Archive | 2021
Teriparatide and abaloparatide treatment for osteoporosis
Abstract
Abstract Teriparatide (TPTD), approved in the United States in 2002, and abaloparatide (ABL), FDA-approved in 2017, are anabolic agents that interact with the PTH1 receptor in bone to increase the rate and extent of bone formation. Some clinical differences between the compounds may relate to the relative affinities of these agents to different conformations of the receptor (RG and R0). Both agents improve bone mass and help restore bone microstructure. When administered by daily subcutaneous injection over 18–24 months, these agents reduce the incidence of both vertebral and nonvertebral fractures. The fracture risk reductions occur more rapidly and are of greater magnitude than those seen with antiresorptive agents. Therefore these anabolic medications should be considered first-line therapy for patients at very high imminent risk of fracture, such as those with recent clinical fracture, recently diagnosed radiographic vertebral fracture, or history of multiple fractures. TPTD and ABL should be followed by potent antiresorptive agents to maintain or enhance bone mass and bone strength.