Effects of Weekly Teriparatide Administration for Vertebral Stability and Bony Union in Patients with Acute Osteoporotic Vertebral Fractures

• Main Authors: Kazuma Kitaguchi, Masafumi Kashii, Kosuke Ebina, Satoru Sasaki, Yasunori Tsukamoto, Hideki Yoshikawa, Tsuyoshi Murase
• Format: Article
• Language: English
• Published: Korean Spine Society 2019-10-01
• Series: Asian Spine Journal
• Subjects: Vertebral fracture; Osteoporosis; Bony union; Teriparatide; Vertebral height
• Online Access: http://www.asianspinejournal.org/upload/pdf/asj-2018-0311.pdf
• ISSN: 1976-1902; 1976-7846

Study Design An open-label, non-randomized prospective study. Purpose Teriparatide (TPTD) is known to be an antiosteoporotic agent that may accelerate the healing of fractures. This study was designed to investigate the effect of once-weekly TPTD administration on vertebral stability and bony union after acute osteoporotic vertebral fracture (OVF). Overview of Literature Once-weekly TPTD administration can lead to early vertebral stability and promote bony union of fractured vertebrae in patients with severe osteoporosis. Methods Forty-eight subjects with acute OVF were assigned to receive activated vitamin D3 and calcium supplementation or onceweekly subcutaneous injection of TPTD (56.5 μg) in combination with activated vitamin D3 and calcium supplementation for 12 weeks. Vertebral stability was assessed using lateral plain radiography. Vertebral height at the anterior location (VHa) and the difference in VHa {ΔVHa=VHa (supine position)−VHa (weight-bearing position)} were measured at baseline and 12 weeks after starting treatment. Bony union was defined as the absence of a vertebral cleft or abnormal motion (ΔVHa >2 mm). Results Although not significant, ΔVHa, indicating vertebral stability, tended to be lower in the TPTD group at 12 weeks (p =0.17). As for subjects with severe osteoporosis, ΔVHa at 12 weeks was significantly lower in the TPTD group than in the control group (mean ΔVHa: control group, 3.1 mm (n=15); TPTD group, 1.4 mm (n=16); p =0.02). The rate of bony union was significantly higher in the TPTD group than in the control group (control group, 40%; TPTD group, 81%; p =0.03). Conclusions Once-weekly TPTD administration may facilitate early bony union after acute OVF accompanied by severe osteoporosis.