AI Article Synopsis
- Teriparatide (TPD) was found to significantly reduce the time-to-union for osteoporotic vertebral compression fractures compared to bisphosphonates (BP), achieving an 89% union rate at six months.
- Although TPD showed higher rates of surgical intervention, there were no severe complications leading to surgery in the TPD group, unlike the BP group where some patients required surgical treatment.
- Overall, while TPD may enhance fracture healing, its increased surgical intervention rate suggests further investigation is necessary to evaluate its long-term effects in comparison to bisphosphonates.
Article Abstract
Background: Teriparatide (recombinant human parathyroid hormone 1-34) is increasingly used for the treatment of severe osteoporosis because it stimulates bone formation and may potentially enhance fracture healing. The objective of this study was to investigate the effects of teriparatide versus a bisphosphonate on radiographic outcomes in the treatment of osteoporotic vertebral compression fractures (OVCF).
Methods: A total of 98 patients undergoing non-operative treatment for recent single-level OVCF were reviewed retrospectively. Thirty-eight patients were treated by a once-daily subcutaneous injection of 20 micrograms of teriparatide (TPD group), whereas 60 patients received 35 mg of alendronate weekly (BP group). Except for these medications, the same treatment protocol was applied to both groups. The radiographic assessments included union status, vertebral kyphosis, and mid-vertebral body height. The rates of fracture site surgical intervention were also compared between the two groups. The mean follow-up period was 27 months (median 22.5, range 2 - 75 months).
Results: Cox regression analysis showed that TPD reduced the time-to-union (adjusted relative hazard ratio: 1.86, 95% C.I.: 1.21 - 2.83). The union rate at six months after treatment was 89% in the TPD group and 68% in the BP group; the surgical intervention rate was significantly higher in the TPD group (p = 0.026, adjusted odds ratio: 8.15, 95% C.I.: 2.02 - 43.33). The change in local kyphosis was 4.6° in the TPD group and 3.8° in the BP group (p = 0.495, paired t-test). The change of mid-vertebral body height was 4.4 mm in the TPD group and 3.4 mm in the BP group (p = 0.228, paired t-test). Fracture site surgical interventions were not required in the TPD group; however, two patients in the BP group eventually underwent surgical treatment for symptomatic non-union or vertebral collapse.
Conclusions: This retrospective study suggests that teriparatide may enhance fracture healing and improve the union rate in OVCF.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384154 | PMC |
| http://dx.doi.org/10.1186/s12891-017-1509-1 | DOI Listing |
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