Investigators have revealed that Forteo or injectable Teriparatide is better than Fosamax or oral Alendronate when it comes to enhancing the level of bone mineral density (BMD) by as much as two times, in a head-to-head comparison.

Philip N. Sambrook, M.D., of the University of Sydney, remarked that teriparatide can be prescribed as a first-line therapy to treat osteoporosis induced by steroids.

From Medpagetoday.com:

“In our study, teriparatide was associated with greater increases in [BMD] at the spine and hip and with significantly fewer new vertebral fractures,” Dr. Saag’s group wrote. But the dropout rate for adverse effects was twice as high for those taking teriparatide.

Only one out of 171 evaluable patients receiving teriparatide had radiographic evidence of a vertebral fracture, while 10 of 165 evaluable patients on alendronate had such fractures (P=0.004).

Nonvertebral fractures occurred at similar rates with the two treatments (5.6% versus 3.7%, P=0.36). BMD in the total hip increased with both drugs, though less dramatically than in the lumbar spine. Teriparatide increased hip BMD by 3.8% while it rose 2.4% in the alendronate group. The advantage for teriparatide was significant (P<0.01). Significantly more patients in the teriparatide group had at least one elevated serum calcium measurement > 10.5 mg/dL (18% versus 5.7%, P<0.001) and there was a tendency toward more patients with at least one measurement > 11 mg/dL (3.8% versus 1%, P=0.06).

Teriparatide is a recombinant peptide drug, based on a portion of the parathyroid hormone protein. Earlier studies had indicated that it leads to increased BMD.

Kenneth Saag, M.D., of the University of Alabama at Birmingham and his colleagues remarked that significant improvements in terms of bone mineral density in the spine and hip regions are attainable with Teriparatide.