Little evidence base for use of teriparatide
More trials are needed to support the use of the osteoporosis drug teriparatide (Forsteo, Eli Lilly), the latest issue of Drug
and Therapeutic Bulletin argues (2004;42:93). Teriparatide is the first parathyroid hormone derivative licensed for the treatment of women with postmenopausal osteoporosis.
“There is no convincing published evidence to support the use of
teriparatide in preference to older treatments for women with postmenopausal
osteoporosis,” Ike
Iheanacho, editor of DTB, said. The DTB says that few published studies
have assessed teriparatide at its licensed dose and no adequate studies
have compared its effects with those of established drugs. It also argues
that there is an urgent need to investigate the drug’s safety as
studies have shown that rats treated with teriparatide are more likely
to develop bone tumours.
A spokesman for Eli Lilly commented: “The clinical and economic
value of teriparatide has been recognised by recommendations from the
Scottish Medicines Consortium and the All Wales Medicines Strategy Group
for its use in high risk patients with no age restrictions. Also, the
National Institute of Clinical Excellence draft guidance recommends that
teriparatide should be used in patients that have had an unsatisfactory
response with bisphosphonate therapy, aged 65 or older and who meet certain
clinical criteria. However, we have submitted an appeal to NICE with
regard to the restrictions on age imposed and await an outcome.” |
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