Teriparatide is safe and effectively increases bone biomarkers in institutionalized individuals with osteoporosis

Kathryn M. Ryder, S. Bobo Tanner, Laura Carbone, John E. Williams, Henry M. Taylor, Andrew Bush, Victorina Pintea, Mitchell A. Watsky

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Institutionalized adults with severe developmental disabilities have a high rate of minimal trauma and appendicular fracture. There is little information about osteoporosis treatment in this population. In this efficacy and safety study, men and women with severe developmental disabilities and osteoporosis received 20 mcg teriparatide subcutaneously daily for 18-24 months. Markers of bone formation [procollagen type 1 intact N-terminal propeptide (P1NP)] and resorption [C-telopeptide (CTx)] were measured at three-month intervals. Serum calcium was measured at two-week intervals for 12 weeks and thereafter at three-month intervals. Twenty-seven individuals received at least one injection. The incidence of hypercalcemia was 11.1% but was persistent and led to medication discontinuation in only one participant. Biomarkers of bone formation increased rapidly, doubling by three months. At 12 months, P1NP and CTx remained elevated from baseline; P1NP had risen from 66.95 ± 83.71 μg/l (mean ± SD) to 142.42 ± 113.85 μg/l (P = 0.05), and CTx had increased from 0.377 ± 0.253 to 1.016 ± 1.048 ng/ml (P = 0.01). The majority of participants had an increase in P1NP of over 10 μg/l. In conclusion, teriparatide is safe and effective in developmentally disabled institutionalized adults. Serial calcium measurements are warranted, particularly during the first three months of therapy.

Original languageEnglish (US)
Pages (from-to)233-239
Number of pages7
JournalJournal of Bone and Mineral Metabolism
Issue number2
StatePublished - Mar 2010
Externally publishedYes


  • Biomarkers
  • Developmental disabilities
  • Disuse osteoporosis
  • Institutionalized
  • Teriparatide

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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