Effects of Weekly Teriparatide Administration for Vertebral Stability and Bony Union in Patients with Acute Osteoporotic Vertebral Fractures

Study Design: An open-label, non-randomized prospective study. Purpose: Teriparatide (TPTD) is known to be an antiosteoporotic agent that may accelerate the healing of fractures. This study was designed to investigate the effect of once-weekly TPTD administration on vertebral stability and bony union after acute osteoporotic vertebral fracture (OVF). Overview of Literature: Once-weekly TPTD administration can lead to early vertebral stability and promote bony union of fractured vertebrae in patients with severe osteoporosis. Methods: Forty-eight subjects with acute OVF were assigned to receive activated vitamin D3 and calcium supplementation or once-weekly subcutaneous injection of TPTD (56.5 mu g) in combination with activated vitamin D3 and calcium supplementation for 12 weeks. Vertebral stability was assessed using lateral plain radiography. Vertebral height at the anterior location (VHa) and the difference in VHa {Delta VHa=VHa (supine position)-VHa (weight-bearing position)} were measured at baseline and 12 weeks after starting treatment. Bony union was defined as the absence of a vertebral cleft or abnormal motion (Delta VHa >2 mm). Results: Although not significant, Delta VHa, indicating vertebral stability, tended to be lower in the TPTD group at 12 weeks (p=0.17). As for subjects with severe osteoporosis, Delta VHa at 12 weeks was significantly lower in the TPTD group than in the control group (mean Delta VHa: control group, 3.1 mm (n=15); TPTD group, 1.4 mm (n=16); p=4.02). The rate of bony union was significantly higher in the TPTD group than in the control group (control group, 40%; TPTD group, 81%; p=0.03). Conclusions: Once-weekly TPTD administration may facilitate early bony union after acute OVF accompanied by severe osteoporosis.