BoneKEy Reports | BoneKEy Watch
Teriparatide and fracture risk in postmenopausal women
DOI:10.1038/bonekey.2012.92
Teriparatide (TPTF) is known to reduce non-vertebral (NV) fractures in women with postmenopausal osteoporosis. This study evaluated the effects of teriparatide therapy in the Fracture Prevention Trial on NV fracture risk, according to several definitions and groupings of NV fractures, including those used by the Food and Drug Administration and the European Union. A total of 541 women in the treatment group were compared with 544 women given a placebo over a 21 month period. Nonvertebral fractures were recorded at various nonvertebral sites (wrist, humerus, rib/clavicle, pelvis, hip, foot, ankle and other). Investigators determined whether a fracture was due primarily to fragility or to trauma.
Treatment with TPTD 20 ugm/day reduced the incidence of fragility NV fracture by each of the several definitions. In contrast, traumatic NV fracture risk was not reduced by TPTD therapy.
Editor's comment: This study would have been more helpful if it had evaluated the effects of osteoporosis treatment on the four major osteoporotic fractures incorporated in FRAX. The capacity of a treatment to reduce the risk of nonvertebral fractures differs according to the fracture site and the degree of trauma involved; not all nonvertebral fractures have the same clinical implications. A clearer understanding of which fractures respond to osteoporosis treatments would be valuable for both clinicians and researchers designing clinical trials.
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