Abstract
Osteoporosis is defined as a disease characterized by low bone mass and deterioration of the bone tissue microarchitecture. Teriparatide stimulates the formation and action of osteoblasts, which are responsible for bone formation, thus promoting bone tissue increase. The aim was to assess the effectiveness and safety of teriparatide for treating postmenopausal osteoporosis. A systematic review was conducted using the Cochrane Collaboration methodology. 1) Teriparatide 20 microg or 40 microg versus placebo: there was a benefit from teriparatide, considering the following outcomes: reduction in the number of new vertebral and non-vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density. 2) Teriparatide 40 microg versus alendronate 10 mg/day for 14 months: there was no statistical difference regarding the incidence of new vertebral or non-vertebral fractures, although in the group that received teriparatide there was greater bone mineral density increase in the whole body, lumbar column and femur. 3) Estrogen plus teriparatide 25 microg versus estrogen: there was a benefit, considering the following outcomes: reduction in the number of new vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density after three years. When teriparatide is intermittently administered in low doses, it reduces the incidence of vertebral fractures (67%) and non-vertebral fractures (38%) and increases bone mineral density in the lumbar column and femur. There is a need for studies with longer observation in order to allow conclusions regarding the safety and duration of the therapeutic effects.
Highlights
Osteoporosis is a disease that is characterized by low bone mass and deterioration of the bone tissue microarchitecture, which cause bone fragility and increased risk of fractures.1 It is defined by bone densitometry as bone mineral density values lower than 2.5 standard deviations below the reference values.2 Fractures caused by low-level impact and increased mortality are the main outcomes from osteoporosis
When teriparatide is intermittently administered in low doses, it reduces the incidence of vertebral fractures (67%) and nonvertebral fractures (38%) and increases bone mineral density in the lumbar column and femur
There was no difference between the two doses of teriparatide when considering whole-body bone mineral density (RR -11.4; CI -3.08 to 0.28), lumbar bone mineral density (RR -4.00; CI -5.07 to -2.93) or femoral bone mineral density (RR -1.00; CI -0.95 to -0.05)
Summary
Osteoporosis is a disease that is characterized by low bone mass and deterioration of the bone tissue microarchitecture, which cause bone fragility and increased risk of fractures. It is defined by bone densitometry as bone mineral density values lower than 2.5 standard deviations below the reference values. Fractures caused by low-level impact and increased mortality are the main outcomes from osteoporosis. Osteoporosis is a disease that is characterized by low bone mass and deterioration of the bone tissue microarchitecture, which cause bone fragility and increased risk of fractures.. Osteoporosis is a disease that is characterized by low bone mass and deterioration of the bone tissue microarchitecture, which cause bone fragility and increased risk of fractures.1 It is defined by bone densitometry as bone mineral density values lower than 2.5 standard deviations below the reference values.. Fractures caused by low-level impact and increased mortality are the main outcomes from osteoporosis. The etiology of approximately 70% of hip fractures has been attributed to osteoporosis, with mortality ranging from 12 to 34%.6. In the United States, approximately 10% of these patients become incapacitated following hip fractures, and 19% of them are institutionalized.. Such patients present two to three times greater chance of dying than do individuals who have not had fractures. After suffering a hip fracture, only 30 to 40% of such individuals return to their usual activities. In the United States, approximately 10% of these patients become incapacitated following hip fractures, and 19% of them are institutionalized. In 2002, the expenditure on patients with osteoporosis exceeded 17 billion dollars, taking into account hospitalizations, home visits, physiotherapy and nursing.
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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