At 12 months, the teriparatide-treated patients averaged a bone gain of 1.86 mm (29%), compared with baseline, whereas the placebo patients averaged a 0.16-mm (3%) gain from baseline.
Teriparatide treatment was also associated with a 2.42-mm (33%) average reduction in probing depth at the surgical site after a period of 12 months, compared with baseline. The placebo group averaged a 1.32-mm (20%) reduction in probing depth from baseline, a statistically significant difference.
Clinical attachment improved by an average of 1.58 mm (22%) at 1-year follow-up, compared with baseline, in the teriparatide patients, significantly better than the average value of 0.42 mm (7%) for attachment improvement in the placebo group.
No improvements in probing depth occurred in the teriparatide and placebo patients in areas of severe, chronic periodontitis that did not undergo surgery.
At entry to the study, five patients in the teriparatide arm and nine in the placebo group had osteopenia on dual x-ray absorptiometry examinations. At the 12-month follow-up, patients in both of the study arms showed no significant changes in bone density scores or in quality of life scores.
Teriparatide treatment was not associated with any pattern of adverse events that differed from the placebo group.
Although teriparatide is available in the United States for treating osteoporosis, its widespread use in patients who are undergoing periodontal surgery should await results from studies involving larger numbers of patients, Dr. McCauley said. She also cautioned against extrapolating the results to other types of bone surgery.
Dr. McCauley said she would like to run studies on a delayed-release, topical formulation of teriparatide that would be implanted during surgery and would then release over the subsequent 6 weeks. Such a mode of delivery would precludeithe necessity of administering daily injections. Teriparatide formulations of this type now exist, but they have not reached the clinical-testing stage.
Parathyroid hormone stimulates formation of preosteoblast cells and bone.
Source DR. BASHUTSKI
Teriparatide increased 1-year bone gain at a rate that was 10-fold higher than placebo.
Source DR. MCCAULEY