Effectiveness of parathyroid hormone (PTH) analogues on fracture healing: a meta-analysis

Katharine Eastman, Matthew Gerlach, Isabelle Piec, Julie Greeves, William Fraser

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20 Citations (Scopus)
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Purpose: This meta-analysis evaluated the evidence of Parathyroid Hormone (PTH) analogues in fracture healing. The use of PTH analogues to prevent osteoporotic fractures is well investigated and studies are emerging on extended indications. One such indication receiving increasing attention is the effect of PTH in fracture healing; however, the overall degree of efficacy remains inconclusive.
Methods: A systematic electronic database search of MEDLINE, EMBASE and the Cochrane Library was conducted for relevant articles in August 2019 with no date restrictions. Randomised controlled trials of adults with acute fractures treated with a PTH analogue were included. PTH was compared with a comparator intervention, placebo, or no treatment.
Results: PTH analogue treatment improved functional outcomes in a range of fracture types but did not affect the fracture healing rate or reduce pain. Most trials included in this review were in elderly patients with osteoporosis. There was no evidence that PTH treatment caused harm or impeded fracture healing.
Conclusions: Meta-analysis of published data supports the use of PTH analogues to improve functional outcomes but not fracture healing rate or pain for different fracture types. The evidence for PTH analogue use in fracture healing is less clear in younger, nonosteoporotic patient populations. Trial design was heterogeneous and of limited quality justifying further original trials.
Original languageEnglish
Pages (from-to)1531–1546
Number of pages16
JournalOsteoporosis International
Issue number8
Early online date9 Feb 2021
Publication statusPublished - Aug 2021


  • Fracture healing
  • Meta-analysis
  • Osteoporosis
  • Parathyroid hormone
  • Teriparatide

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