Peptide reference
Teriparatide
Forteo ·Forsteo ·rhPTH(1-34) ·Recombinant human parathyroid hormone (1-34) ·LY333334
What cited sources report about Teriparatide
Teriparatide is recombinant human parathyroid hormone (1-34), the N-terminal 34-amino-acid fragment of full-length PTH, expressed in E. coli and developed by Eli Lilly as Forteo (US) / Forsteo (EU). It was the first anabolic (bone-forming) osteoporosis therapy approved by the FDA, with pivotal authorization in 2002. Daily subcutaneous injection produces transient PTH receptor activation that favors osteoblast over osteoclast activity. The summaries below report what individual cited sources state; this page does not assert claims beyond what those sources report.
FDA DailyMed — Forteo prescribing information
The current US prescribing information for Forteo lists three FDA-approved indications: treatment of postmenopausal women with osteoporosis at high risk for fracture; increase of bone mass in men with primary or hypogonadal osteoporosis at high fracture risk; and treatment of glucocorticoid-induced osteoporosis at high fracture risk. The label includes a Boxed Warning concerning the dose- and duration-dependent osteosarcoma signal observed in rats and a corresponding caution against use in patients with elevated baseline osteosarcoma risk.
FORTEO is a parathyroid hormone (PTH) analog indicated for: Treatment of postmenopausal women with osteoporosis at high risk for fracture.
Neer et al. (2001) — New England Journal of Medicine (Fracture Prevention Trial)
The pivotal Fracture Prevention Trial randomized 1,637 postmenopausal women with prior vertebral fractures to teriparatide 20 µg/day, 40 µg/day, or placebo, all with calcium and vitamin D, for a median 21 months. The 20 µg arm reported a 65% relative reduction in new vertebral fractures and a 53% reduction in non-vertebral fragility fractures versus placebo. The trial was stopped early after the rat osteosarcoma signal emerged.
Treatment of postmenopausal osteoporosis with parathyroid hormone (1-34) decreases the risk of vertebral and nonvertebral fractures; increases vertebral, femoral, and total-body bone mineral density; and is well tolerated.
Lim and La (2026) — Asian Spine Journal
A 2026 narrative review using systematic search methodology surveyed anabolic agents (teriparatide, abaloparatide, romosozumab) and other bone-quality enhancers in the context of spinal fusion in osteoporotic patients. The authors catalogued the comparative evidence for perioperative anabolic bridging and noted the absence of large head-to-head fusion-outcome trials.
European Medicines Agency — Forsteo EPAR
The EMA European Public Assessment Report for Forsteo summarizes the centralized authorization for treatment of postmenopausal and male osteoporosis at high fracture risk and glucocorticoid-induced osteoporosis. The product information specifies a maximum cumulative treatment duration of 24 months.
ClinicalTrials.gov NCT01709110 — VERO trial
The VERO trial was a 24-month randomized double-blind double-dummy phase 4 study comparing teriparatide 20 µg daily with risedronate 35 mg weekly in 1,360 postmenopausal women with severe osteoporosis and prior vertebral fractures. The primary endpoint was new radiographic vertebral fracture incidence.
PubChem CID 16133850 — National Center for Biotechnology Information
The PubChem record for teriparatide lists the recombinant 34-residue N-terminal fragment of human parathyroid hormone, molecular formula C181H291N55O51S2, molecular weight 4117.7 g/mol, and aggregated synonyms (Forteo, Forsteo, LY333334).
Coverage notes
Teriparatide was the first FDA-approved anabolic agent for osteoporosis and remains a reference standard for high-fracture-risk patients alongside abaloparatide and romosozumab. The Neer 2001 Fracture Prevention Trial provides the pivotal randomized fracture-reduction evidence. The Boxed Warning concerning rat osteosarcoma findings was removed in 2020 in the US after extended postmarketing surveillance; users should consult current labeling. This page reflects FDA labeling current as of the cited sources.