Does Teriparatide Improve Femoral Neck Fracture Healing: Results From A Randomized Placebo-controlled Trial
Background There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo ® / Forsteo ® , recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal wom...
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Published in | Clinical orthopaedics and related research Vol. 474; no. 5; pp. 1234 - 1244 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.05.2016
Lippincott Williams & Wilkins Ovid Technologies |
Subjects | |
Online Access | Get full text |
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Abstract | Background
There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo
®
/ Forsteo
®
, recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing.
Questions/purposes
We wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety.
Methods
We initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 μg/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery.
Results
The proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79–0.93) versus 84% in the teriparatide group (90% CI, 0.75–0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46–1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25–3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period.
Conclusions
The small sample size limited this study’s power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing.
Level of Evidence
Level II, prospective study. |
---|---|
AbstractList | There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo super( registered )/ Forsteo super( registered ), recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing. We wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety. We initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 mu g/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery. The proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79-0.93) versus 84% in the teriparatide group (90% CI, 0.75-0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46-1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25-3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period. The small sample size limited this study's power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing. Level II, prospective study. BACKGROUNDThere is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo(®)/ Forsteo(®), recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing.QUESTIONS/PURPOSESWe wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety.METHODSWe initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 μg/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery.RESULTSThe proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79-0.93) versus 84% in the teriparatide group (90% CI, 0.75-0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46-1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25-3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period.CONCLUSIONSThe small sample size limited this study's power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing.LEVEL OF EVIDENCELevel II, prospective study. Background There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo ® / Forsteo ® , recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing. Questions/purposes We wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety. Methods We initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 μg/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery. Results The proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79–0.93) versus 84% in the teriparatide group (90% CI, 0.75–0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46–1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25–3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period. Conclusions The small sample size limited this study’s power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing. Level of Evidence Level II, prospective study. Background There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo^sup ^/ Forsteo^sup ^, recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing. Questions/purposes We wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety. Methods We initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 [mu]g/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery. Results The proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79-0.93) versus 84% in the teriparatide group (90% CI, 0.75-0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46-1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25-3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period. Conclusions The small sample size limited this study's power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing. Level of Evidence Level II, prospective study. There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo(®)/ Forsteo(®), recombinant human parathyroid hormone) is a bone anabolic drug that is approved for treatment of osteoporosis and glucocorticoid-induced osteoporosis in men and postmenopausal women at high fracture risk. Preclinical and preliminary clinical data also suggest that teriparatide may enhance bone healing. We wished to test the hypotheses that treatment with teriparatide versus placebo would improve femoral neck fracture healing after internal fixation as measured by (1) frequency of revision surgery, (2) radiographic fracture healing, and (3) other outcomes including pain control, gait speed, and safety. We initiated two separate, but identically designed, clinical trials to meet FDA requirements to provide substantial evidence to support approval of a new indication. The two