[Teriparatide in biphosphonate-resistant osteoporosis and high fracture risk]
Salvi R, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A.
Record ID 32018001540
Spanish
Original Title:
Teriparatida en osteoporosis refractaria a bifosfonatos y alto riesgo de fractura
Authors' recommendations:
High-quality evidence suggests that teriparatide, when compared with risedronate, decreases the risk of vertebral fracture in post-menopausal patients with osteoporosis and at high risk of fracture. Moderate-quality evidence suggests that teriparatide, in patients with osteoporosis resistant to at least one biphosphonate, would be associated to a lower risk of vertebral and non-vertebral fracture when compared with bisphosphonates or denosumab; however, it would have a lower benefit than denosumab in reducing the risk of hip fracture. The greatest benefit obtained with teriparatide is observed in selected patients at very high risk of fracture or presence of previous fractures: T score < -3.5 and who have failed with two previous lines of biphosphonates.
There is partial consensus among the clinical practice guidelines consulted in recommending its use in patients with osteoporosis at very high risk of fracture, mainly vertebral, who have failed or do not tolerate biphosphonates; and in patients with osteoporosis secondary to glucocorticoids.
Most of the coverage policies consulted cover the use of teriparatide in patients with diagnosed osteoporosis and high fracture risk who have not adequately responded to bisphosphonates; i.e., elderly patients with a history of osteoporotic fractures, use of glucocorticoids and a T-score less than -3. No cost-effectiveness studies on teriparatide have been found in Argentina. Among the health technology assessments consulted, Colombia and Peru do not consider it cost-effective. However, the assessments conducted in Europe and Brazil conclude that teriparatide is cost-effective when used in selected patients, i.e., in patients with osteoporosis and very high fracture risk who have failed to previous therapy with bisphosphonates.
Details
Project Status:
Completed
Year Published:
2019
URL for published report:
https://www.iecs.org.ar/home-ets/
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Osteoporosis, Postmenopausal
- Teriparatide
- Osteoporotic Fractures
- Bone Density Conservation Agents
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.