Clinical Interventions in Aging (Jun 2020)
Abaloparatide and the Spine: A Narrative Review
Abstract
Jeremy C Thompson,1 Nathan Wanderman,1 Paul A Anderson,2 Brett A Freedman1 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; 2Department of Orthopaedic Surgery, Department of Orthopedics Surgery & Rehabilitation, University of Wisconsin, Madison, WI 53705-2281, USACorrespondence: Brett A FreedmanMayo Clinic, 200 First Street S.W., Rochester, MN 55905, USATel +507 284-2884Fax +507 266-4234Email [email protected]: 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: abaloparatide, Tymlos, anabolic, osteoporosis, spine, teriparatide