[Monitoring bone turnover markers during treatment with the anabolic agent teriparatide; in particular, treatment using daily and weekly subucutaneous injections].

Teriparatide (recombinant human PTH1-34 daily subcutaneous injection) has been approved for osteoporosis at high risk of fracture in many countries including Japan. Teriparatide daily injection therapy has been reported to increase BMD, improve microarchitecture of bone, and reduce the risk of new vertebral fractures and that of non-vertebral fractures. The observed rapid increase in bone formation marker and later increase in bone resorption marker has been described as a bone anabolic window. The accumulated information using data from global clinical trials further tested in the Phase 3 trial of Japanese patients suggests that P1NP monitoring may be a useful aid in the management of patients with osteoporosis during teriparatide daily injection treatment. Recently once weekly subcutaneous injection of teriparatide has been approved in Japan. Weekly teriparatide injection treatment has been reported to reduce the risk of new vertebral fractures compared with placebo. Regarding bone turnover markers, serum osteocalcin increased and urinary NTX decreased during the weekly teriparatide treatment.