Table 4.

Human Subject Studies—PTH and Fracture Healing in Patients Previously Treated with BPs

Subject	Study design	Findings	Reference
n = 189 Retrospective study	Surgically treated osteoporotic intertrochanteric fractures; TPTD (20 μg/d) for 6 months with or without a history of BP treatment vs. controls	TPTD had significantly shorter time‐to‐union, better QOL, and lower‐frequency complications and mortality rates regardless of previous BP treatment.	Huang et al.,71 2016
14 AFF patients Prospective study	5 patients received TPTD (20 μg/d) for 6 months and 9 patients conservative treatment. HRpQCT scans of the distal radius and tibia at BL and 6 months.	TPTD significantly increased bone remodeling markers and resulted in less dense bone at the distal radius and tibia. TPTD promoted fracture healing compared with conservative therapy.	Chiang et al.,74 2013
45 AFF patients (37 Sx and 8 conventional therapy)	37 surgically treated patients: 16 with and 21 without TPTD. Time to healing and frequency of delayed healing or nonunion were assessed.	TPTD treatment significantly shortened time to healing and lowered the frequency of delayed healing or nonunion vs. non‐TPTD treatment.	Miyakoshi et al.,75 2015
13 AFF patients All women	7 patients received TPTD (20 μg/d) for 12 months immediately after AFF and 6 patients received TPTD for 12 months beginning 6 months after AFF. Radiographic healing at 6 and 12 months was assessed.	Superior healing with immediate TPTD therapy vs. delayed therapy. There were lesser BMD declines at the distal 1/3 radius in the immediate vs. delayed group.	Greenspan et al.,76 2018

TPTD = teriparatide [rhPTH (1‐34)]; BP = bisphosphonate; QOL = quality of life; HRpQCT = high‐resolution peripheral micro‐computed tomography.