Teriparatide, a drug that contains a synthetic form of a natural human hormone call parathyroid hormone, is a useful treatment for the bone-thinning disease osteoporosis even in patients who have already been treated with “bisphosphonate” drugs, such as Allendronate or zoledronate, new research shows.

Bisphosphonate drugs strengthen bones by blocking the body’s cells that break down bone. Teriparatide, works by enhancing the activity of cells that build bone.

Teriparatide may be prescribed as a second-line treatment for severe osteoporosis, but the effect of prior bisphosphonate therapy on the response to the drug is unclear, according to the report in the Journal of Clinical Endocrinology and Metabolism.

Dr. Steven Boonen at Universitaire Ziekenhuizen in Leuven, Belgium, and colleagues analyzed data from a European study to evaluate the effects of teriparatide on bone growth n women with osteoporosis. The study included many women who had never received treatment before as well as 245 women who had been treated with a bisphosphonate or similar drug.

All of the women were given teriparatide as well as calcium and vitamin D for 24 months. Adequate body levels of calcium and vitamin D are needed for the drug to work properly.

Biochemical tests showed that teriparatide did, in fact, increase bone formation.

Although women previously treated with a bisphosphonate showed less bone growth than women who were never treated before, it was still a significant improvement over their bone levels before teriparatide was given.

Bone growth was noted in the lumbar spine and in the hip.

In women previously treated with a bisphosphonate, the benefit seen with teriparatide did not depend on the duration of therapy with the bisphosphonate or on the lag time between stopping the bisphosphonate and starting teriparatide.

Although 15 subjects developed high blood calcium levels, none required treatment discontinuation. Other side effects, similar to those reported for previously untreated patients, caused seven patients to withdraw from the study during the second year.

Boonen and his team conclude that the use of teriparatide as an effective treatment option in women with severe osteoporosis after prior treatment with bisphosphonates and similar drugs.

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