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Forteo ® (teriparatide injection)20-mcg daily dose in a 2.4-mL prefilled delivery device
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
FORTEO® (teriparatide [rDNA origin] injection): Pharmacodynamic Response
PINP has been shown to be an aid for monitoring pharmacodynamic response to Forteo.
PINP as a Marker for Measuring Pharmacodynamic Response to Teriparatide
For monitoring pharmacodynamic response to teriparatide, PINP may be a useful marker.
Serum N-terminal propeptide of type I procollagen
increases rapidly after initiation
remains elevated during continued treatment
is not greatly impacted by food or circadian rhythm effects, and
has a high signal-to-noise ratio.1-5
Additionally, increases in PINP have been correlated with later increases in BMD in PMW with osteoporosis treated with teriparatide, but have not been directly validated to predict fracture risk reduction.6
Enclosed Prescribing Information
1. Chen P, Satterwhite JH, Licata AA, et al. Early changes in biochemical markers of bone formation predict BMD response to teriparatide in postmenopausal women with osteoporosis. J Bone Miner Res. 2005;20(6):962-970. http://dx.doi.org/10.1359/JBMR.050105
2. Eastell R, Krege JH, Chen P, et al. Development of an algorithm for using PINP to monitor treatment of patients with teriparatide. Curr Med Res Opin. 2006;22(1):61-66. http://dx.doi.org/10.1185/030079905X75096
3. Glover SJ, Eastell R, McCloskey EV, et al. Rapid and robust response of biochemical markers of bone formation to teriparatide therapy. Bone. 2009;45(6):1053-1058. http://dx.doi.org/10.1016/j.bone.2009.07.091
4. Lane NE, See K, Warner M, Krege JH. Algorithm for using a bone formation marker PINP to monitor the response to teriparatide (TPTD) in patients with glucocorticoid-induced osteoporosis (GIO) [abstract]. Arthritis Rheum. 2010;62(suppl S10):957. https://acrabstracts.org/wp-content/uploads/2018/06/2010_ACR_ARHP_Abstract_Supplement.pdf
5. Blumsohn A, Marin F, Nickelsen T, et al. Early changes in biochemical markers of bone turnover and their relationship with bone mineral density changes after 24 months of treatment with teriparatide. Osteoporos Int. 2011;22(6):1935-1946. http://dx.doi.org/10.1007/s00198-010-1379-y
6. Krege JH, Lane NE, Harris JM, Miller PD. PINP as a biological response marker during teriparatide treatment for osteoporosis. Osteoporos Int. 2014;25(9):2159-2171. http://dx.doi.org/10.1007/s00198-014-2646-0
BMD = bone mineral density
PINP = serum N-terminal propeptide of type I procollagen
PMW = postmenopausal women
Date of Last Review: January 29, 2020