Osteoporosis is a common condition among postmenopausal women. After menopause, hormonal changes in the body lead to a reduction of bone mass and a corresponding increased risk of fracture, particularly of the hips and vertebrae. Typical osteoporosis treatment methods include bone-building exercise, calcium and vitamin D supplementation and medications that destroy bone-consuming cells, such as Fosamax.
These treatment modalities don’t work for everyone. People with severe osteoporosis face many challenges, including disability and early mortality. There is a medication available that sparks the body’s bone growing mechanisms, but this medication comes with serious risks.
Teriparatide: The Benefits
Teriparatide is an injectable medication. It’s a synthetic version of parathyroid hormone that contains 34 amino acids. Its brand name is Forteo.
Research into the medication in patients with severe osteoporosis and high fracture risk has yielded promising results. Though there are relatively few studies and the available studies have short durations (under two years), they have found teriparatide to cause increased bone density and decreased fracture risk.
A study into women with osteoporosis found those who took teriparatide to be 35-40% less likely to incur a new non-vertebral fracture than those taking a placebo. Another study into men with osteoporosis found a 5.9-9% increase in lumbar vertebral bone density (depending on dosage, with higher dosage corresponding with greater increases in bone density) and 0.9-1.5% increase in femoral bone density (with great increases in bone density corresponding to lower dosage).
The systematic review containing the above results dates back to 2004. Due to the small number of studies into this drug, more research is needed to either verify or contest these results. See more on the review at www.ncbi.nlm.nih.gov.
There’s a reason that studies into teriparatide for humans have short durations: Animal studies have shown high rates of osteosarcoma, a rare but often fatal form of bone cancer, among rats taking the medication.
Cancer occurs when damaged cells reproduce quickly, form tumors and spread throughout the body. Teriparatide likely increases bone cancer risk because it increases cell production, providing a ripe environment for cancerous cell proliferation.
There is to date no sure figure on the percentage of osteosarcoma incidences among patients taking Forteo; the incidence in the general population is about 4 in a million. As of 2009, three cases among Forteo takers had been reported. See more on this at www.betterbones.com.
Given its risks, teriparatide is not for people with mild osteoporosis or for preventative purposes. It is a treatment decision that requires serious consideration, full knowledge of risks and a benefit/risk analysis.
For more information on teriparatide and its risks, see www.fda.gov.
There are many possible paths to bone fracture prevention; though teriparatide may be the most successful for those with severe osteoporosis, it may also be the most risky. Consider this medication only as a last resort.