prospective, randomized double-blind, placebo-controlled Phase III studies were designed to evaluate the effect of subcutaneous teriparatide (20 μg/day) for 6 months versus placebo on fracture healing at 24 months. The trials were conducted concurrently with a planned enrollment of 1220 patients per trial. However, enrollment was stopped owing to very slow patient accrual, and an a priori decision was made to pool the results of those studies for statistical analyses before study completion; pooling was specified in both protocols. Randomization was stratified by fixation (sliding hip screw or multiple cancellous screws) and fracture type (displaced or nondisplaced). An independent Central Adjudication Committee reviewed revision surgical procedures and radiographs. A total of 159 patients were randomized in the two trials (81 placebo, 78 teriparatide). The combined program had very low power to detect the originally expected treatment effect but had approximately 80% power to detect a larger difference of 12% between treatment groups for risk of revision surgery. The proportion of patients undergoing revision surgery at 12 months was 14% (11 of 81) in the placebo group versus 17% (13 of 78) in the teriparatide group. Central Adjudication Committee review excluded two of these patients treated with placebo from the primary analysis. After exclusions, the proportion of patients who did not undergo revision surgery at 12 months (primary endpoint) was not different between the study and placebo groups, at 88% in the placebo group (90% CI, 0.79-0.93) versus 84% in the teriparatide group (90% CI, 0.75-0.90; p = 0.743). There also were no differences between groups in the proportion of patients achieving radiographic fracture healing at 12 months (75% [61 of 81] placebo versus 73% [57 of 78] teriparatide; odds ratio, 0.89; 90% CI, 0.46-1.72; p = 0.692) or in measures of pain control (such as pain during ambulation, 92% [55 of 62] placebo versus 91% [52 of 57] teriparatide; odds ratio, 0.91; 90% CI, 0.25-3.37; p = 0.681). The frequency of patients reporting adverse events was 49% [40 of 81] in the placebo group versus 45% [35 of 78] in the teriparatide group (p = 0.634) during the 6-month treatment period. The small sample size limited this study's power to detect potential differences, and the results are exploratory. With the patients available, teriparatide did not decrease the risk of revision surgery, improve radiographic signs of fracture healing, or decrease pain compared with the placebo. The adverse event data observed were consistent with the teriparatide safety profile. Functional and health outcome data from the studies may help improve our understanding of patients recovering from femoral neck fractures. Further large controlled studies are required to determine the effect of teriparatide on fracture healing. Level II, prospective study. |
Author | Burge, Russel Bhandari, Mohit Jin, Ling Warner, Margaret R. Ahmad, Qasim I. Witvrouw, Richard Krohn, Kelly D. Mitlak, Bruce Gilchrist, Nigel See, Kyoungah |
Author_xml | – sequence: 1 givenname: Mohit surname: Bhandari fullname: Bhandari, Mohit email: bhandam@mcmaster.ca organization: Department of Surgery, McMaster University – sequence: 2 givenname: Ling surname: Jin fullname: Jin, Ling organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 3 givenname: Kyoungah surname: See fullname: See, Kyoungah organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 4 givenname: Russel surname: Burge fullname: Burge, Russel organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 5 givenname: Nigel surname: Gilchrist fullname: Gilchrist, Nigel organization: Canterbury District Health Board and Canterbury Geriatric Medical Research Trust Research, The Princess Margaret Hospital – sequence: 6 givenname: Richard surname: Witvrouw fullname: Witvrouw, Richard organization: Department of Traumatology and Orthopaedics, Sint Jan Hospital – sequence: 7 givenname: Kelly D. surname: Krohn fullname: Krohn, Kelly D. organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 8 givenname: Margaret R. surname: Warner fullname: Warner, Margaret R. organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 9 givenname: Qasim I. surname: Ahmad fullname: Ahmad, Qasim I. organization: Lilly Research Laboratories, Eli Lilly and Company – sequence: 10 givenname: Bruce surname: Mitlak fullname: Mitlak, Bruce organization: Lilly Research Laboratories, Eli Lilly and Company |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26932738$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | The Association of Bone and Joint Surgeons® 2016 The Association of Bone and Joint Surgeons 2016 |
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Discipline | Medicine |
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Keywords | Fracture Healing Revision Surgery Teriparatide Gait Speed Internal Fixation |
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PublicationTitle | Clinical orthopaedics and related research |
PublicationTitleAbbrev | Clin Orthop Relat Res |
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PublicationYear | 2016 |
Publisher | Springer US Lippincott Williams & Wilkins Ovid Technologies |
