Journal of Bone and Mineral Metabolism

, Volume 32, Issue 4, pp 441–446 | Cite as

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

  • Tetsuo Nakano
  • Masataka Shiraki
  • Toshitsugu Sugimoto
  • Hideaki Kishimoto
  • Masako Ito
  • Masao Fukunaga
  • Hiroshi Hagino
  • Teruki Sone
  • Tatsuhiko Kuroda
  • Toshitaka Nakamura
Original Article


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.


Teriparatide Once-weekly injection Osteoporosis Vertebral fracture 


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Copyright information

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

Authors and Affiliations

  • Tetsuo Nakano
    • 1
  • Masataka Shiraki
    • 2
  • Toshitsugu Sugimoto
    • 3
  • Hideaki Kishimoto
    • 4
  • Masako Ito
    • 5
  • Masao Fukunaga
    • 6
  • Hiroshi Hagino
    • 7
  • Teruki Sone
    • 8
  • Tatsuhiko Kuroda
    • 9
  • Toshitaka Nakamura
    • 10
  1. 1.Tamana Central HospitalTamanaJapan
  2. 2.Research Institute and Practice for Involutional DiseasesAzuminoJapan
  3. 3.Internal Medicine 1Shimane University Faculty of MedicineIzumoJapan
  4. 4.Nojima HospitalKurayoshiJapan
  5. 5.Medical Work-Life-Balance CenterNagasaki University HospitalNagasakiJapan
  6. 6.Kawasaki Medical SchoolKurashikiJapan
  7. 7.School of Health Science and Rehabilitation Division, Faculty of MedicineTottori UniversityYonagoJapan
  8. 8.Department of Nuclear MedicineKawasaki Medical SchoolKurashikiJapan
  9. 9.Project for Bone Metabolic DiseaseAsahi Kasei Pharma CorporationTokyoJapan
  10. 10.National Center for Global Health and MedicineTokyoJapan

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