Teriparatide may be ineffective in fracture healing, meta-analysis finds
There is no evidence supporting the efficacy of teriparatide for healing fractures despite having no adverse effect, according to a new meta-analysis. However, more high-quality studies are needed to yield more definitive conclusions about its effectiveness.
Databases including the Cochrane Library, Embase and PubMed were accessed using combinations of the following search terms: “hPTH (1-34),” “Parathar,” “Teriparatide Aventis Brand,” “Forteo,” “Fracture Healings,” “Teriparatide Lilly Brand,” and “Healing, Fracture,” among others.
Because the authors were not contacted for clarifications and additional information, only those that were completely published were included in the final study. No language restriction was applied to the search.
Inclusion criteria were as follows: study design being a randomized controlled trial, participants being adults with acute fractures and administered teriparatide, and teriparatide treatment being compared with a placebo treatment.
Studies that included participants who had histories of teriparatide or parathyroid hormone use, included participants that had contraindications to the drugs used in the study, weren’t randomized controlled trials or weren’t complete, or included participants with serum calcium levels above the reference limit were excluded from the analysis.
Information regarding authors, date of publication, characteristics of population, type of fracture, treatments administered, number of cases, duration of follow-up, rate of fracture healing, pain score, time of radiological healing of fracture and functional outcomes were retrieved. The primary endpoints of the study were the fracture healing rate and the time of fracture healing.
After applying the exclusion and inclusion criteria, five trials corresponding to a total of 380 patients were included in the analysis.
While the meta-analysis showed that teriparatide was associated with a significant improvement in terms of functioning after the fracture, no significant improvement was observed in pain reduction, healing rate of the fracture and radiographic healing of the fracture.
The data indicate a lack of evidence showing the efficacy of teriparatide in healing fractures. However, more studies of high quality are needed to make stronger conclusions.