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References_xml | – volume: 21 start-page: 1059 year: 2010 end-page: 1063 ident: CR8 article-title: Successful treatment of sternal fracture nonunion with teriparatide publication-title: Osteoporos Int. doi: 10.1007/s00198-009-1061-4 contributor: fullname: Gruber – volume: 2 start-page: 285 year: 1992 end-page: 289 ident: CR9 article-title: Hip fractures in the elderly: a world-wide projection publication-title: Osteoporos Int. doi: 10.1007/BF01623184 contributor: fullname: Melton – volume: 17 start-page: 971 year: 2006 end-page: 977 ident: CR26 article-title: Women with hip fracture have a greater rate of decline in bone mineral density than expected: another significant consequence of a common geriatric problem publication-title: Osteoporos Int. doi: 10.1007/s00198-006-0092-3 contributor: fullname: Hochberg – ident: CR14 – ident: CR12 – volume: 10 start-page: 293 year: 2004 ident: CR19 article-title: Teriparatide and fracture healing in cortical bone publication-title: Endocr Pract. contributor: fullname: Knecht – volume: 15 start-page: 219 year: 2014 ident: CR11 article-title: Fixation using alternative implants for the treatment of hip fractures (FAITH): design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures publication-title: BMC Musculoskelet Disord. doi: 10.1186/1471-2474-15-219 – volume: 55 start-page: M498 year: 2000 end-page: 507 ident: CR24 article-title: Recovery from hip fracture in eight areas of function publication-title: J Gerontol A Biol Sci Med Sci. doi: 10.1093/gerona/55.9.M498 contributor: fullname: Kenzora – volume: 93 start-page: 1583 year: 2011 end-page: 1587 ident: CR30 article-title: Parathyroid hormone 1–84 accelerates fracture-healing in pubic bones of elderly osteoporotic women publication-title: J Bone Joint Surg Am. doi: 10.2106/JBJS.J.01379 contributor: fullname: Holzer – volume: 81 start-page: 122 year: 2010 end-page: 125 ident: CR10 article-title: Can orthopedic trials change practice? publication-title: Acta Orthop. doi: 10.3109/17453671003587093 contributor: fullname: Bhandari – volume: 14 start-page: 1441 year: 2013 end-page: 1447 ident: CR7 article-title: Healing of the bone with anti-fracture drug publication-title: Expert Opin Pharmacother. doi: 10.1517/14656566.2013.801959 contributor: fullname: Brandi – volume: 76 start-page: 15 year: 1994 end-page: 25 ident: CR23 article-title: Outcomes after displaced fractures of the femoral neck: a meta-analysis of one hundred and six published reports publication-title: J Bone Joint Surg Am. contributor: fullname: Wennberg – volume: 89 start-page: 163 year: 2011 end-page: 171 ident: CR28 article-title: Experimental stimulation of bone healing with teriparatide: histomorphometric and microhardness analysis in a mouse model of closed fracture publication-title: Calcif Tissue Int. doi: 10.1007/s00223-011-9503-3 contributor: fullname: Barbos – volume: 367 start-page: 2010 year: 2006 end-page: 2018 ident: CR34 article-title: Osteoporosis publication-title: Lancet. doi: 10.1016/S0140-6736(06)68891-0 contributor: fullname: Cooper – volume: 292 start-page: 837 year: 2004 end-page: 846 ident: CR6 article-title: Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial publication-title: JAMA. doi: 10.1001/jama.292.7.837 contributor: fullname: Schechtman – volume: 311 start-page: 129 year: 1995 end-page: 135 ident: CR27 article-title: Epidemiology of hip fractures among the elderly: risk factors for fracture type publication-title: Clin Orthop Relat Res. contributor: fullname: Van Natta – volume: 47 start-page: 480 year: 2010 end-page: 492 ident: CR20 article-title: Effect of human parathyroid hormone hPTH (1–34) applied at different regimes on fracture healing and muscle in ovariectomized and healthy rats publication-title: Bone. doi: 10.1016/j.bone.2010.05.013 contributor: fullname: Stuermer – volume: 13 start-page: 624 year: 2002 end-page: 629 ident: CR36 article-title: Does a fracture at one site predict later fractures at other sites? 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Snippet | Background
There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo
®
/ Forsteo
®
, recombinant human parathyroid hormone)... There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo(®)/ Forsteo(®), recombinant human parathyroid hormone) is a bone... Background There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo^sup ^/ Forsteo^sup ^, recombinant human parathyroid... BACKGROUNDThere is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo(®)/ Forsteo(®), recombinant human parathyroid hormone)... There is a medical need for therapies that improve hip fracture healing. Teriparatide (Forteo super( registered )/ Forsteo super( registered ), recombinant... |
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SubjectTerms | Aged Aged, 80 and over Biomechanical Phenomena Bone Density Conservation Agents - adverse effects Bone Density Conservation Agents - therapeutic use Bone Screws Clinical Research Combined Modality Therapy Conservative Orthopedics Double-Blind Method Female Femoral Neck Fractures - diagnosis Femoral Neck Fractures - physiopathology Femoral Neck Fractures - therapy Femur Neck - diagnostic imaging Femur Neck - drug effects Femur Neck - physiopathology Femur Neck - surgery Fracture Fixation, Internal - adverse effects Fracture Fixation, Internal - instrumentation Fracture Healing - drug effects Gait Hip Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Odds Ratio Orthopedics Pain Measurement Pain, Postoperative - etiology Prospective Studies Radiography Recovery of Function Reoperation Risk Factors Sports Medicine Surgery Surgical Orthopedics Teriparatide - adverse effects Teriparatide - therapeutic use Time Factors Treatment Outcome |
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Title | Does Teriparatide Improve Femoral Neck Fracture Healing: Results From A Randomized Placebo-controlled Trial |
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