Effect of Subcutaneous Administration of Teriparatide in Postmenopausal Osteoporosis

Abstract— Postmenopausal osteoporosis is a serious health problem in Indian women as it increases chances of both vertebral and non-vertebral fractures. Currently standard treatment guidelines do not offer any effective prevention of osteoporosis. Teriparatide, in various international studies has been found as an effective treatment option for prevention of postmenopausal osteoporosis. However, there is very limited of data of Indian postmenopausal women. Therefore, present study is an attempt to observe the treatment effect of teriparatide for prevention of postmenopausal osteoporosis. Objective: To observe the treatment effect of teriparatide in patients suffering from postmenopausal osteoporosis in terms of bone mineral density. Methods: This randomized control study was done in 62 randomly selected patients with postmenopausal osteoporosis at SMS Hospital, Jaipur. After administering teriparatide (20 mcg daily), we measured lumbar spine, total hip and distal radius BMD at 6 and 12 months. Results: At 6 months, lumbar spine BMD increased more in teriparatide group (0.74±1.43, P=0.007) than in control group (0±0.32, P=0.007) and at the end of 12 months also, lumbar spine BMD increased more in teriparatide group (0.8±0.43) than in control group (-0.03±0.41). Similarly, at 6 months, total hip BMD increased more in teriparatide group (0.36±0.45, P˂0.001) than in control group (-0.08±0.22, P˂0.001) and at the end of 12 months, total hip BMD increased more in teriparatide (0.59±0.45) than in control group (-0.1±0.36). ). At 6 months, distal radius BMD increased more in teriparatide group (0.44±0.74, P=0.004) compared to control group (0.00±0.37, P=0.004) and at 12 months, distal radius BMD increased more in teriparatide group (0.77±0.68) compared to control group (-0.04±0.43). Conclusions: Teriparatide is an effective agent to treat postmenopausal osteoporosis and it is more effective at lumbar spine than at hip and radius. To conclude further treatment is needed as sequential therapy because on stopping treatment BMD again start receding over the period