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Osteoporosis Peptides 2026 Update: Comparison
| Peptide | Mechanism | BMD Increase (Lumbar Spine, 18mo) | Fracture Risk Reduction | Dosing Frequency | FDA Status 2026 | Professional Assessment ||—|—|—|—|—|—|| Teriparatide (PTH 1-34) | PTH receptor agonist. Stimulates osteoblasts | 9–11% | 65% vertebral, 5
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- | Peptide | Mechanism | BMD Increase (Lumbar Spine, 18mo) | Fracture Risk Reduction | Dosing Frequency | FDA Status 2026 | Professional Assessment ||—|—|—|—|—|—|| Teriparatide (PTH 1-34) | PTH receptor agonist. Stimulates osteoblasts | 9–11% | 65% vertebral, 53% non-vertebral | Daily subcutaneous | Approved (generic available) | Gold standard anabolic. Proven efficacy, now cost-effective || Abaloparatide (PTHrP analog) | PTHrP receptor selectivity. Less hypercalcemia | 11–13% | 86% vertebral, 43% non-vertebral | Daily subcutaneous | Approved | Safer PTH alternative for patients with renal concerns || Romosozumab (sclerostin inhibitor) | Blocks sclerostin. Dual anabolic + antiresorptive | 13–15% | 73% vertebral, 36% non-vertebral | Monthly subcutaneous | Approved | Strongest single-agent effect. Cardiovascular monitoring required || PTH-rP fusion peptide (investigational) | Dual PTH/PTHrP activation | 14.2% (Phase 3 data) | Not yet reported | Weekly subcutaneous (projected) | Breakthrou