Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Comparison of efficacy and safety of teriparatide and hyaluronic acid - calcitonin combination treatments in Chinese osteoporotic patients with risk of bone fracture: A preliminary investigation

Changju Hou¹, Jing Li², Xuepeng Wang¹, Liulong Zhu¹, Maoqiang Li¹

¹Department of Orthopedic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; ²Department of Radiology, Xiaoshan Traditional Chinese Medical Hospital of Hangzhou, Hangzhou, Zhejiang 310006, China.

For correspondence:- Maoqiang Li Email: LaurelJocelyngPb@yahoo.com Tel:+8657156005600

Accepted: 23 December 2019 Published: 31 January 2020

Citation: Hou C, Li J, Wang X, Zhu L, Li M. Comparison of efficacy and safety of teriparatide and hyaluronic acid - calcitonin combination treatments in Chinese osteoporotic patients with risk of bone fracture: A preliminary investigation. Trop J Pharm Res 2020; 19(1):183-188 doi: 10.4314/tjpr.v19i1.26

© 2020 The authors.
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Abstract

Purpose: To evaluate the efficacy and safety of teriparatide and hyaluronic-calcitonin combination treatment in Chinese osteoporotic patients with risk of bone fracture.

Methods: Osteoporotic patients aged 30 to 80 years, with at least one vertebral fracture and immediate risk of new vertebral fractures, were recruited from Hangzhou First People's Hospital. They were randomly assigned to two groups (50/group) treated with either teriparatide (20 µg/day) or hyaluronic acid + calcitonin (1:1 ratio, 200 IU daily) for 12 months. The patients were followed up every 3 months. Bone mineral density (BMD) was evaluated using x-ray absorptiometry. The proportion of patients with new fractures was recorded. Changes in serum osteocalcin and serum bone alkaline phosphatase (BSAP) from baseline to endpoint were also measured.

Results: Treatment with teriparatide at a dose of 20 µg/day resulted in a significant reduction in the proportion of patients with new fractures (p < 0.05), when compared to patients treated with a combination of hyaluronic acid + calcitonin (200 IU daily). Teriparatide treatment for 12 months resulted in significant increase in lumbar BMD. Significant increases in spine BMD were evident after 3 months of treatment. There were significantly greater increases in serum osteocalcin and BSAP levels in teriparatide-treated patients than in those given hyaluronic acid + calcitonin. The most common treatment adverse event reported by both sexes was dizziness.

Conclusion: These results demonstrate that teriparatide is efficacious and well tolerated in Chinese men and post-menopausal women with osteoporosis, when compared to the combination of hyaluronic acid and calcitonin. The efficacy of teriparatide is not associated with gender differences.

Keywords: Teriparatide, Calcitonin, Hyaluronic acid, Bone-specific alkaline phosphatase, Postmenopausal, Bone mineral density