Abaloparatide and the Spine: A Narrative Review

Clin Interv Aging. 2020 Jun 29:15:1023-1033. doi: 10.2147/CIA.S227611. eCollection 2020.

Abstract

Osteoporosis is a common and debilitating condition characterized by diminished bone mass and architecture leading to bone fragility. Antiresorptive medicines like bisphosphonates (and less commonly denosumab) are the typical first-line agents for the medical treatment of osteoporosis. However, newer anabolic agents have been shown to improve bone mass and architecture, as well as reduce fracture risk, to a greater degree than traditional antiresorptive therapies. Teriparatide (human recombinant parathyroid hormone (PTH) 1-34, Forteo, Ely Lilly, Indianapolis, IN), which was the first in class to be approved in the United States, is the most widely used anabolic osteoporosis medicine and has shown significant benefit over traditional antiresorptive therapies. However, abaloparatide (synthetic parathyroid-related peptide (PTHrP), Tymlos, Radius Health, Waltham, MA), the second drug in this family, has recently become available for use. In this narrative review, we review the mechanism, effects, and benefits of abaloparatide compared to alternative treatments as well as discuss the current literature in regard to its effect on osteoporosis-related complications in the spine.

Keywords: Tymlos; abaloparatide; anabolic; osteoporosis; spine; teriparatide.

Publication types

  • Review

MeSH terms

  • Anabolic Agents / pharmacology
  • Anabolic Agents / therapeutic use*
  • Bone Density / drug effects
  • Bone Density Conservation Agents / pharmacology
  • Bone Density Conservation Agents / therapeutic use*
  • Diphosphonates / therapeutic use
  • Humans
  • Osteoporosis / drug therapy*
  • Osteoporosis / prevention & control
  • Parathyroid Hormone-Related Protein / pharmacology
  • Parathyroid Hormone-Related Protein / therapeutic use*
  • Spine
  • Teriparatide / therapeutic use

Substances

  • Anabolic Agents
  • Bone Density Conservation Agents
  • Diphosphonates
  • Parathyroid Hormone-Related Protein
  • Teriparatide
  • abaloparatide