PTH1 receptor agonists for fracture risk: a systematic review and network meta-analysis
An erratum to this article was published (Osteoporos Int, May 2025 ↗)
Authors' conclusion
This review highlights that PTH1 receptor agonists effectively reduce fracture risk, with abaloparatide offering enhanced benefits for non-vertebral and hip fractures compared to teriparatide.
Study context
- Population
- Studies of osteoporosis treatment reporting reduction in vertebral, non-vertebral, hip or all fractures as primary endpoint; Medline, Embase, Cochrane up to May 202417 studies (11 randomized controlled trials (RCTs), 6 real-world evidence (RWE))
- Comparison
- Teriparatide vs abaloparatide, and each vs other osteoporosis treatments
- Outcome
- Reduction in vertebral, non-vertebral, hip, or all fractures
Methodological detailspairwise meta-analyses, Bayesian network meta-analysis (NMA)
- Pairwise meta-analyses
- Bayesian NMA
Pooled result
As reported in the abstract
Abaloparatide vs TeriparatideOdds ratio (95% CI)
Non-vertebral fractures
0.87(0.80–0.95)
Hip fractures
0.81(0.71–0.93)
Further pooled results
Vertebral fracture (NMA)
- Teriparatide and abaloparatide superior to placebo, raloxifene and calcitonin; teriparatide further superior to denosumab and risedronate
Non-vertebral fracture (NMA)
- Abaloparatide better than any other treatment; teriparatide only superior to alendronate or placebo
All fractures and hip fracture (NMA)
- PTH1 analogs better than placebo for all fractures; no difference for hip fracture
Original publication
PTH1 receptor agonists for fracture risk: a systematic review and network meta-analysis. Osteoporos Int. Published 6 March 2025. doi:10.
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