Teriparatide for treatment of patients with bisphosphonate-associated atypical fracture of the femur

Greenspan, Susan L.; Vujevich, Karen T.; Britton, Cynthia A.; Herradura, A.; Gruen, Gary S.; Tarkin, Ivan S.; Siska, Peter A.; Hamlin, Brian R.; Perera, Subashan

doi:10.1007/s00198-017-4286-7

Cited by 45 publications

(35 citation statements)

References 21 publications

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“…Teriparatide therapy significantly shortened the healing time and resulted in a reduced incidence of delayed healing or nonunion compared with non‐teriparatide therapy. The pro‐healing effect of teriparatide therapy on AFFs was compared between patients with immediate initiation and a delay of 6 months . In that study, radiographic bone healing at 6 and 12 months was assessed in 13 women with AFFs.…”

Section: Resultsmentioning

confidence: 99%

“…The pro-healing effect of teriparatide therapy on AFFs was compared between patients with immediate initiation and a delay of 6 months. (76) In that study, radiographic bone healing at 6 and 12 months was assessed in 13 women with AFFs. The study found that immediate teriparatide initiation promoted healing of AFFs more than delayed initiation did.…”

Section: Pth Effects On Healing Of Atypical Femoral Fracturesmentioning

confidence: 99%

“…Greenspan et al, (76) PTH and PTHrP both bind to the same receptor (PTH1R) with similar bioactivity in their N-terminal region. This forms a rational foundation that PTHrP would be osteoanabolic as well as benefit fracture healing and several studies have supported this (Table 5).…”

Section: Pth Effects On Healing Of Atypical Femoral Fracturesmentioning

confidence: 99%

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Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone‐Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies

Yamashita

McCauley

2019

JBMR Plus

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Intermittent administration of parathyroid hormone (PTH) stimulates skeletal remodeling and is a potent anabolic agent in bone. PTH‐related protein (PTHrP) is anabolic acting on the same PTH1 receptor and is in therapeutic use for osteoporosis. The body of literature for PTH actions in fracture healing is emerging with promising yet not entirely consistent results. The objective of this review was to perform a literature analysis to extract up‐to‐date knowledge on the effects of intermittent PTH and PTHrP therapy in bone fracture healing. A literature search of the PubMed database was performed. Clinical case studies and articles related to “regeneration,” “implant,” and “distraction osteogenesis” were excluded. A narrative review was performed to deliberate the therapeutic potential of intermittent PTH administration on fracture healing. A smaller number of studies centered on the use of PTHrP or a PTHrP analog were also reviewed. Animal studies clearly show that intermittent PTH therapy promotes fracture healing and revealed the strong therapeutic potential of PTH. Human subject studies were fewer and not as consistent as the animal studies yet provide insight into the potential of intermittent PTH administration on fracture healing. Differences in outcomes for animal and human studies appear to be attributed partly to variable doses, fracture sites, age, remodeling patterns, and bone architectures, although other factors are involved. Future studies to examine the dose, timing, and duration of PTH administration will be necessary to further delineate the therapeutic potential of PTH for fracture healing in humans. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Section: Resultsmentioning

confidence: 99%

Section: Pth Effects On Healing Of Atypical Femoral Fracturesmentioning

confidence: 99%

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Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone‐Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies

Yamashita

McCauley

2019

JBMR Plus

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“…The papers included in the review are reported by category in Table 2. (15)(16)(17)25,26,(29)(30)(31)(32)(33) 205 Bone substitutes (41,42,45,46,48) 331 Growth factors (53,(55)(56)(57)(58) 615 Cell therapies (66,69,73) 69 Pharmacological therapy (97)** (98)(99)(100)(101)(102)(103)(104)(105)(107)(108)(109)(110)(111)(112)(113)(114) 110 ** Systematic review including case series and case reports.…”

Section: Resultsmentioning

confidence: 99%

“…In their series, the patients who received 20 µg of daily teriparatide for 6 to 24 months had an improvement in bone turnover markers serum levels, but, on the other hand, there was no significant effect on fracture healing. More recently, Greenspan et al reported the result of a pilot randomized clinical trial of 13 patients, to determine the correct timing of teriparatide administration after an AFF [101]. They found a trend in better healing rates in the group of patients who received immediate therapy with teriparatide compared to the group who received teriparatide therapy with a 6-month delay.…”

Section: Parathormone Analoguesmentioning

confidence: 99%

The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence

et al. 2020

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Background: The healing of long bones diaphyseal fractures can be often impaired and eventually end into delayed union and non-union. A number of therapeutic strategies have been proposed in combination with surgical treatment in order to enhance the healing process, such as scaffolds, growth factors, cell therapies and systemic pharmacological treatments. Our aim was to investigate the current evidence of bone healing enhancement of acute long bone diaphyseal fractures. Methods: A systematic review was conducted by using Pubmed/MEDLINE; Embase and Ovid databases. The combination of the search terms “long-bones; diaphyseal fracture; bone healing; growth factors; cell therapies; scaffolds; graft; bone substitutes; orthobiologics; teriparatide”. Results: The initial search resulted in 4156 articles of which 37 papers fulfilled the inclusion criteria and were the subject of this review. The studies included 1350 patients (837 males and 513 females) with a mean age of 65.3 years old. Conclusions: General lack of high-quality studies exists on the use of adjuvant strategies for bone healing enhancement in acute shaft fractures. Strong evidence supports the use of bone grafts, while only moderate evidence demineralized bone matrix and synthetic ceramics. Conflicting results partially supported the use of growth factors and cell therapies in acute fractures. Teriparatide showed promising results, particularly for atypical femoral fractures and periprosthetic femoral fractures.

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Atypical Femur Fractures

Miedany

2022

New Horizons in Osteoporosis Management

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Teriparatide for treatment of patients with bisphosphonate-associated atypical fracture of the femur

Abstract: There is a preliminary signal for greater improvements with immediate teriparatide therapy vs delayed therapy. However, because an AFF is a rare event, and only a small number of patients were included, the results must be interpreted with caution.

Cited by 45 publications

References 21 publications

Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone‐Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies

Effects of Intermittent Administration of Parathyroid Hormone and Parathyroid Hormone‐Related Protein on Fracture Healing: A Narrative Review of Animal and Human Studies

The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence

Atypical Femur Fractures

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