28/03/2024
Romosozumab
vs
Teriparatide
🚦🚦🚦🚦
1️⃣ Teriparatide is anabolic drug that increase remodeling - based bone formation but also increase bone resorption .
Romosozumab has dual action , increase bone formation and decrease bone resorption.
2️⃣ Teriparatide approved in post menopausal OP, Male OP and steroid OP .
Romosozumab is approved only for post menopausal OP until now.
3️⃣ Romosozumab has better compliance than teriparatide ( monthly vs Dialy use ).
4️⃣Anti fracture effect of romosozumab on non vertebral sites & Hip is more obvious ( statistically) than teriparatide.
5️⃣Coast:💰 Teriparatide is expensive than Romosozumab. (annual coast 44000 $ vs 22000 ).
6️⃣ Romosozumab is approved to be used up to one year .
Teriparatide is approved for two years and recently longer durations or repeated course of treatment may be appropriate in patients whose risk of fracture remains at high level or who don't have response to other therapies.
7️⃣ In Sequential therapy .
Clinically Romosozumab may be utilized after antiresorptive drugs as alendronate or denosumab.
Switch from denosumab to teriparatide is not recommended.
Switch from bisphosphonates to teriparatide is an option but some bulnting of BMD is seen as initial use of bispphosphonates may decrease effects of teriparatide.
8️⃣ Transient hypercalcemia may occur with teriparatide vs occasional hypocalcemia may occur with Romosozumab.
9️⃣ Romosozumab is contraindicated in patients with history of recent stroke or CVD.
Teriparatide is contraindicated in patients with history of previous radiation and malignancy.
🔟Romosozumab like other drugs that inhibit bone resorption may be associated with jaw osteonecrosis or atypical femoral fracture .
Teriparatide increase bone resorption in addition to its anabolic effects so these hazards are not expected to occur.
