Teriparatide Treatment in Patients with Severe Osteoporosis Based on Romanian Protocol

Introduction Teriparatide (TPT) is an anti-osteoporotic drug designed for selected severe cases and prescribed based on national protocols. We introduce a cohort treated in accordance to Romanian protocol for TPT (the drug is indicated in severe cases of osteoporosis as those with high fracture risk of prevalent fragility fractures, as well as glucocorticoid osteoporosis in accordance to specific criteria of T-score and medical history). The drug administration includes (as generally recommended): daily 20 mu g, subcutaneous injections for 24 months with self administration (specific device), once in life (non- repeatable). Method This is an observational descriptive study with cross-sectional and longitudinal results (12, 24 months) on TPT patients according to national protocol criteria, conducted between 2013-2018 at a tertiary centre of endocrinology on patients with informed written consent. Statistical significance: p<0.05. Results 50 patients were enrolled; 50% reached the first of two years and, except one patient, further therapy for one more year as recommended based on protocol. Mean age was 77 yrs (majority: menopausal women). Half had upper digestive tract conditions that contraindicated oral bisphosphonates. One tenth had current/recent glucocorticoid exposure. 15% of patients used TPT as first-line therapy for osteoporosis. Prior specific medication for osteoporosis exposure was between 1 and 14 years. An average number of prior fractures were 3 (more than 80% of vertebral site). Conclusion TPT was introduced based on Romanian protocol applied for this studied cohort, in severe patients with long time estrogen deprivation since menopause; the majority of them have a long history of other anti-osteoporotic drugs exposure while the number of first time TPT uses is rather low.