. Tsuchie.

Ethics declarations

The study was approved by the Institutional Review Board for Clinical Research at our university, and informed consent was obtained from all patients.

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Tsuchie, H., Miyakoshi, N., Iba, K. et al. The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration. Osteoporos Int 29, 2659–2665 (2018). https://doi.org/10.1007/s00198-018-4658-7

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  • DOI: https://doi.org/10.1007/s00198-018-4658-7

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