Teriparatide treatment of osteoporosis in solid organ transplant recipients-a single-center experience
Abstract
Solid organ transplant recipients face high fracture risk with limited evidence guiding anabolic therapy. In this real-world cohort, teriparatide was associated with significant improvements in bone mineral density and acceptable safety without adverse graft effects. These findings support selective anabolic treatment in high-risk transplant recipients and highlight the need for prospective studies.
Purpose: Solid organ transplant (SOT) recipients are at high risk for osteoporosis and fragility fractures due to pre-existing organ dysfunction and long-term immunosuppressive therapy, particularly glucocorticoids. However, evidence supporting the use of anabolic osteoporosis therapy in this population remains limited.
Methods: We conducted a retrospective cohort study at a large transplant center including adult kidney, lung, and liver transplant recipients selected for teriparatide treatment based on clinical indications for severe post-transplant osteoporosis for at least 3 months. Bone mineral density (BMD), incident fractures, biochemical parameters, renal function, and adverse events were evaluated during treatment and follow-up.
Results: Thirty-nine SOT recipients (33% men; mean age 61.3 ± 11.6 years) were included, comprising kidney (n = 10), lung (n = 20), and liver (n = 9) transplant recipients. Prior fragility fractures were present in 90% of patients, and 79% had multiple fractures. Median teriparatide treatment duration was 22.3 months. Significant increases in BMD…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 20 participants or records.
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