Teriparatide Plus Zoledronic Acid for Osteogenesis Imperfecta

Can intervention with the parathyroid hormone analogue teriparatide followed by zoledronic acid reduce the risk of fractures in adults with osteogenesis imperfecta?In this randomized clinical trial, 65 of 176 participants (36.9%) allocated to receive teriparatide plus zoledronic acid had incident fractures compared with 63 of 173 participants (36.4%) allocated to receive standard care. This difference was not significant, despite significantly greater increases in bone density with teriparatide plus zoledronic acid.Increasing bone density with teriparatide plus zoledronic acid did not prevent fractures in osteogenesis imperfecta, emphasizing that defects in bone quality may be more important than low bone density in the pathogenesis of fracture.

Corresponding Author: Stuart H. Ralston, MD, Center for Genomic and Experimental Medicine, Edinburgh University, Crewe Road South, Edinburgh EH4 2XU, United Kingdom (stuart.ralston@ed.ac.uk).

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