Editorials

Recombinant human parathyroid hormone

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7335.435 (Published 23 February 2002) Cite this as: BMJ 2002;324:435

Osteoporosis is proving amenable to treatment

  1. Jonathan Reeve, head of bone research group
  1. University Department of Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ

    On 27 July the US Food and Drug Administration held a public hearing on an application for a licence for the use of recombinant human parathyroid hormone in the treatment of postmenopausal osteoporosis. The application, from Eli Lilly, is for teriparatide (Forsteo), the N-terminal fragment rhPTH(1-34). The hearing's advisory panel voted unanimously in favour of the parathyroid hormone and approval could be expected after resolution of a few technical concerns. The application was partly based on solid evidence that parathyroid hormone, given as a daily injection for several weeks or months in experimental animals, increases bone mass and strength.1 This evidence led to a multicentre randomised controlled trial in women with osteoporosis, which showed that treatment with parathyroid hormone reduced spine fractures by 66% to 90% (according to whether smaller fractures and those causing minor symptoms were counted) and other fractures by 50%.2

    The first experiments showing an anabolic effect of parathyroid hormone on bone in young rats took place in various North American laboratories …

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