Retrospective evaluation of patients receiving teriparatide therapy at Pamukkale University Hospital

This study aimed to retrospectively evaluate the changes in bone mineral density (BMD), biochemical, and hematological parameters in osteoporotic patients receiving teriparatide therapy at Pamukkale University Hospital. The study was designed as a retrospective cohort study, and the data of 136 patients who were initiated on teriparatide therapy at the Pamukkale University Hospital, Department of Endocrinology and Metabolic Diseases between June 4, 2018, and September 19, 2023, were reviewed. After excluding cases that did not meet the inclusion criteria, 54 patients who completed at least 12 months of treatment were included in the study. Bone mineral density (BMD) values and T-scores of the lumbar vertebrae (L1–L4) and femoral neck, measured at baseline, 12 months, and 18 months, were evaluated. In addition, biochemical parameters (Ca, P, ALP, 25(OH)D, PTH, etc.) and hematological parameters (NLR, MLR, PLR) were statistically analyzed for changes during the treatment period. The mean age of the participants was 68.6 ± 11.9 years, and 74.1% were female. Lumbar BMD and T-scores significantly increased at both 12 and 18 months (p<0.001), while femoral neck BMD showed an increasing trend without statistical significance (p>0.05). ALP (p=0.030) and 25(OH)D (p=0.025) levels significantly increased, whereas no significant changes were found in calcium, phosphorus, PTH, AST, ALT, creatinine, or CRP/albumin ratios. Hematologic indices (NLR, MLR, PLR) remained stable throughout the treatment period. Teriparatide demonstrated a significant anabolic effect on lumbar spine bone density with a favorable biochemical safety profile. The absence of notable changes in inflammatory markers suggests that its mechanism of action primarily involves localized effects on bone cells rather than systemic inflammation. Larger, prospective, multicenter studies are warranted to further elucidate its long-term efficacy and immunomodulatory potential. Keywords: Osteoporosis, Teriparatide, Bone Mineral Density, Lumbar Spine, ALP, Vitamin D