Lumbar spinal fusion is a common procedure increasingly being performed in older patients many of whom have poor bone quality. Poor bone quality is associated with increased risk of bone related complications and need for revision surgery. Preoperative bone health optimization has been proposed to address this poor bone health using antiosteoporosis medications. However, there remains ongoing controversy regarding the use of bisphosphonates and teriparatide for osteoporotic patients and few studies have explored the cost-effectiveness of teriparatide in lumbar spinal fusion.

PURPOSE:

The aim of the study is to determine the cost-effectiveness, quantified in terms of absolute risk reduction (ARR) and number needed to treat (NNT), of teriparatide to prevent symptomatic pseudarthrosis following lumbar spinal fusion.

STUDY DESIGN/SETTING:

Economic analysis, Level of Evidence 3.

PATIENT SAMPLE:

The present break-even analysis considers simulated patients with and without osteoporosis undergoing primary posterior lumbar spinal fusion. The analysis is independent of the total number of annual surgeries and can be applied to any sized cohort of patients with osteoporosis undergoing primary posterior lumbar spinal fusion.

OUTCOME MEASURES:

We calculated the final break-even cost rate of pseudoarthrosis, the absolute risk reduction, and the number need to treat to prevent one symptomatic pseudoarthrosis event while breaking even on cost utilization.

METHODS:

The MEDLINE database was queried for prior literature regarding the cost of teriparatide and revision lumbar fusion surgery for symptomatic pseudarthrosis in the United States as well as the rate of symptomatic bony nonunion in osteoporotic patients undergoing spinal fusion. Two break-even cost analyses were performed utilizing the surgical cost alone and the total overall cost to calculate the ARR in pseudarthrosis required to deem teriparatide as cost-effective. The ARR was then used to calculate the number of patients that would require teriparatide, NNT, to prevent one pseudarthrosis event while breaking-even on overall cost expenditure.

RESULTS:

When observing surgical cost alone, daily-use teriparatide was determined to be positively cost effective at initial rates of pseudarthrosis >53.4% in osteoporotic patients. Utilization of the total overall cost in our break-even model showed daily-use teriparatide to be cost effective when the initial nonunion rate exceeded 30.6%. Teriparatide was not cost-effective at lower initial rates of pseudarthrosis for osteoporotic patients. In both scenarios of investigating total overall cost and surgical cost alone, the ARR decreases as the cost of symptomatic pseudarthrosis treatment rises. At higher costs of revision surgery and higher initial pseudarthrosis rates, teriparatide becomes cost-effective at a more efficient rate.

CONCLUSIONS:

Daily-use teriparatide is a cost-effective treatment for preventing symptomatic pseudarthrosis in osteoporotic patients undergoing lumbar spinal fusion, with a NNT of 5 in this population.

01 Sep 2025·Bone Reports

Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures

Article

Author: Menkes-Caspi, Noa ; Bornstein, Robyn Jacob ; Mazza, Orit ; Bahar, Michael ; Amir, Hagay ; Haim, Amir ; Gluck, Chemda

Background:

Secondary fracture prevention is a well-defined treatment-gap within osteoporosis management. Fracture Liaison Service (FLS) coordinates the management and treatment of patients following a fragility fracture in order to close the care gap. We aim to assess the efficacy of the FLS initiative in the management and treatment of patients following fragility hip fracture in the inpatient rehabilitation setting.

Methods:

This is a diagnostic, retrospective cohort study using a deidentified, electronic health record database. In the extraction process, patients with fragility hip fractures were identified. Patients after major trauma or malignancy were excluded. The prevalence of initiation and adherence to anti-osteoporotic treatments, including alendronate, risedronate, zoledronate, denosumab, romosozumab, and teriparatide, was compared between the rehabilitation FLS initiative patients and patients from other hospitals without FLS.

