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Teriparatide, sold under the brand name Forteo among others, is a form of parathyroid hormone (PTH) consisting of the first (N-terminus) 34 amino acids, which is the portion of the hormone activating the Parathyroid hormone 1 receptor. It is an effective anabolic (promoting bone formation) agent used in the treatment of some forms of osteoporosis. Teriparatide is a recombinant human parathyroid hormone analog (PTH 1-34). It has an identical sequence to the 34 N-terminal amino acids of the 84-amino acid human parathyroid hormone.
Read the full article on WikipediaSevere established osteoporosis Clinical criteria: Treatment Phase: Initial treatment Treatment criteria: Must be treated by a specialist; OR Must be treated by a consultant physician. Patient must be at very high risk of fracture, AND Patient must have a bone mineral density (BMD) T-score of -3.0 or less, AND Patient must have had 2 or more fractures due to minimal trauma, AND Patient must have experienced at least 1 symptomatic new fracture after at least 12 months continuous therapy with an anti-resorptive agent at adequate doses, AND The treatment must be the sole PBS-subsidised therapy for this condition, AND The treatment must not exceed a lifetime maximum of 18 months therapy, AND Patient must not have received treatment with PBS-subsidised romosozumab; OR Patient must have developed intolerance to romosozumab of a severity necessitating permanent treatment withdrawal within the first 6 months of therapy. A vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or, a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body. If treatment with anti-resorptive therapy is contraindicated according to the relevant TGA-approved Product Information, details of the contraindication must be documented in the patient's medical record at the time treatment with teriparatide is initiated. If an intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use of one anti-resorptive agent, alternate anti-resorptive agents must be trialled so that the patient achieves the minimum requirement of 12 months continuous therapy. Details must be documented in the patient's medical record at the time treatment with teriparatide is initiated. Anti-resorptive therapies for osteoporosis and their adequate doses which will be accepted for the purposes of administering this restriction are alendronate sodium 10 mg per day or 70 mg once weekly, risedronate sodium 5 mg per day or 35 mg once weekly or 150 mg once monthly, raloxifene hydrochloride 60 mg per day (women only), denosumab 60 mg once every 6 months and zoledronic acid 5 mg per annum. Details of prior anti-resorptive therapy, fracture history including the date(s), site(s), the symptoms associated with the fracture(s) which developed after at least 12 months continuous anti-resorptive therapy and the score of the qualifying BMD measurement must be documented in the patient's medical record.
“Teriparatide is a portion of human parathyroid hormone (PTH), amino acid sequence 1 through 34, of the complete molecule (containing 84 amino acids). Endogenous PTH is the primary regulator of calcium and phosphate metabolism in bone and kidney. PTH increases serum calcium, partially accomplishing this by increasing bone resorption. Thus, chronically elevated PTH will deplete bone stores. However, intermittent exposure to PTH will activate osteoblasts more than osteoclasts. Thus, once-daily injections of teriparatide have a net effect of stimulating new bone formation leading to increased bone mineral density.”
“Subcutaneous: 1 hour”
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