The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration.

Abstract

We compared the effectiveness of promoting bone healing between two teriparatide preparations for atypical femoral fracture (AFF). A total of 45 AFFs were included in this study, and we compared the duration of bone union. Teriparatide administered by daily injection enhanced bone union more than weekly administration in complete AFFs.

INTRODUCTION:

The efficacy of teriparatide for atypical femoral fracture (AFF) has been recently reported. Although two different teriparatide preparations can be used to treat osteoporosis in Japan, daily or weekly injection, all previous reports on the effectiveness of teriparatide for AFF only examined daily injection formulations. Therefore, we compared the promotion of bone healing between the two teriparatide preparations for AFF.

METHODS:

A total of 45 consecutive AFFs in 43 Japanese patients were included in this study. They received either a daily 20-μg teriparatide injection (daily group; n = 32) or a once-a-week 56.5-μg teriparatide injection (weekly group; n = 13). We compared the clinical background and duration of bone union between these two groups.

RESULTS:

When all patents were included, the fracture healing time was not significantly different between the two groups. Only patients with complete AFFs had significantly fewer daily bisphosphonate or denosumab injections than the weekly group (P < 0.05). The fracture healing time in the daily group (6.1 ± 4.1 months) was significantly shorter than that in the weekly group (10.1 ± 4.2 months) (P < 0.05). Even if the influence of bisphosphonate or denosumab usage was excluded, a similar significant difference was observed in the fracture healing time (P < 0.05). There was no significant difference between the two groups among patients with incomplete AFFs.

CONCLUSIONS:

Daily teriparatide injections enhance bone union more than weekly injections in complete AFF patients.

• Authors: H Tsuchie, N Miyakoshi, K Iba, Y Kasukawa, K Nozaka, T Dohke, I Kosukegawa, T Aizawa, S Maekawa, H Abe, M Takeshima, T Tomite, T Segawa, K Ouchi, H Kinoshita, M Suzuki, T Yamashita, Y Shimada
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 29 Issue 12 Pg. 2659-2665 (Dec 2018) ISSN: 1433-2965 [Electronic] England
• PMID: 30105400 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Bone Density Conservation Agents
• Teriparatide

Topics

• Aged
• Aged, 80 and over
• Bone Density Conservation Agents (administration & dosage, therapeutic use)
• Combined Modality Therapy
• Drug Administration Schedule
• Female
• Femoral Fractures (drug therapy, physiopathology, surgery)
• Fracture Fixation, Internal (methods)
• Fracture Healing (drug effects)
• Humans
• Injections, Subcutaneous
• Male
• Middle Aged
• Osteoporotic Fractures (drug therapy, physiopathology, surgery)
• Retrospective Studies
• Teriparatide (administration & dosage, therapeutic use)