The use of parathyroid hormone in the treatment of osteoporosis

  • Monica Girotra
  • Mishaela R. Rubin
  • John P. Bilezikian
Article

Abstract

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.

Keywords

Parathyroid hormone (as treatment for osteoporosis) Osteoporosis (treatment) Teriparatide Anabolic skeletal agents (parathyroid hormone) 

Abbreviations

BMD

bone mineral density

BMI

body mass index

DXA

dual X-ray absorptiometry

FDA

Food and Drug Administration

GH

growth hormone

GIO

glucocorticoid-induced osteoporosis

IGF-1

insulin-like growth factor

IGFBP-3

insulin-like growth factor binding protein-3

PTH

parathyroid hormone

QCT

quantitative computed tomography

rhIGF-1

recombinant human insulin-like growth factor

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Copyright information

© Springer Science + Business Media, LLC 2006

Authors and Affiliations

  • Monica Girotra
    • 1
  • Mishaela R. Rubin
    • 1
  • John P. Bilezikian
    • 1
    • 2
  1. 1.Department of Medicine, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  2. 2.Department of Pharmacology, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA

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