テリパラチド 化学特性,用途語,生産方法
用途
医薬品 (骨粗鬆症治療剤、副甲状腺機能診断薬) (JAPIC 医療医薬品集 2017)
使用
A fragment of human parathyroid hormone (hPTH) peptide sequence containing the 34 N-terminal residues of hPTH. This fragment was also found to be an agonist at PTH1 and PTH2 receptors.
一般的な説明
Teriparatide is a recombinantform of parathyroid hormone, which is used for the treatmentof osteoporosis in men and postmenopausal women.The N-terminal region possesses 34 amino acids, which areidentical to the biologically active region of the 84-aminoacid sequence of human parathyroid hormone. It has beenshown to act on osteoblasts to stimulate new bone growthand improve bone density.
薬物動態学
If administered once daily or intermittently, teriparatide preferentially enhances osteoblastic function,and bone formation occurs. Continuous exposure to endogenous PTH may result in poor skeletal composition
because of enhanced osteoclast-mediated bone resorption. After 18 months of treatment, lumbar BMD
increased up to 12% in postmenopausal women. After 10 months of treatment, 53% of men had an increase of
5% or greater in spine BMD. The risk for developing new vertebral fractures was reduced by 65% after 21
months of treatment, and the number of nonvertebral fragility fractures was reduced by 53%.
臨床応用
In 2002, the U.S. FDA approved teriparatide for the treatment of postmenopausal osteoporosis in patients who
have a high risk of fracture as well as to increase bone mass in men with primary or hypogonadal osteoporosis
who have a high risk of fracture. Teriparatide is recombinant human PTH 1-34, the
biologically active portion of the endogenously produced preprohormone. Unlike the bisphosphonates, which
are classified as bone restorative agents, teriparatide is the first approved bone-forming agent. Bone formation
is possible because of the ability of this agent to increase the number of osteoblasts. Although teriparatide
enhances the function of both osteoclasts and osteoblasts, the exposure incidence dictates its effect on the
skeleton.
副作用
Temporary increases in serum calcium levels occur following administration of teriparatide. As a result, this
agent is contraindicated in patients who are predisposed to hypercalcemia. Some evidence suggests that these
elevations in serum calcium levels may cause a patient who is taking digitalis to experience digitalis toxicity
(39). Teriparatide should not be prescribed to patients with Paget's disease, children, young adults, women
who are pregnant or nursing, and those patients who have received skeletal radiation therapy. Because of
an increased incidence of osteosarcoma (malignant bone tumors) observed in rats, teriparatide also carries a
black box warning
Dosage
Teriparatide acetate requires subcutaneous injection into the thigh or abdominal wall, and the recommended dose is 20 mcg once daily. If symptoms of orthostatic hypotension occur, it is administered while the patient is sitting or lying down. It is not recommended to use the drug for more than 2 years in the lifetime of the patient. Use teriparatide injection with caution in patients receiving digoxin. Transient hypercalcemia may predispose patients to digitalis toxicity.
テリパラチド 上流と下流の製品情報
原材料
準備製品