How long should one be treated with Teriparatide?

Question

Hello doctor,

My mother is 70 years old and has had rheumatoid arthritis for more than 40 years now. Recently, she did a bone density scan after five years, and the bone mineral density for the lumbar spine (L1-L4) is 0.858 (low bone mass), and for the total hip (left) is 0.559 (osteoporosis). The doctor prescribed Forteo (Teriparatide) 20 mcg every other day. However, when I read online, it says that it should be injected every day. When I asked the doctor, he said this injection could only be used for two years, but if injected every other day instead, it could be used for three years. I wanted to ask you if it should be injected every day or every other day.

My mother's medications are as follows:

Prednisone 5 mg per day.
Methotrexate 0.25 mg four tablets per week.
Folic acid 5 mg every other day.
Humira injection every 15 days.
Supracal 1500 mg per day.
Atorvastatin at night.
Voltaren pill sometimes.

I wanted to ask if you think these medications are suitable or if there is a better alternative. Her CRP is 7 mg/L and her ESR is 12 mm/hr. Lastly, she had 5 COVID-19 vaccinations (4 AstraZeneca, 1 Pfizer), and her D-Dimer is 870 ng/mL (the maximum negative reference is 750 ng/mL). Is this concerning, and does she need any follow-up or medications for this? Also, should she get a COVID-19 booster vaccine again?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I went through your post. One thing you need to know is that Teriparatide works best for one year, and the maximum duration you can administer it is 18 months. The best bone-building window is the initial six months when it works most effectively. Regarding your question, there is no alternate-day dosing. It has to be given daily, as that is the guideline to achieve maximum benefits, and that is what you need to follow.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.