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Management of osteoporosis with Teriparatide

Osteoporosis is a global health concern that affects millions worldwide. This condition leads to low bone mass and structural deterioration of bone tissue, increasing the risk of fractures, especially in women.1 It affects an estimated 200 million women worldwide, with two-thirds over the age of 90.2 Osteoporosis affects a staggering 61 million people in India alone. Around 80% of these are women.3

The development of osteoporosis is influenced by a combination of factors including age, genetics, hormonal changes, and lifestyle choices. With the aging population and longer life expectancy in India, the risk of osteoporosis is on the rise, making it an urgent public health concern that requires attention and action.4

Managing osteoporosis with pharmacological agents

The primary goal of managing osteoporosis is to prevent fractures that are associated with significant morbidity and mortality. Treatment options include antiresorptive and anabolic agents.

Antiresorptive agents

Antiresorptive agents such as bisphosphonates and denosumab are the cornerstone of therapy to reduce the risk of fractures. However, their usage is limited due to the side-effect profile, limited effectiveness in severely affected individuals, and poor treatment adherence. Bisphosphonates, in particular, can cause gastrointestinal disturbances and rare but serious side effects like osteonecrosis of the jaw and atypical femoral fractures. Additionally, they can only achieve finite gains in bone mineral density since they cannot restore previously lost bone.4

Anabolic agents

Anabolic agents are effective in replacing lost bone and have shown greater effects on bone mineral density and fracture risk. Teriparatide is the most recent anabolic agent and is a parathyroid hormone type 1 receptor agonist.5

Role of Teriparatide in the Management of Osteoporosis

Teriparatide is a potent medication in the anabolic therapy category that stimulates new bone growth similar to parathyroid hormone, making it the first osteoporosis treatment that generates new bone with architecture resembling normal bone.6

Teriparatide works through two distinctive mechanisms:

  • Direct stimulation of bone formation within active remodelling sites
  • Increase in the initiation of new remodelling sites

Both mechanisms contribute to the increase in bone density observed by non-invasive tools such as DXA.

Clinical studies have confirmed the efficacy of teriparatide in reducing the risk of vertebral and non-vertebral fractures. Treatment at the FDA-approved dose of 20 μg/day has been found to reduce the risk of vertebral fractures by 65% and decrease the risk of non-vertebral fractures by 53%.7

The Fracture Prevention Trial played a key role in getting FDA and EMA approval for teriparatide as the first anabolic agent for severe osteoporosis in postmenopausal women.8.9 Later, it was also approved for treating osteoporosis in both men and women at risk of fracture due to glucocorticoid therapy.9 Real-world experience has confirmed that teriparatide provides fracture and bone density benefits in post-menopausal osteoporosis, similar to those observed in clinical trials.10


Osteoporosis is a significant public health issue affecting millions globally, with women being at a higher risk. The primary goal of treating osteoporosis is to prevent fractures. Teriparatide is a potent drug in the anabolic therapy category that stimulates new bone growth and enhances bone microarchitecture, substantially reducing the risk of fractures. Early diagnosis and timely intervention can prevent complications associated with osteoporosis and improve the quality of life of affected individuals.

About the Author: Shailly Dave is a project manager and content writer with expertise in Medico-Marketing and Healthcare Communications. Shailly is a master juggler, weaving words, managing projects and handling clients, all while being a busy mum. She makes time to share her perspective on various healthcare topics through blogs and articles. Click on this link to connect with Shailly on LinkedIn. 

Editorial support provided by Dr. Geetika Gupta.


1. Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019 Jan 26;393(10169):364-376.

2. Epidemiology: International osteoporosis foundation (no date) IOF International Osteoporosis Foundation. Available at: Accessed: May 8, 2023.

3. Khinda R, Valecha S, Kumar N, et al. Prevalence and Predictors of Osteoporosis and Osteopenia in Postmenopausal Women of Punjab, India. Int J Environ Res Public Health. 2022 Mar 4;19(5):2999.

4. Hassan N, Gregson CL, Tobias JH. Anabolic treatments for osteoporosis in postmenopausal women. Fac Rev. 2021 May 5;10:44.

5. Girotra M, Rubin MR, Bilezikian JP. Anabolic Agents for Osteoporosis : What is Their Likely Place in Therapy? Treat Endocrinol. 2006;5(6):347-58.

6. Bodenner D, Redman C, Riggs A. Teriparatide in the management of osteoporosis. Clin Interv Aging. 2007;2(4):499-507.

7. Lindsay R, Krege JH, Marin F, et al. Teriparatide for osteoporosis: importance of the full course. Osteoporos Int.2016;27(8):2395-410.

8. FDA Approved Drug Products: FORTEO (teriparatide) injection, for subcutaneous use.

9. EMA Approved Drug Products: Sondelbay (teriparatide) Subcutaneous Injection.

10. Hauser B, Alonso N, Riches PL. Review of Current Real-World Experience with Teriparatide as Treatment of Osteoporosis in Different Patient Groups. J Clin Med. 2021 Apr 1;10(7):1403.

Disclaimer: The matter published in this blog has been developed by independent medical writers from various healthcare backgrounds including members from MedWriters Alumni Network. It has been validated by the experts' panel of Crixus. Although great care has been taken in compiling and checking the information, the authors, Crixus Communications Pvt Ltd and its servants or agents, and sponsors shall not be responsible or in any way liable for any errors, omissions, or inaccuracies in this blog article whether arising from negligence or otherwise, however or for any consequences arising therefrom. The inclusion and exclusion of any product do not mention that the publisher advocates or rejects its use generally or in any particular field or field.