Parathyroid hormone for the treatment of osteoporosis: a systematic review

Cranney, Ann; Papaioannou, Alexandra; Zytaruk, Nicole; Hanley, David; Adachi, Jonathan; Goltzman, David; Murray, Timothy; Hodsman, Anthony
July 2006
CMAJ: Canadian Medical Association Journal;7/4/2006, Vol. 175 Issue 1, p52
Academic Journal
Background: Human parathyroid hormone (hPTH)(1-34) was approved in 2004 for the treatment of severe osteoporosis. Members of the Osteoporosis Canada clinical guidelines committee conducted a systematic review of randomized controlled trials (RCTs) to assess the efficacy and safety of hPTH for fracture prevention in postmenopausal women and men with osteoporosis. Methods: We searched MEDLINE, EMBASE, HTA, Current Contents and the Cochrane Controlled Trials Registry for published data from 1966 to February 2005. A systematic literature search for RCTs was conducted using the Cochrane Collaborative approach. We identified 12 trials that randomly assigned patients either to hPTH or placebo or to hPTH or an active comparator and were at least 1 year in duration. Outcomes included change in bone mineral density (BMD), fractures, back pain and adverse events. Two independent reviewers abstracted data on study characteristics and outcomes. Results: hPTH(1-34) significantly increases lumbar spine BMD, with smaller increases at the femoral neck and total hip. hPTH(1-84) significantly increases lumbar spine BMD. The data show a significant reduction in both vertebral and nonvertebral fractures with hPTH(1-34) in postmenopausal women with previous vertebral fractures. There were no data on fractures comparing the approved dose of hPTH(1-34) with active comparators. Interpretation: There is Level I evidence that hPTH(1-34) significantly increases BMD at all skeletal sites except the radius and significantly reduces the risk of new vertebral and nonvertebral fractures in postmenopausal women with prior fractures.


Related Articles

  • Impact of Treatments for Postmenopausal Osteoporosis (Bisphosphonates, Parathyroid Hormone, Strontium Ranelate, and Denosumab) on Bone Quality: A Systematic Review. Gallacher, S. J.; Dixon, T. // Calcified Tissue International;Dec2010, Vol. 87 Issue 6, p469 

    The objective of this systematic review was to examine the influence of treatments for postmenopausal osteoporosis (parathyroid hormone [PTH], bisphosphonates, strontium ranelate, and denosumab) on bone quality and discuss the clinical implications. Most bone-quality data for PTH is from...

  • Bone-Loss Epidemic Ahead? Coles, Clifton // Futurist;Mar/Apr2005, Vol. 39 Issue 2, p11 

    Highlights the potential epidemic of fractures and osteoporosis in the U.S. in 2020. Ways to develop stronger bones; Physiological effects of osteoporosis; Tips on minimizing the risk of falls and fractures.

  • Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Richy, Florent; Ethgen, Olivier; Bruyere, Olivier; Reginster, Jean-Yves // Osteoporosis International;Apr2004, Vol. 15 Issue 4, p301 

    Vitamin D metabolites alphacalcidol and calcitriol (D-hormones) have been investigated for two decades, but few and conflicting results are available from high-quality randomized controlled trials. Our objectives were to provide an evidence-based update quantitatively summarizing their efficacy...

  • Parathyroid hormone(1-84) treatment of postmenopausal women with low bone mass receiving hormone replacement therapy. Fogelman, I.; Fordham, J. N.; Fraser, W. D.; Spector, T. D.; Christiansen, C.; Morris, S. A.; Fox, J. // Calcified Tissue International;Aug2008, Vol. 83 Issue 2, p85 

    Treatment of postmenopausal osteoporosis (PMO) is based primarily on antiresorptive agents, including hormone replacement therapy (HT). To evaluate whether anabolic therapy together with HT provides additional benefits in the treatment of PMO, we evaluated the effects of parathyroid hormone...

  • bmj updates.  // BMJ: British Medical Journal (International Edition);8/12/2006, Vol. 333 Issue 7563, preceding p311 

    The article provides a summary of the article "Parathyroid hormone for the treatment of osteoporosis: a systematic review," by A. Cranney, et al. The study evaluated the use of parathyroid hormone as a treatment for osteoporosis in women. The research found that the use of parathyroid hormone...

  • Among Older Adults, Men and Women Have Similar Refracture Risk.  // PT: Magazine of Physical Therapy;Apr2007, Vol. 15 Issue 4, p95 

    The article reports on a bone fracture study for people age 60 and older. After a low trauma break, both men and women share similar risks for additional fractures. Osteoporosis education is important for both sexes since treatment can substantially lower the frequency of subsequent injuries.

  • Targeting Vascular Niche by Parathyroid Hormone. Pagliarulo, Caterina; Salvatore, Paola; Napoli, Claudio // Current Medicinal Chemistry;2008, Vol. 15 Issue 28, p2984 

    Currently, the parathyroid hormone (PTH) is a drug approved for use in humans only in bone metabolism diseases, as the osteoporosis. The PTH acts primarily by binding to its principal receptor, PTH/PTHrP-R, a member of the class B G protein-coupled receptor (GPCR) family that includes together...

  • Recombinant Full-Length Parathyroid Hormone (1-84). Moen, Marit D.; Scott, Lesley J // BioDrugs;2007, Vol. 21 Issue 3, p205 

    The article discusses the importance of recombinant full-length parathyroid hormone in treating osteoporosis. Osteoporosis occurs when the rate of bone resorption exceeds the rate of bone formation. The resulting loss of bone mass and strength can lead to fragility fractures. Available...

  • Recombinant Full-Length Parathyroid Hormone (1-84): A Viewpoint by James Whitfield. Whitfield, James // Drugs;2006, Vol. 66 Issue 18, p2382 

    â–´ The fentanyl buccal tablet (FBT) is a new formulation of fentanyl that uses an effervescent drug delivery system to enhance penetration across the buccal mucosa for the treatment of breakthrough pain in opioid-tolerant patients with cancer.â–´ Fentanyl is rapidly absorbed from FBT...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics