PEARL: Teriparatide/Abaloparatide need to be following by another osteoporosis treatment to maintain gains!

The benefits of anabolic therapy are quickly lost after discontinuation .” (JCEM 2019 – Teriparatide and Abaloparatide)

Teriparatide or Abaloparatide should be followed by antiresorptive therapy bisphosphonate or denosumab.  If those cannot be tolerated raloxifene or menopausal hormone therapy is acceptable

Teriparatide and Abaloparatide should not be extended past two years due to unproved clinical benefit, cost, and potential risk of teratogenicity