Teriparatide more effective than alendronate for drug-induced osteoporosis

Teriparatide, a recombinant human parathyroid hormone, is more effective than alendronate, a bisphosphonate, in improving bone mineral density (BMD) and reducing fractures in patients with glucocorticoid-induced osteoporosis, according to a report in the Nov. 15 issue of the New England Journal of Medicine.

Kenneth G. Saag, MD, from the University of Alabama at Birmingham, and colleagues randomly assigned 428 men and women with osteoporosis who had received glucocorticoids for at least 3 months to either 20 μg teriparatide or 10 mg alendronate once a day for 18 months.

The researchers found that mean BMD at the lumbar spine increased significantly more in the teriparatide group (7.2%) versus the alendronate group (3.4%), which was evident after 6 months. The mean BMD in the hip also increased significantly more in patients treated with teriparatide, which was evident after 12 months. The teriparatide group had significantly fewer new vertebral fractures (0.6% vs. 6.1%) and at least one elevated measure of serum calcium.

Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007;357:2028-2039.