TORONTO — Short-term teriparatide administration
for 6 weeks was associated with improved clinical and radiographic outcomes
during the year of observation after periodontal surgery, a new study found.
Results of the small study showed that patients taking
teriparatide therapy experienced significantly greater radiographic linear
resolution of osseous defects at 6 months, compared with placebo. The mean
linear bone gain in the teriparatide group was 29% at 1 year as compared with
3% in the placebo group (P<.001).>
“The use of a systemic anabolic agent like
teriparatide provides an exciting new avenue of therapeutic potential,”
Jill D. Bashutski, DDS, and colleagues at the University of Michigan
said at the American Society of Bone and Mineral Research 2010 Annual Meeting.
The study was simultaneously published in the New England Journal of
The double-masked, placebo-controlled study included 40
patients with severe, chronic periodontitis who underwent periodontal surgery.
Patients were assigned to daily injections of teriparatide 20 mcg or placebo
for 6 weeks, as well as oral calcium 1,000 mg and vitamin D 800 IU.
Teriparatide therapy was also associated with a
reduction in periodontal probing depth of 33% vs. 20% (2.42 mm vs. 1.32 mm) and
a gain in clinical attachment level of 22% vs. 7% (1.58 mm vs. 0.42 mm) in
target lesions at 1 year (P=.02 for both).
No serious adverse events were reported.
Teriparatide is composed of the first 34 amino acids of
parathyroid hormone. It is known to have anabolic effects on bone. The drug has
been evaluated for its
effects on the treatment of osteoporosis and fractures,
however, clinical trials for the treatment of osseous conditions of the oval
cavity were previously lacking.
Treatment with teriparatide is currently limited to 2 years
because data have suggested that long-term exposure may be associated with
increased risk for osteosarcoma.
The data suggest that “a short dosing regimen may
have long-lasting effects,” the researchers wrote in the study.
“Similarly, gains in clinical attachment levels continued to be seen
throughout the course of the study in the teriparatide group, whereas the
maximum gain occurred at 3 months in the placebo group.”
According to Andrew Grey, MD, of the department
of medicine at University of Auckland, New Zealand, results of this small,
preliminary study suggested that teriparatide “might confer additional
benefit over that achieved with standard care in patients with severe
However, Grey wrote, many questions remain, including:
“How durable is the effect of teriparatide? What is the optimal dosing
regimen? Does teriparatide alter important end points such as tooth loss or the
need for further operative intervention? Do antiresorptive agents, which cost
considerably less than teriparatide, confer similar benefits?” Grey
recommended larger, longer-term trials that compare different regimens to
answer these questions.
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