Teriparatide

approved

Also known as: Forteo, PTH(1-34)

**Mechanism of Action** Teriparatide (recombinant human parathyroid hormone [1-34]) exerts its effects through intermittent activation of the PTH1 receptor on osteoblasts. Unlike continuous PTH exposure, which promotes bone resorption, daily subcutaneous administration stimulates osteoblast proliferation, differentiation, and activity, leading to net bone formation. This anabolic action increases trabecular connectivity and cortical thickness, particularly at the spine and hip. **Key Research Findings** Clinical trials (e.g., the Fracture Prevention Trial) demonstrated that teriparatide reduces vertebral and nonvertebral fracture risk in postmenopausal women with severe osteoporosis. Bone mineral density (BMD) increases of 9–13% at the lumbar spine and 3–6% at the femoral neck were observed over 18–24 months. Studies also show efficacy in glucocorticoid-induced osteoporosis and hypogonadal men. Duration of therapy is limited to 24 months due to a dose-dependent risk of osteosarcoma in rat models, though human data have not confirmed this association. **Clinical Relevance** Teriparatide is indicated for patients with very high fracture risk, including those with T-scores ≤ -3.5, prior fragility fractures, or failure/intolerance to antiresorptive therapy. It is typically followed by an antiresorptive agent (e.g., bisphosphonate) to maintain gained BMD. Contraindications include Paget disease, prior radiation therapy, and unexplained hypercalcemia. For research purposes only — not medical advice.

Key data

Category
Clinical Therapeutics
Molecular weight
4118 g/mol
Molecular formula
C181H291N55O51S2
CAS number
52232-67-4
Administration
subcutaneous
Research status
approved
References
2,963
Tags
pth-analog, approved, osteoporosis

Research & studies

PTH1 receptor agonists for fracture risk: a systematic review and network meta-analysis
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025 · PubMed

Abaloparatide showed advantage over teriparatide for non-vertebral fractures (OR: 0.87, 95% CI: 0.80-0.95) and hip fractures (OR: 0.81, 95% CI: 0.71-0.93).; Teriparatide and abaloparatide were superior to placebo, raloxifene, and calcitonin in reducing vertebral fracture; teriparatide was also superior to denosumab and risedronate.; For non-vertebral fracture, abaloparatide was better than any other treatment, while teriparatide was only superior to alendronate or placebo.; Both agents had acceptable safety profiles with no increased cardiovascular risk compared to other osteoporosis treatments.

Comparative Effectiveness of Abaloparatide and Teriparatide in Women 50 Years of Age and Older: Update of a Real-World Retrospective Analysis
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025 · PubMed
Latest on Anabolic Agents for Osteoporosis Treatment
Endocrinology and metabolism clinics of North America · 2024 · PubMed
Comparative effectiveness and cardiovascular safety of romosozumab versus teriparatide in patients with osteoporosis: a population-based cohort study
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024 · PubMed
Therapy with transitions from one bone-forming agent to another: a retrospective cohort study on teriparatide and romosozumab
JBMR plus · 2024 · PubMed
Efficacy and safety of teriparatide vs. bisphosphonates and denosumab vs. bisphosphonates in osteoporosis not previously treated with bisphosphonates: a systematic review and meta-analysis of randomized controlled trials
Archives of osteoporosis · 2024 · PubMed

Teriparatide significantly decreased fracture risk versus bisphosphonates (RR 0.61, 95% CI 0.51-0.74).; Denosumab showed no significant benefit in fracture reduction compared to bisphosphonates (RR 0.99, 95% CI 0.62-1.57).; Both teriparatide and denosumab significantly improved femoral neck, total hip, and lumbar spine bone mineral density versus bisphosphonates.; Neither teriparatide nor denosumab increased the incidence of adverse events compared to bisphosphonates.

Change in spinal bone mineral density as estimated by Hounsfield units following osteoporosis treatment with romosozumab, teriparatide, denosumab, and alendronate: an analysis of 318 patients
Journal of neurosurgery. Spine · 2024 · PubMed
Off-Label Use of Teriparatide in Spine
Cureus · 2021 · PubMed

Frequently asked questions

What is Teriparatide?

**Mechanism of Action** Teriparatide (recombinant human parathyroid hormone [1-34]) exerts its effects through intermittent activation of the PTH1 receptor on osteoblasts. Unlike continuous PTH exposure, which promotes bone resorption, daily subcutaneous administration stimulates osteoblast proliferation, differentiati

How does Teriparatide work?

Recombinant PTH(1-34) that, given intermittently, stimulates osteoblastic bone formation; approved for severe osteoporosis.

What is the research status of Teriparatide?

Teriparatide is currently classified as approved, with 2,963 research references on record. This is for research purposes only and is not medical advice.

What is the molecular weight of Teriparatide?

Teriparatide has a molecular weight of approximately 4118 g/mol (formula C181H291N55O51S2).

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