Abaloparatide versus teriparatide: a head to head comparison of effects on fracture healing in mouse models.

Bernhardsson M, Aspenberg P

Acta orthopaedica18 Oct 2018Cited by 31 (Europe PMC)

PMID30334479PMCIDPMC6300720DOI10.1080/17453674.2018.1523771PepBankPUB-30334479

Summary

Background and purpose - Teriparatide accelerates fracture healing in animals and probably in man. Abaloparatide is a new drug with similar although not identical effects on the teriparatide receptor. Given at 4 times the teriparatide dose in a human osteoporosis trial, abaloparatide increased bone density more than teriparatide, and both reduced fracture risk. We investigated in mice whether abaloparatide stimulates fracture healing, and if it does so with the suggested dose effect relation (4:1). Patients and methods - In a validated mouse model for metaphyseal healing (burr hole with screw pull-out), 96 mice were randomly allocated to 11 groups: control (saline), teriparatide or abaloparatide, where teriparatide and abaloparatide were given at 5 different doses each. In a femoral shaft osteotomy model, 24 mice were randomly allocated to 3 groups: control (saline), teriparatide (15 µg/kg) or abaloparatide (60 µg/kg). Each treatment was given daily via subcutaneous injections. Results were evaluated by mechanical testing and microCT. Results - In the metaphyseal model, a dose-dependent increase in screw pull-out force could be seen. In a linear regression analysis (r = 0.78) each increase in ln(dose) by 1 (regardless of drug type) was associated with an increase in pull-out force by 1.50 N (SE 0.18) (p < 0.001). Changing drug from teriparatide to abaloparatide increased the force by 1.41 N (SE 0.60; p = 0.02). In the diaphyseal model, the callus density was 23% (SD 10), 38% (SD 10), and 47% (SD 2) for control, for teriparatide and abaloparatide respectively. Both drugs were significantly different from controls (p = 0.001 and p = 0.008), but not from each other. Interpretation - Both drugs improve fracture healing, but in these mouse models, the potency per µg of abaloparatide seems only 2.5 times that of teriparatide, rather than the 4:1 relation chosen in the clinical abaloparatide-teriparatide comparison trial.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study8

6 results from studies that gave the peptide. No result from this study comes from people.

