PTH/PTHrP analogues as osteoanabolic treatment in patients with osteoporosis

Med Clin (Barc). 2025 Oct;165(4):107076. doi: 10.1016/j.medcli.2025.107076. Epub 2025 Jun 25.
[Article in English, Spanish]

Abstract

Teriparatide (TPTD) and abaloparatide (ABL) are osteoanabolic drugs belonging to the group of parathyroid hormone analogues and parathyroid hormone-related protein analogues, respectively. Both drugs have been shown to be effective and safe in the treatment of postmenopausal osteoporosis (PMO), reducing the risk of vertebral and nonvertebral fractures and improving bone microarchitecture, especially in patients with severe osteoporosis. For this reason, guidelines recommend their use as first-line treatment for patients at very high risk of fracture. Although TPTD and ABL act on the same receptor, PTHR1, they trigger a different signaling response, which explains why their effects on bone remodeling are also different, with similar osteoanabolic action, but with less stimulation of resorption by ABL, which confers a greater benefit on cortical bone.

Keywords: Abaloparatida; Abaloparatide; Análogos de la PTH/PTHrP; Bone forming agents; Osteoanabolics; Osteoanabólicos; Osteoformadores; Osteoporosis posmenopáusica; PTH/PTHrP analogues; Postmenopausal osteoporosis; Teriparatida; Teriparatide.

Publication types

  • Review

MeSH terms

  • Bone Density Conservation Agents* / pharmacology
  • Bone Density Conservation Agents* / therapeutic use
  • Bone Remodeling / drug effects
  • Female
  • Humans
  • Osteoporosis* / drug therapy
  • Osteoporosis, Postmenopausal* / drug therapy
  • Osteoporotic Fractures / prevention & control
  • Parathyroid Hormone* / analogs & derivatives
  • Parathyroid Hormone* / therapeutic use
  • Parathyroid Hormone-Related Protein* / pharmacology
  • Parathyroid Hormone-Related Protein* / therapeutic use
  • Receptor, Parathyroid Hormone, Type 1
  • Teriparatide* / pharmacology
  • Teriparatide* / therapeutic use

Substances

  • Parathyroid Hormone-Related Protein
  • Teriparatide
  • abaloparatide
  • Bone Density Conservation Agents
  • Parathyroid Hormone
  • Receptor, Parathyroid Hormone, Type 1