For a patient who would benefit from an anabolic agent for osteoporosis, do you prefer romosuzumab over teriparatide in the absence of contraindications to either agent?
Answer from: at Academic Institution
Both teriparatide and romozosumab are excellent drugs to treat osteoporosis with documented risk reduction in fractures. TPTD reduces spine fracture about 85% and romozosumab about 75%. Both are excellent.
They have very different biologies with TPTD being a remodeling-based anabolic and romozosuma...
I agree with @Kelly, once the decision to use an anabolic has been made insurance becomes the determining factor. For commercial insurance, they will generally approve a PTH agent over Romo. For Medicare Romo is generally more affordable if they are not on and Advantage plan. If they are even if app...
Agree that the costs/insurance coverage, the patient's preference for daily injectable guides my treatment plan. I encourage and try to do PTH analog followed by sclerostin inhibitor if the patient and insurance agreeable.