Most of the reports on the successful use of PTH include patients with fractures who either have healing problems or have some features suggesting that healing can be compromised. Although most studies show positive results, there is a clear risk of bias since the literature consists almost entirely of case reports or case series. During this process, periarticular chondrocytes differentiate into extensively proliferating chondrocytes which eventually cease their proliferation and differentiate into hypertrophic chondrocytes. The healing process is similar to the process of fetal and infant bone growth and it appears that PTH specifically affects endochondral ossification by stimulating the proliferation and differentiation of osteoprogenitor cells and increasing the production of bone matrix proteins. It seems that teriparatide may have a potential role in fracture healing by enhancing various processes involved in the initial formation of endochondral bone and in the construction of the primary callus. Patients should receive calcium and vitamin D supplements if they have a low-nutrition diet. This 24-month treatment should not be repeated over the life of the patient. The maximum total duration of treatment with teriparatide should be 24 months. Currently, based on the World Health Organization guidelines, the recommended dose of teriparatide is 20 micrograms once a day. Finally, it is also used in patients who, while under treatment with bisphosphonates, suffer from osteoporotic fractures or fragility fractures or have a decreasing bone density. It is also used to treat osteoporosis associated with prolonged and systemic glucocorticoid therapy in women and men. Officially, teriparatide is indicated for the treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture. The purpose of this paper is to summarize the relevant information from the international bibliography and to draw conclusions about the progress of science in the subject.
Furthermore, it seems that it may have a potential role in fracture healing by enhancing various processes involved in the initial formation of endochondral bone and in the construction of the primary callus. To date, most studies show positive results, but as the literature consists almost entirely of case reports or case series, there is a clear risk of bias. Its osteo-anabolic action has led to the investigation of the use of teriparatide for the improvement of bone quality and restoration of other bone diseases (incomplete fracture of fractures, osteoarthritis, incomplete osteogenesis, dentistry, endocrine diseases, etc.). Teriparatide promotes the maturation of circulating osteoblast precursors and differentiation of lining osteoblasts, triggers the formation of new bone tissue by the preexisting osteoblasts, and limits osteoblast and osteocyte apoptosis. Teriparatide belongs to osteo-anabolic compounds and has been used in recent years to treat patients with osteoporosis, and has the benefit of increasing bone density. The microscopic structures of the skeleton are improved by increasing the thickness of cancellous bone, while cortical bone improves both its structure and its thickness. lumbar spine), will exhibit the greatest increase in bone density. Since PTH stimulates bone production, areas with an increased rate of bone metabolism, such as cancellous bones (e.g. This polypeptide contains all the classical biological and biochemical effects of the entire PTH molecule, that with the 84 amino acids. It is the N-terminal portion of PTH, consisting of the first 34 amino acids. The recombinant analogue of PTH (rPTH or PTH1-34) or teriparatide has been used since 2002 as an osteoanabolic agent with great success. While PTH is included in osteoclasting agents, when it is administered periodically in small doses, it stimulates bone tissue production. PTH is secreted as a response to the reduction in calcium serum levels and acts by increasing calcium release from bones and reabsorption from the renal tubules while increasing calcium absorption from the small intestine via the 1,25-VitD synthesis (VitD3). Parathyroid hormone (PTH) is a polypeptide consisting of 84 amino acids produced by parathyroids and involved in maintaining calcium and phosphate homeostasis.