Teriparatide in postmenopausal osteoporosis: uncovering novel insights into efficacy and safety compared to other treatments - a systematic review and meta-analysis.
Por:
Arthur Vithran DT, Essien AE, Rahmati M, Opoku M, Keon Yon D, López Sánchez GF, Koyanagi A, Smith L, Il Shin J, Xiao W, Liu S and Li Y
Publicada:
2 sep 2024
Ahead of Print:
2 sep 2024
Resumen:
OBJECTIVE: The aim of the study was to evaluate the efficacy and safety of teriparatide compared to other treatments for postmenopausal osteoporosis. METHODS: A review of studies from 2000 to January 2023 analyzed randomized controlled trials on postmenopausal women treated with teriparatide (PTH 1-34), comparing it to placebo or other osteoporosis treatments. The analysis focused on bone mineral density (BMD), bone turnover markers, and clinical outcomes, employing Review Manager 5.4.1 and the RoB 2 tool for bias assessment. RESULTS: Our analysis of 23 randomized controlled trials (RCTs) found that PTH (134) treatment significantly increased lumbar spine BMD (mean difference (MD) = 0.02, 95% CI: 0.01-0.03) and femoral neck BMD (MD = 0.01, 95% CI: 0.00-0.01). However, there were no significant changes in total hip and radial bone BMD among the 3536 and 2046 participants, respectively. We also found that PTH (1-34) increased P1NP in a larger cohort (n = 1415) when compared to osteocalcin (n = 206). Although the risk of adverse events increased (relative risk (RR) = 1.65, 95% CI: 1.32-2.07), the incidence of fractures decreased significantly (RR = 0.57, 95% CI: 0.45-0.072), with no significant difference observed in mortality rates between treatment and control groups. CONCLUSION: Teriparatide improves lumbar spine and femoral neck BMD in postmenopausal women. Particularly notable is the novel finding regarding its effect on radius BMD, an area less explored in previous research. Despite an uptick in adverse events, the marked decrease in fracture incidence confirms its clinical utility for high-risk osteoporosis patients, highlighting the necessity for ongoing investigations into its full skeletal effects.
Filiaciones:
Arthur Vithran DT:
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
Essien AE:
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
Rahmati M:
Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
Opoku M:
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
Keon Yon D:
Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
López Sánchez GF:
Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Smith L:
Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Il Shin J:
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
Xiao W:
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
Liu S:
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
Li Y:
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
Open Access
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