Parathyroid Drugs

Question 1

What is Teriparatide (Fortero), PTH 1-34?

Answer 1

PTH Analog
A recombinant amino terminal fragment of PTH comprised of the first 34 amino acids of PTH (the sequence responsible for the biological effects)

Question 2

What are the characteristics of Teriparatide?

Answer 2

● Comprised of the first 34 A.A.s of PTH
● Must use at low, intermittent doses (then OB action predominates = bone formation)
● RANK ligand (aka OPGL) and RANK – definitely need to know mechanism of how osteoblast and osteoclast actions are coupled–refer to diagram and text in the handout
● A peptide so requires sc injection
● Treatment of osteoporosis
● Don’tuseinpeople

Question 3

What is Denosumab?

Answer 3

is a human monoclonal antibody that binds with high affinity to RANK ligand (RANKL), mimicking the effect of OPG, and thereby reducing the binding of RANKL to RANK. Denosumab thus blocks osteoclast formation and activation. It increases bone mass density, and decreases bone turnover markers when administered subcutaneously once every six months. At this dose , it resulted in 68%, 41%, and 20% reductions in vertebral, hip, and non­vertebral fractures, respectively in a phase III clinical trial. Denosumab is administered subcutaneously once every 6 months