Abaloparatid – eine neue osteoanabole Therapieoption für die Osteoporose bei postmenopausalen Frauen

Zusammenfassung

Abaloparatid ist ein synthetisches Strukturanalogon des Parathormon-verwandten Peptids (PTHrP). Durch Bindung an Parathormon-1-Rezeptor stimuliert es Osteoblasten zum Knochenaufbau, dies bei einer geringeren begleitenden Osteoklastenstimulation, so dass in der Summe ein größerer osteoanaboler Nettoeffekt im Vergleich zu Teriparatid resultiert. Auch klinisch ist es mindestens so stark wirksam wie Teriparatid, möglicherweise diesem sogar überlegen, wobei hier unmittelbare head-to-head Studien derzeit nicht vorliegen. Abaloparatid reduziert effektiv das Auftreten vertebraler und peripherer osteoporotischer Frakturen mit auch entsprechenden günstigen Effekten auf die Knochendichte und die Knochenumbaumarker. Zu beachten ist, dass nach der subcutanen Injektion ein moderater Anstieg der Herzfrequenz beobachtet werden kann, wobei es aber keine Anhaltspunkte dafür gibt, dass dies mit schwerwiegenderen kardiovaskulären Komplikationen zu assoziieren wäre. Abaloparatid (Eladynos) wurde in Europa zur Behandlung der Osteoporose bei postmenopausalen Frauen mit erhöhtem Frakturrisiko für eine Therapiedauer von 18 Monaten zugelassen. Nachfolgend ist die Durchführung einer osteoklasteninhibierenden Bisphosphonattherapie als Sequenz zu empfehlen.

Abstract

Abaloparatide is a synthetic structural analogue of the parathyroid hormone related peptide (PTHrP). It stimulates osteoblasts to synthesize bone by binding to the parathyroid hormone 1 receptor, which is accompanied by just a slight osteoclast activation. Thus, compared to teriparatide, the resulting osteoanabolic net effect is more pronounced. Clinically, its therapeutic effect is at least equal, perhaps superior to teriparatide. However, direct head-to-head studies are not available yet. Abaloparatide reduces effectively the risk for vertebral and peripheral osteoporotic fractures accompanied by positive effects on bone density and bone turnover markers. Following subcutaneous injection, a moderate increase of the heart rate may be observed. However, there are no indications that this might be correlated to serious cardiovascular events. Abaloparatide (Eladynos) has been approved in Europe for the treatment of osteoporosis in postmenopausal women with an increased fracture risk for a therapy duration of 18 months. Thereafter, an osteoclast inhibiting bisphosphonate sequential treatment is needed.

Schlüsselwörter

Osteoporose - Abaloparatid - postmenopausal - Fraktur - Knochen

Keywords

osteoporosis - abaloparatide - postmenpausal - fracture - bone

Publication History

Received: 25 January 2024

Accepted: 26 April 2024

Article published online:
10 July 2024

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