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A systematic review on the use of daily subcutaneous administration of teriparatide for treatment of patients with osteoporosis at high risk for fracture in Asia

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Abstract

This systematic review aimed to examine the evidence for teriparatide in Asia for osteoporosis with a high fracture risk and for exploratory (unapproved) bone-related indications. MEDLINE (1946+), EMBASE (1966+), and ClinicalTrials.gov (2008+) were searched (16 August 2013); all studies of daily subcutaneous teriparatide 20 μg for bone-related conditions from China, Hong Kong, Japan, Republic of Korea, Philippines, Singapore, and Taiwan were included. Evidence on efficacy/safety was retrieved primarily from randomized controlled trials (10 publications) of postmenopausal women from Japan and China. In these studies, teriparatide was well tolerated; subjects had significantly greater increases in lumbar spine bone mineral density (BMD) from baseline compared with placebo, antiresorptive agents, or elcatonin/calcitonin; bone turnover markers increased from baseline and were sustained at elevated levels during teriparatide treatment. Few studies reported fracture risk, pain, or quality of life; one study showed a lower incidence of new-onset vertebral fracture with teriparatide versus antiresorptive agents. Nonrandomized studies (nine publications, one unpublished trial) conducted mainly in Taiwan, Japan, and the Republic of Korea provided supporting data for efficacy. The exploratory (unapproved) use of teriparatide (17 publications) for fracture healing and osteonecrosis of the jaw was described primarily in case reports. The clinical effectiveness of teriparatide for treatment of postmenopausal women with osteoporosis who are at high risk of fracture in Asia is focused primarily on improvements in BMD and tolerability. Recommended additional studies may include assessment of fracture risk and the effect of teriparatide on pain, quality of life, and mortality in Asia.

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Acknowledgments

Medical writing assistance was provided by Serina Stretton, PhD, CMPP and Rebecca Lew, PhD, CMPP of ProScribe - Envision Pharma Group and was funded by Eli Lilly, manufacturer of teriparatide. ProScribe’s services complied with international guidelines for Good Publication Practice (GPP2).

Conflicts of interest

JF Chen serves as a speaker and consultant/advisor for Eli Lilly and Company, Taiwan. KH Yang and Z Zhang have no conflicts of interest that may influence the current work. HC Chang, Y Chen, H Sowa, and S Gürbüz are employees of Eli Lilly and Company or Eli Lilly Japan K.K. S Gürbüz is an Eli Lilly stockholder.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Chang Gung Memorial Hospital, No. 123, Dapi Rd, Niaosong District, Kaohsiung City, 83301, Taiwan

    J.F. Chen

  2. Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam, PO Box 1217, Seoul, Republic of Korea

    K. H. Yang

  3. Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 200233, Shanghai, China

    Z.L. Zhang

  4. Medical Division (Taiwan), Eli Lilly and Company, No. 365, Fu-Hsing North Road, Taipei, Taiwan, 105

    H.C. Chang

  5. Lilly Suzhou Pharmaceutical Co., Ltd, 21F, 1 Corporate Avenue, No. 222, Hu Bin Road, 200021, Shanghai, China

    Y. Chen

  6. Medical Science, Eli Lilly Japan K.K., Sannomiya Plaza Bldg 7-1-5, Isogamidori, Chuo-ku, Kobe, 651-0086, Japan

    H. Sowa

  7. Eli Lilly and Company, Lilly Corporate Centre, DC 1850, 893 S Delaware St, Indianapolis, IN, 46285, USA

    S. Gürbüz

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  1. J.F. Chen
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  3. Z.L. Zhang
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  5. Y. Chen
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Correspondence to S. Gürbüz.

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Chen, J., Yang, K.H., Zhang, Z. et al. A systematic review on the use of daily subcutaneous administration of teriparatide for treatment of patients with osteoporosis at high risk for fracture in Asia. Osteoporos Int 26, 11–28 (2015). https://doi.org/10.1007/s00198-014-2838-7

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  • DOI: https://doi.org/10.1007/s00198-014-2838-7

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