Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review

Overview

Journal J Bone Metab

Date 2017 Mar 23

PMID 28326303

Citations 17

Authors

Sang-Min Kim

Kyung-Chung Kang

Ji Wan Kim

Seung-Jae Lim

Myung Hoon Hahn

Affiliations

Soon will be listed here.

Abstract

Background: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients.

Methods: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab].

Results: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis. Fracture location was 2 in pelvis, 3 in proximal femur, 1 in distal femur, 1 in shoulder, 2 in wrist and 2 in spine. The use of teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3. In terms of functional recovery, teriparatide injection was related with decrease in pain or shorter time to mobilization in 6 studies, but not related with pain numerical scale and mobility in 3.

Conclusions: Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. A better understanding of the role of teriparatide on osteoporotic fractures requires greater evidences from large volume prospective trials.

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References

Johansson T . PTH 1-34 (teriparatide) may not improve healing in proximal humerus fractures. A randomized, controlled study of 40 patients. Acta Orthop. 2015; 87(1):79-82. PMC: 4940597. DOI: 10.3109/17453674.2015.1073050. View

Peichl P, Holzer L, Maier R, Holzer G . Parathyroid hormone 1-84 accelerates fracture-healing in pubic bones of elderly osteoporotic women. J Bone Joint Surg Am. 2011; 93(17):1583-7. DOI: 10.2106/JBJS.J.01379. View

Aspenberg P, Johansson T . Teriparatide improves early callus formation in distal radial fractures. Acta Orthop. 2010; 81(2):234-6. PMC: 2895344. DOI: 10.3109/17453671003761946. View

Kawaguchi H, Oka H, Jingushi S, Izumi T, Fukunaga M, Sato K . A local application of recombinant human fibroblast growth factor 2 for tibial shaft fractures: A randomized, placebo-controlled trial. J Bone Miner Res. 2010; 25(12):2735-43. DOI: 10.1002/jbmr.146. View

Orive M, Aguirre U, Garcia-Gutierrez S, Las Hayas C, Bilbao A, Gonzalez N . Changes in health-related quality of life and activities of daily living after hip fracture because of a fall in elderly patients: a prospective cohort study. Int J Clin Pract. 2015; 69(4):491-500. DOI: 10.1111/ijcp.12527. View

Lindsay R, Scheele W, Neer R, Pohl G, Adami S, Mautalen C . Sustained vertebral fracture risk reduction after withdrawal of teriparatide in postmenopausal women with osteoporosis. Arch Intern Med. 2004; 164(18):2024-30. DOI: 10.1001/archinte.164.18.2024. View

Ha Y, Park Y, Nam K, Kim S . Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci. 2015; 30(4):483-8. PMC: 4366971. DOI: 10.3346/jkms.2015.30.4.483. View

Alkhiary Y, Gerstenfeld L, Krall E, Westmore M, Sato M, Mitlak B . Enhancement of experimental fracture-healing by systemic administration of recombinant human parathyroid hormone (PTH 1-34). J Bone Joint Surg Am. 2005; 87(4):731-41. DOI: 10.2106/JBJS.D.02115. View

Lou S, Lv H, Wang G, Zhang L, Li M, Li Z . The Effect of Teriparatide on Fracture Healing of Osteoporotic Patients: A Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2016; 2016:6040379. PMC: 4939202. DOI: 10.1155/2016/6040379. View

10.

Kurland E, Cosman F, McMahon D, Rosen C, Lindsay R, Bilezikian J . Parathyroid hormone as a therapy for idiopathic osteoporosis in men: effects on bone mineral density and bone markers. J Clin Endocrinol Metab. 2000; 85(9):3069-76. DOI: 10.1210/jcem.85.9.6818. View

11.

Magaziner J, Hawkes W, Hebel J, Zimmerman S, Fox K, Dolan M . Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci. 2000; 55(9):M498-507. DOI: 10.1093/gerona/55.9.m498. View

12.

Aspenberg P, Genant H, Johansson T, Nino A, See K, Krohn K . Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res. 2009; 25(2):404-14. DOI: 10.1359/jbmr.090731. View

13.

Barnes G, Kakar S, Vora S, Morgan E, Gerstenfeld L, Einhorn T . Stimulation of fracture-healing with systemic intermittent parathyroid hormone treatment. J Bone Joint Surg Am. 2008; 90 Suppl 1:120-7. DOI: 10.2106/JBJS.G.01443. View

14.

Yoo J, Moon S, Ha Y, Lee D, Gong H, Park S . Osteoporotic Fracture: 2015 Position Statement of the Korean Society for Bone and Mineral Research. J Bone Metab. 2015; 22(4):175-81. PMC: 4691591. DOI: 10.11005/jbm.2015.22.4.175. View

15.

Orwoll E, Scheele W, Paul S, Adami S, Syversen U, Diez-Perez A . The effect of teriparatide [human parathyroid hormone (1-34)] therapy on bone density in men with osteoporosis. J Bone Miner Res. 2003; 18(1):9-17. DOI: 10.1359/jbmr.2003.18.1.9. View

16.

Binder E, Brown M, Sinacore D, Steger-May K, Yarasheski K, Schechtman K . Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA. 2004; 292(7):837-46. DOI: 10.1001/jama.292.7.837. View

17.

Morimoto T, Kaito T, Kashii M, Matsuo Y, Sugiura T, Iwasaki M . Effect of Intermittent Administration of Teriparatide (Parathyroid Hormone 1-34) on Bone Morphogenetic Protein-Induced Bone Formation in a Rat Model of Spinal Fusion. J Bone Joint Surg Am. 2014; 96(13):e107. DOI: 10.2106/JBJS.M.01097. View

18.

Komrakova M, Stuermer E, Werner C, Wicke M, Kolios L, Sehmisch S . Effect of human parathyroid hormone hPTH (1-34) applied at different regimes on fracture healing and muscle in ovariectomized and healthy rats. Bone. 2010; 47(3):480-92. DOI: 10.1016/j.bone.2010.05.013. View

19.

Bhandari M, Jin L, See K, Burge R, Gilchrist N, Witvrouw R . Does Teriparatide Improve Femoral Neck Fracture Healing: Results From A Randomized Placebo-controlled Trial. Clin Orthop Relat Res. 2016; 474(5):1234-44. PMC: 4814417. DOI: 10.1007/s11999-015-4669-z. View

20.

Chiang C, Zebaze R, Ghasem-Zadeh A, Iuliano-Burns S, Hardidge A, Seeman E . Teriparatide improves bone quality and healing of atypical femoral fractures associated with bisphosphonate therapy. Bone. 2012; 52(1):360-5. DOI: 10.1016/j.bone.2012.10.006. View