Results:

A total of 4,124 patients with fragility hip fractures were identified between 2017 and 2021. The FLS initiative showed significantly higher rates of treatment initiation, with 72.1 % of patients receiving pharmacological therapy following a hip fracture, compared to 45.1 % in hospitals without FLS (p < 0.001). Patients in the FLS group also demonstrated higher rates of good adherence and lower rates of poor adherence (p < 0.001). Denosumab was the most commonly prescribed anti-osteoporotic treatment within the FLS initiative.

Conclusions:

The FLS in the inpatient rehabilitation setting was found to be highly effective in improving time to treatment initiation and adherence rates to prescribe anti-osteoporosis therapy. These findings demonstrate the role of FLS in addressing the osteoporosis treatment gap following fragility hip fracture.

01 Sep 2025·Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Teriparatide as an adjuvant therapy in the management of advanced-stage medication-related osteonecrosis of the jaw

Article

Author: Chung, Kevin ; Yom, SaeHee K ; Huryn, Joseph M ; Estilo, Cherry L ; Singh, Annu ; Farooki, Azeez

Teriparatide, recombinant human parathyroid hormone, is a US Food and Drug Administration (FDA)-approved drug used for the treatment of osteoporosis in men and postmenopausal women. Recent studies have shown that it may promote bone healing in medication-related osteonecrosis of the jaw (MRONJ). We describe a case of successful management of advanced-stage MRONJ with teriparatide therapy that was initially prescribed for osteoporosis. This case demonstrates that in patients with progressive MRONJ with significant pain and frequent flares of acute infection, teriparatide may be a viable adjunct in treating MRONJ, as well as helping alleviate symptoms and improve quality of life. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

News (Medical) associated with Teriparatide(Yunnan Xianshi )

30 Sep 2025

·www.einpresswire.com

April - June 2025 | Potential Signals of Serious Risks/New Safety Information Identified by the FDA Adverse Event Reporting System (FAERS)

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Blincyto (blinatumomab) for injection Columvi (glofitamab-gxbm) injection Elrexfio (elranatamab-bcmm) injection Epkinly (epcoritamab-bysp) injection Imdelltra (tarlatamab-dlle) for injection Kimmtrak (tebentafusp-tebn) injection Lunsumio (mosunetuzumab-axgb) injection Talvey (talquetamab-tgvs) injection Tecvayli (teclistamab-cqyv) injection Progressive multifocal leukoencephalopathy FDA is evaluating the need for regulatory action. BRAF kinase inhibitors Braftovi (encorafenib) capsules Ojemda (tovorafenib) for oral suspension; tablets Tafinlar (dabrafenib) capsules; tablets Zelboraf (vemurafenib) tablets Gingival hypertrophy FDA is evaluating the need for regulatory action. Briumvi (ublituximab-xiiy) injection Kesimpta (ofatumumab) injection Acute hepatic failure The "Warnings and Precautions" section of the labeling was updated in August 2025 to include information about liver injury. 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Drug ApprovalBiosimilar

27 Oct 2008

·www.biospace.com

Zosano Pharma, Inc. Announces Positive Results of Phase 2 Osteoporosis Study

FREMONT, Calif.--(BUSINESS WIRE)--Zosano Pharma, Inc., a privately held pharmaceutical company developing a novel transdermal delivery technology, today announced positive results from its phase 2, randomized, multi-center, double-blind, multi-dose study designed to determine safety and efficacy of its ZP-PTH rapid delivery patch for the treatment of osteoporosis. The product delivers PTH 1-34, teriparatide (PTH), a compound that has been proven to stimulate formation of new bone and reduce the risk of fractures. The ZP-PTH patch uses a unique transdermal technology being developed as an alternative to daily injections.

100 Deals associated with Teriparatide(Yunnan Xianshi )

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Fractures, Bone	Australia	Eli Lilly Australia Pty Ltd.	22 May 2003
Glucocorticoid-induced osteoporosis	Australia	Eli Lilly Australia Pty Ltd.	22 May 2003
Osteoporosis, Postmenopausal	Australia	Eli Lilly Australia Pty Ltd.	22 May 2003
Primary osteoporosis	Australia	Eli Lilly Australia Pty Ltd.	22 May 2003

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