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The use of parathyroid hormone in the treatment of osteoporosis

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Abstract

Anabolic skeletal agents have recently broadened our therapeutic options for osteoporosis. By directly stimulating bone formation, they reduce fracture incidence by improving bone qualities in addition to increasing bone mass. Teriparatide [recombinant human parathyroid hormone(1–34)], the only anabolic agent currently approved in the United States for osteoporosis, has emerged as a major therapeutic approach to selected patients with osteoporosis. Teriparatide is approved for both postmenopausal women and men with osteoporosis who are at high risk for fracture. With the use of this anabolic agent, bone density and bone turnover increase, microarchitecture improves, and bone size is beneficially altered. The incidence of vertebral and nonvertebral fractures is reduced with teriparatide use. Combination therapy with parathyroid hormone and an antiresorptive does not appear to offer definitive advantages over the use of PTH or an antiresorptive alone, although recent ideas about combining these agents may offer new insights. In order to maintain increases in bone density acquired during PTH therapy, it is important to follow its use with an antiresorptive agent.

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Abbreviations

BMD:

bone mineral density

BMI:

body mass index

DXA:

dual X-ray absorptiometry

FDA:

Food and Drug Administration

GH:

growth hormone

GIO:

glucocorticoid-induced osteoporosis

IGF-1:

insulin-like growth factor

IGFBP-3:

insulin-like growth factor binding protein-3

PTH:

parathyroid hormone

QCT:

quantitative computed tomography

rhIGF-1:

recombinant human insulin-like growth factor

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Acknowledgment

Some of the data reported in this review were obtained through support of a grant from the National Institutes of Health (NIDDK 32333).

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Authors and Affiliations

  1. Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W. 168th Street, New York, NY, 10032, USA

    Monica Girotra, Mishaela R. Rubin & John P. Bilezikian

  2. Department of Pharmacology, College of Physicians and Surgeons, Columbia University, 630 W. 168th Street, New York, NY, 10032, USA

    John P. Bilezikian

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  1. Monica Girotra
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  2. Mishaela R. Rubin
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Correspondence to John P. Bilezikian.

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Girotra, M., Rubin, M.R. & Bilezikian, J.P. The use of parathyroid hormone in the treatment of osteoporosis. Rev Endocr Metab Disord 7, 113–121 (2006). https://doi.org/10.1007/s11154-006-9007-z

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