Abaloparatide
PTHrP analog for osteoporosis.
What it is
Abaloparatide (Tymlos) is a synthetic 34-amino-acid analog of parathyroid hormone-related protein (PTHrP). It is FDA-approved for treatment of postmenopausal women with osteoporosis at high risk for fracture. It belongs to the small group of “anabolic” osteoporosis agents (which build bone) as distinct from the “antiresorptive” agents (which slow bone breakdown).
Mechanism of action
PTH receptor agonism (selective for PTH1R) stimulates osteoblast activity and bone formation. The clinical effect is increased bone mineral density and reduced fracture risk in patients with severe osteoporosis. Use is limited to 2 years total lifetime use due to theoretical concerns about osteosarcoma seen in long-term rodent studies.
Approved indications
Postmenopausal women with osteoporosis at high risk of fracture; treatment to increase bone mass in men with osteoporosis at high risk of fracture.
Why this is out of scope at The Tide
Severe osteoporosis with high fracture risk is appropriately managed by endocrinology, rheumatology, or primary care with osteoporosis expertise. Anabolic osteoporosis agents require careful selection of appropriate candidates and coordination with subsequent antiresorptive therapy after the 2-year course. The Tide does not provide osteoporosis management.
Where to learn more
Endocrinology, rheumatology, or primary care with osteoporosis expertise.