J Bone Metab.  2017 Feb;24(1):65-73. 10.11005/jbm.2017.24.1.65.

Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review

• Kim SM
• Kang KC
• Kim JW
• Lim SJ
• Hahn MH

• KMID: 2371834
• DOI: http://doi.org/10.11005/jbm.2017.24.1.65

Abstract

BACKGROUND
The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients.
METHODS
We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab].
RESULTS
This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis. Fracture location was 2 in pelvis, 3 in proximal femur, 1 in distal femur, 1 in shoulder, 2 in wrist and 2 in spine. The use of teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3. In terms of functional recovery, teriparatide injection was related with decrease in pain or shorter time to mobilization in 6 studies, but not related with pain numerical scale and mobility in 3.
CONCLUSIONS
Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. A better understanding of the role of teriparatide on osteoporotic fractures requires greater evidences from large volume prospective trials.

Keyword

Osteoporosis; Parathyroid hormone; Teriparatide

MeSH Terms

Femur
Fracture Healing*
Humans
Osteoporosis
Osteoporotic Fractures
Parathyroid Hormone
Pelvis
Prospective Studies
Retrospective Studies
Shoulder
Spine
Teriparatide*
Wrist
Parathyroid Hormone
Teriparatide

Figure

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  Fig. 1 Flow diagram showing the search strategy to identify studies.

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