Does Teriparatide help with versus risedronate?

What the studies show

In a direct comparison against a standard bisphosphonate in women with severe osteoporosis, teriparatide produced fewer new vertebral fractures. The result that moved it from second-line to first-line for the highest-risk patients in many guidelines.

Several well-run randomised trials in people, pointing the same way. You can plan around this. It still says nothing about whether the effect is worth the side effects for you.

1. 1
   Kendler DL, Marin F, Zerbini CAF, et al. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial.Lancet, 2018Head-to-head; 1,360 women; 24 months.

In context

Teriparatide is the first 34 amino acids of human parathyroid hormone, given as a daily injection for severe osteoporosis. Continuous parathyroid hormone strips bone; a brief daily pulse builds it — which is why the drug works and the hormone's excess does not. In the 1,637-woman trial behind its approval, new spinal fractures fell from 14% to 5% over about 21 months and non-spinal fragility fractures roughly halved. It is a prescription medicine, approved everywhere, with a long safety record; the original two-year lifetime limit was lifted by the FDA in 2020.

Teriparatide is approved (rx). Legal status differs by country — see the regulation section or the jurisdiction pages.

Questions

Other outcomes for Teriparatide

• AVertebral fracture risk (postmenopausal osteoporosis)1 large RCT (n=1,637, median 21 mo)
• ANon-vertebral fracture riskSame RCT
• ABone mineral densitySame RCT + many
• AAdverse effectsadverseApproval trial + 20 years of surveillance

Written and maintained by LYO Research — how pages are written and checked. Reviewed 10 September 2026. Grades count human evidence only; see how LYO grades. Not medical advice. Correct this page →