Adherence to Teriparatide Treatment and Risk of Fracture: A Systematic Review and Meta-Analysis

Abstract

To conduct a retrospective systematic review and meta-analysis of studies investigating the fracture risk among adherence versus non-adherence patients to treatment for osteoporosis. Cohort studies involving adherence to specifically Teriparatide treatment and the risk of fracture, published from inception to June 10 2019, were identified through PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus database of Systematic Reviews. Five eligible cohort studies were included for analysis. Overall, adherence, compared with nonadherence, had a significant 28% reduction in the risk of all fractures, an 49% reduction in the risk of hip fracture and an 26% reduction in the risk of non-vertebral fracture. Subgroup analyses showed that treatment compliant North American patients had a lower incidence of fracture than treatment compliant Asian patients. The effect size associated with adherence showed no difference with non-adherence when the analysis was limited to a small sample size (<10 000 patients). The findings of this retrospective review indicate that high compliance of Teriparatide treatment result in a decreased risk of fracture, particularly in North American treatment adherence, compared with Asian treatment adherence. Improvement of treatment adherence in patients with osteoporosis should be considered through various means in clinical practice.

Predictors for self-discontinuation of anti-osteoporosis medication: A hospital-based real-world study

“…In this study, denosumab discontinuation was defined as the absence of denosumab claim more than 6 months + 8 weeks since the last dose and without any anti-osteoporosis medication other than denosumab within 6 months + 8 weeks after prior denosumab treatment [ 17 , 18 ]. Teriparatide discontinuation was defined as the absence of any anti-osteoporosis medication more than 8 weeks after a prior dose of teriparatide and the duration of teriparatide treatment after the first dose was limited to less than 18 months [ 19 , 20 ]. Bisphosphonates or raloxifene discontinuation were defined as ≥12 months without any anti-osteoporosis medication prescription claims after prior bisphosphonate or raloxifene treatment [ 21 ].…”

Old Bones

“…Two parathormone analogs, teriparatide and abaloparatide are available for persons with severe osteoporosis (T score <-3.0) or severe hip fractures (24)(25)(26). They are anabolic agents which are recommended not to be taken for longer than 2 years: A number of different delivery mechanisms (e.g., nasal, patch, microchips) are available for teriparatide.…”