Teriparatide
aka PTH 1-34 · Parathyroid Hormone (1-34) · rhPTH(1-34) · Forteo · Bonsity
Mechanism
Recombinant human parathyroid hormone fragment consisting of the biologically active N-terminal 34 amino acids of endogenous PTH (PTH 1-34). It is a PTH1 receptor (PTH1R) agonist; when administered as a once-daily intermittent injection it preferentially stimulates osteoblast-mediated bone formation, increasing bone mineral density and reducing fracture risk. Teriparatide is FDA-approved (originally as Forteo, approved 2002) for osteoporosis at high fracture risk in postmenopausal women, men, and glucocorticoid-induced osteoporosis, and was the first anabolic (bone-building) osteoporosis therapy. It is one of the few peptides in this directory with full FDA marketing approval.
Studied uses
- treatment of osteoporosis at high fracture risk (FDA-approved)
- glucocorticoid-induced osteoporosis (FDA-approved)
- off-label investigational use in fracture healing and bone defects
Identification
| CAS number | 52232-67-4 |
|---|---|
| Molecular formula | C181H291N55O51S2 |
| Sequence | SVSEIQLMHNLGKHLNSMERVEWLRKKLQDVHNF |
| Typical dose | 20 mcg once daily subcutaneous (approved labeling); maximum cumulative use historically limited to ~2 years |
| Half-life | ~1 hour after subcutaneous injection (serum), though the systemic exposure window is short; longer than after intravenous administration (~5 minutes) |
Safety
FDA-approved. Labeling carried a boxed warning for osteosarcoma based on rat studies (the 2-year cumulative-use limit and boxed warning were removed by the FDA in 2020 after long-term human data did not show increased osteosarcoma risk). Contraindicated/cautioned in patients at increased baseline osteosarcoma risk (e.g., Paget disease, prior skeletal radiation, unexplained elevated alkaline phosphatase). Common effects include orthostatic hypotension and transient hypercalcemia. Not a WADA-prohibited substance.
Vendors selling Teriparatide
No vendor listings on file yet.
Research
Rationale Teriparatide (TPT) is a synthetic peptide primarily used in the clinical treatment of osteoporosis, with its reference materials available from both synthetic and recombinant DNA origin used for generic drug preparations.
source →Purpose Teriparatide is a potent anabolic therapy for osteoporosis and is frequently prescribed after prior bisphosphonate (BP) treatment in routine clinical practice. Whether such pretreatment alters teriparatide efficacy, particularly with respect to fracture outcomes, remains uncertain.
source →Case A 32-year-old man with end-stage renal disease (ESRD) from anti-neutrophil cytoplasmic antibody-associated vasculitis and tertiary hyperparathyroidism, presented with progressive right hip pain. A giant cell-rich lesion biopsy confirmed Brown tumor.
source →Calcium sensing receptor (CaSR) variants are a rare cause of congenital hypoparathyroidism. Current standard treatment consists of calcitriol and calcium supplements, but this regimen increases the risk of kidney complications due to hypercalciuria.
source →Importance Osteogenesis imperfecta causes multiple fractures throughout life, causing substantial morbidity. Objective To determine whether the parathyroid hormone analogue teriparatide followed by zoledronic acid reduces the risk of fractures in adults with osteogenesis imperfecta.
source →Teriparatide, (recombinant human PTH 1-34) is an Food and Drug Administration (FDA)-approved anabolic therapy for osteoporosis.
source →Background : Despite stable fixation, aseptic tibial shaft nonunion represents a severe orthopedic complication. Teriparatide and adipose-derived stem-cell augmentation have been proposed as biological supports, but comparative clinical evidence remains limited.
source →This study evaluated whether prior anti-osteoporosis medication (AOM) use influences fracture risk in patients at very high fracture risk who subsequently initiated teriparatide. Using a nationwide cohort of 14,770 patients, participants were categorized based on prior AOM exposure.
source →This observational study of teriparatide-treated PLO documents a substantial effect of postpartum treatment timing on BMD response.
source →Objectives This randomised controlled trial assessed the effectiveness and safety of weekly 56.5 μg teriparatide (SAL056) compared to alendronate in postmenopausal women in China with osteoporosis at high risk of fractures over 48 weeks.
source →Ankle fractures are among the most common fragility fractures in older adults. Osteoporosis, age-related impairment of bone regeneration, and multimorbidity increase the risk of delayed union, nonunion, and postoperative complications.
source →Parathyroid hormone is the main hormonal regulator of bone remodeling; thus, chronic hypoparathyroidism (HypoPT) leads to low bone turnover that might compromise bone strength, despite the normal or even high bone mineral density. Recent studies suggest that fracture risk might be increased in patients with HypoPT.
source →This study is a 1:1 randomized controlled trial with an intervention for 18 months and a follow up period of 12 months. The purpose of the study is to assess the safety and efficacy of recombinant human parathyroid hormone for treatment of adynamic bone disorder in patients with chronic kidney disease.
source →Pediatric hypoparathyroidism is an orphan disease. Conventional management combines native and active vitamin D, calcium supplementation and sometimes phosphate binders, with the risk of long term hypercalciuria, nephrocalcinosis and further renal impairment.
source →Objective: This is a randomized controlled trial (RCT) in osteoporosis patients randomized to standard parathyroid hormone (PTH) treatment alone or to standard PTH treatment and Whole-body vibration (WBV). PTH is an effective but expensive anabolic treatment for osteoporosis. WBV stimulates muscles and bones.
source →The objective of this study is to investigate the pharmacokinetics, safety, and tolerability of AK159 administered to healthy postmenopausal women.
source →Parathyroid (PTH) hormone has been shown to enhance fracture healing in animal studies. There are so far only three published papers concerning humans. Postero-lateral fusions have shown a healing rate of less than 50% after bone.
source →This is a 12 month study designed to evaluate the safety and effectiveness of SB-751689 in the treatment of osteoporosis in post-menopausal women, in comparison with 2 active comparators and placebo.
source →The purpose of this study is to evaluate the adequacy of zoledronic acid in maintaining bone mass after two years of treatment with Forteo, in postmenopausal women.
source →To determine how prior therapy with alendronate or risedronate in postmenopausal women with osteoporosis influences the clinical effectiveness of teriparatide; The primary objective of the study is to compare the teriparatide (human, recombinant PTH\[1-34\])-associated change from baseline in a marker of bone formation…
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