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KMID : 1024720160060020035
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Geriatric Rehabilitation
2016 Volume.6 No. 2 p.35 ~ p.41
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Clinical Guidelines for the Use of Parathyroid Hormone in the Treatment of Osteoporosis
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Seo Kyoung-Ho
Jung Soo-Jin
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Abstract
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Anabolic agents results in the formation of new bone in both trabecular and cortical envelopes and thus partially repair the deterioration in microarchitecture that leads to the increased fragility of adult osteoporotic bone. Teriparatide (PTH[I-34]) opened new era of remodeling of osteoporotic bone and recommended as a treatment option for the secondary prevention of osteoporotic fragility fracture in women aged 65 years and older who have had an unsatisfactory response to bisphosphonates or intolerance to bisphosphonates and who have extremely low BMD (T score ~-4SD or below). Due to carcinogenicity studies demonstrating an increased incidence of osteosarcoma in rats treated from adolescence through to senescence, treatment with Teriparatide is limited to a maximum of 18months. There remain a number of important issues surrounding the use of PTH (1-34) and its interactions with bisphosphonates. Prior or concurrent use of alendronate appears to diminish the increments in BMD and biochemical markers of bone turnover induced by PTH (1-34). But variable combination therapy including risedronate, zolendronate, and calcitonin is continually tried and parts of their study shows increments of BMD and good results. At these times, due to lack of long-term use of PTH (1-34) and limited used of combination therapy with anti-resorptive drug, more comprehensive study is needed.
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KEYWORD
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Teriparatide, Parathyroid hormone, Osteoporosis, Combination therapy with anti-resoptive drug
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