The two major categories of pharmacologic treatment for osteoporosis are antiresorptive and bone anabolic medications. Teriperatide is the only currently approved anabolic medication for the treatment of osteoporosis. This study compared the effects of this medication with that of a bisphosphonate, risondronate, on the functional and radiographic outcomes after a hip fracture.

This multinational, randomized active controlled trial included patients with peritrochanteric hip fractures and bone mineral density T-scores of －2.0 or less, and 25-OH-vitamin D levels of 9.2 ng/mL or greater. The patients were randomized to receive teriperatide 20 μg per day subcutaneously, or risondronate 35 mg per week. At screening, both groups began oral supplements of calcium and vitamin D and discontinued any ongoing osteoporotic drugs. Patients were assessed for functional mobility at six, 12, 18 and 26 weeks, with outcome measures including the SF - 36 survey, Timed up and Go (TUG) test, a visual analogue pain scale, the modified Charnley hip pain score, as well as the ability to walk.

Of the patients randomized, 171 contributed to the efficacy analysis. The time required to complete the TUG test was shorter in the teriperatide group compared with the risondronate group at six, 12, 18, and 26 weeks (P＝0.021 for the overall between-treatment effect). The self-reported pain was reduced more in the teriperatide group than the risondronate group (P＝0.032). There was no difference between groups in the domains of the SF - 36, radiographic healing, or the ability to walk at 26 weeks.

This prospective randomized trial of patients with peritrochanteric hip fractures found that teriperatide treatment after fracture is associated with better functional outcome compared with risondronate.