Teriparatide
Teriparatide is a synthetic form of human parathyroid hormone that increases bone formation. Teriparatide reduces the incidence of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Teriparatide has been shown to increase bone mineral density (BMD) in men, but it has not been studied for fracture prevention in men.
Teriparatide’s use is limited by strict eligibility criteria for Pharmaceutical Benefits Scheme (PBS) subsidy—therapy must be started by a specialist, and the patient must have a T-score of –3 or less, and at least two minimal-trauma fractures, including a fracture after at least one year of antiresorptive therapy. Patients previously treated with PBS-subsidised romosozumab are not eligible for PBS-subsidised teriparatide1.
Do not use teriparatide in patients:
- younger than 25 years (especially children)
- with known or suspected Paget disease of bone
- who have previously had radiotherapy involving bone
- with pre-existing hypercalcaemia, malignancy, severe kidney disease or primary hyperparathyroidism.
If teriparatide is indicated, a suitable regimen is:
teriparatide 20 micrograms subcutaneously, once daily. osteoporosis teriparatide teriparatide teriparatide
The maximum lifetime duration of teriparatide is 24 months2. Following a course of teriparatide, start antiresorptive therapy (ie a bisphosphonate or denosumab) to increase BMD further and maintain the antifracture effect.
Teriparatide caused bone osteosarcomas in rats, but this effect has not been observed in humans.