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Injury. 2013 Jan;44 Suppl 1:S54-7. doi: 10.1016/S0020-1383(13)70013-5.

Teriparatide in the treatment of non-unions: scientific and clinical evidences.

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1
Dipartimento di Scienza della Salute, Università degli Studi di Milano, Milano, Italy. luca.pietrogrande@unimi.it

Abstract

INTRODUCTION:

Each fracture has a failing risk which can lead to a non-union. Among the non-invasive strategies proposed to improve bone healing, also in non-union, the use of teriparatide, a drug for the treatment of the osteoporosis, has increasing supporting data.

EXPERIMENTAL DATA:

Many studies mainly on rats, but also on primates, demonstrate the positive effect on fracture healing of teriparatide, both in physiological and pathological conditions, with a more rapid evolution of the reparative callus.

CLINICAL DATA:

A double blinded randomized controlled study on wrist fractures demonstrated a positive effect, in term of healing speed, of teriparatide at the dose of 20 μg/day, but not at the higher dose of 40 μg/day. A prospectic randomized study on pelvic fractures showed a faster healing in teriparatide treated patients. The use of teriparatide in non-unions is reported as effective in numerous case report. The effect of teriparatide seems very useful in the non-unions consequent to an atypical femoral fracture after long-term administration of bisphosphonates.

CONCLUSIONS:

A conceivable positive effect of teriparatide on fracture healing is well-documented on animals, and very likely on humans, however further studies are needed to confirm these hopeful hypotheses.

PMID:
23351873
DOI:
10.1016/S0020-1383(13)70013-5
[Indexed for MEDLINE]
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