01AnimalAnimal study (in vivo)Efficacy outcome
In mice, abaloparatide increased screw pull-out force compared with teriparatide in the regression analysis.
In plain wordsIn mice, abaloparatide increased screw pull-out force compared with teriparatide.
Peptide
Abaloparatide (Tymlos)
Outcome
IncreaseScrew pull-out force
Study
mousen: not reported in source
metaphyseal healing
Comparator
teriparatide
Outcome group
Bone and joint · Musculoskeletal
Studied dose
Dose not stated · subcutaneousAs given in this study (mouse).
Measurements
Force difference
1.41 N
abaloparatide versus teriparatide
Source sentences
Summary
Changing drug from teriparatide to abaloparatide increased the force by 1.41 N (SE 0.60; p = 0.02).
1 context sentence(design, population, supporting numbers)
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447903
02AnimalAnimal study (in vivo)Efficacy outcome
In mice, teriparatide produced lower screw pull-out force than abaloparatide in the regression analysis.
In plain wordsIn mice, teriparatide produced lower screw pull-out force than abaloparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
DecreaseScrew pull-out force
Study
mousen: not reported in source
metaphyseal healing
Comparator
abaloparatide
Outcome group
Bone and joint · Musculoskeletal
Studied dose
Dose not stated · subcutaneousAs given in this study (mouse).
Source sentences
Summary
Changing drug from teriparatide to abaloparatide increased the force by 1.41 N (SE 0.60; p = 0.02).
1 context sentence(design, population, supporting numbers)
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447904
03AnimalAnimal study (in vivo)Efficacy outcome
In mice, abaloparatide increased callus density compared with saline.
In plain wordsIn mice, abaloparatide increased callus density compared with saline.
Peptide
Abaloparatide (Tymlos)
Outcome
IncreaseCallus density
Study
mousen: not reported in source
femoral shaft osteotomy
Comparator
saline
Outcome group
Bone and joint · Musculoskeletal
Studied dose
60 µg/kg · subcutaneousAs given in this study (mouse).
Measurements
Callus density
47%
abaloparatide
Callus density
23%
control
Source sentences
Summary
In the diaphyseal model, the callus density was 23% (SD 10), 38% (SD 10), and 47% (SD 2) for control, for teriparatide and abaloparatide respectively.
3 context sentences(design, population, supporting numbers)
Summary · context
Both drugs were significantly different from controls (p = 0.001 and p = 0.008), but not from each other.
Summary · context
In a femoral shaft osteotomy model, 24 mice were randomly allocated to 3 groups: control (saline), teriparatide (15 µg/kg) or abaloparatide (60 µg/kg).
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447905
04AnimalAnimal study (in vivo)Efficacy outcome
In mice, teriparatide increased callus density compared with saline.
In plain wordsIn mice, teriparatide increased callus density compared with saline.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseCallus density
Study
mousen: not reported in source
femoral shaft osteotomy
Comparator
saline
Outcome group
Bone and joint · Musculoskeletal
Studied dose
15 µg/kg · subcutaneousAs given in this study (mouse).
Measurements
Callus density
38%
teriparatide
Callus density
23%
control
Source sentences
Summary
In the diaphyseal model, the callus density was 23% (SD 10), 38% (SD 10), and 47% (SD 2) for control, for teriparatide and abaloparatide respectively.
3 context sentences(design, population, supporting numbers)
Summary · context
Both drugs were significantly different from controls (p = 0.001 and p = 0.008), but not from each other.
Summary · context
In a femoral shaft osteotomy model, 24 mice were randomly allocated to 3 groups: control (saline), teriparatide (15 µg/kg) or abaloparatide (60 µg/kg).
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447906
05AnimalAnimal study (in vivo)Efficacy outcome
In mice, callus density did not differ significantly between abaloparatide and teriparatide.
In plain wordsIn mice, callus density did not differ significantly between abaloparatide and teriparatide.
Peptide
Abaloparatide (Tymlos)
Outcome
No significant changeCallus density
Study
mousen: not reported in source
femoral shaft osteotomy
Comparator
teriparatide 15 µg/kg
Outcome group
Bone and joint · Musculoskeletal
Studied dose
60 µg/kg · subcutaneousAs given in this study (mouse).
Source sentences
Summary
Both drugs were significantly different from controls (p = 0.001 and p = 0.008), but not from each other.
3 context sentences(design, population, supporting numbers)
Summary · context
In the diaphyseal model, the callus density was 23% (SD 10), 38% (SD 10), and 47% (SD 2) for control, for teriparatide and abaloparatide respectively.
Summary · context
In a femoral shaft osteotomy model, 24 mice were randomly allocated to 3 groups: control (saline), teriparatide (15 µg/kg) or abaloparatide (60 µg/kg).
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447907
06AnimalAnimal study (in vivo)Efficacy outcome
In mice, callus density did not differ significantly between teriparatide and abaloparatide.
In plain wordsIn mice, callus density did not differ significantly between teriparatide and abaloparatide.
Peptide
Teriparatide (PTH 1-34)
Outcome
No significant changeCallus density
Study
mousen: not reported in source
femoral shaft osteotomy
Comparator
abaloparatide 60 µg/kg
Outcome group
Bone and joint · Musculoskeletal
Studied dose
15 µg/kg · subcutaneousAs given in this study (mouse).
Source sentences
Summary
Both drugs were significantly different from controls (p = 0.001 and p = 0.008), but not from each other.
3 context sentences(design, population, supporting numbers)
Summary · context
In the diaphyseal model, the callus density was 23% (SD 10), 38% (SD 10), and 47% (SD 2) for control, for teriparatide and abaloparatide respectively.
Summary · context
In a femoral shaft osteotomy model, 24 mice were randomly allocated to 3 groups: control (saline), teriparatide (15 µg/kg) or abaloparatide (60 µg/kg).
Summary · context
Each treatment was given daily via subcutaneous injections.
Show in the study text Report a problemFND-3033447908

Studies that did not test the peptide alone2

In this study, the peptide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking the peptide.

07AnimalNot a test of Abaloparatide (Tymlos) aloneAnimal study (in vivo)Efficacy outcome
In mice, pooled abaloparatide and teriparatide doses showed increasing screw pull-out force with increasing dose.
In plain wordsIn mice, pooled drug results linked higher doses to greater screw pull-out force.
Peptide
Abaloparatide (Tymlos)
Outcome
IncreaseDose-response of screw pull-out force
Study
mousen: not reported in source
metaphyseal healing
Comparator
Higher versus lower ln(dose), pooled across abaloparatide and teriparatide
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
In a linear regression analysis (r = 0.78) each increase in ln(dose) by 1 (regardless of drug type) was associated with an increase in pull-out force by 1.50 N (SE 0.18) (p < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
Each treatment was given daily via subcutaneous injections.
In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Abaloparatide (Tymlos).
Show in the study text Report a problemFND-3033447901
08AnimalNot a test of Teriparatide (PTH 1-34) aloneAnimal study (in vivo)Efficacy outcome
In mice, pooled teriparatide and abaloparatide doses showed increasing screw pull-out force with increasing dose.
In plain wordsIn mice, pooled drug results linked higher doses to greater screw pull-out force.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseDose-response of screw pull-out force
Study
mousen: not reported in source
metaphyseal healing
Comparator
Higher versus lower ln(dose), pooled across abaloparatide and teriparatide
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
In a linear regression analysis (r = 0.78) each increase in ln(dose) by 1 (regardless of drug type) was associated with an increase in pull-out force by 1.50 N (SE 0.18) (p < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
Each treatment was given daily via subcutaneous injections.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Show in the study text Report a problemFND-3033447902

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 2NCT04249232

Abaloparatide and Pelvic Fracture Healing

Hospital for Special Surgery, New Yorkn = 4817 Sept 2020 to 25 Apr 2024

Fracture of Pelvis (Disorder)

Trial page ClinicalTrials.govUpdated 14 Jun 2024

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 3Current
22 Oct 2026, 02:25 UTC
Study results updated
Version 2
21 Oct 2026, 18:59 UTC
Study data updated · source update from Europe PMC
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC