Clinical outcomes of twice-weekly teriparatide acetate administration in osteoporosis.

W2TPD, a twice-weekly teriparatide administration regimen, was used on 163 patients. The continuation rate was 47%, with only one new fracture. Even after performing antiresorptive therapy, spine BMD increased significantly in the majority of groups. W2TPD demonstrated good efficacy and tolerability in a real-world sequential osteoporosis treatment model. PURPOSE: Teriparatide is the most commonly administered daily, but there are also once-weekly and twice-weekly regimens. The former demonstrated high efficacy in increasing bone mineral density (BMD) and preventing new fractures; however, the continuation rate was reported to be low due to a high incidence of side effects. As a result, the twice-weekly teriparatide administration schedule (W2TPD) was created. In this study, we conducted a real-world clinical evaluation of its efficacy as part of a sequential osteoporosis treatment regimen. METHODS: The study included 163 patients with osteoporosis who were treated with W2TPD. Patients treated with W2TPD were divided into five groups based on their prior medication use: treatment-naïve (N), post-denosumab (post-D), post-bisphosphonate (post-B), post-romosozumab (post-R), and post-SERM (post-S). We examined treatment continuation rates, adverse events, and changes in BMD. RESULTS: The overall treatment continuation rate was 47.9%, with only one patient developing a new fracture during treatment. Gastrointestinal side effects, such as heartburn, nausea, and vomiting, were common. The percent changes in spine BMD were 10%, 5.2%, 5%, - 1.5%, and 12.3% in the N, post-D, post-B, post-R, and post-S groups, respectively. Meanwhile, hips were found in 3.1%, 0.4%, 1.5%, 0%, and 2.2%, respectively. In terms of spine BMD, all groups except post-R had responder rates greater than 50%. CONCLUSION: The continuation rate of W2TPD was 47% and resulted in particularly favorable BMD gains in the spine. It was also discovered to be effective in increasing BMD even when following bisphosphonate treatment.