Methods of improving spinal fusion with abaloparatide
Provided herein are methods of enhancing spinal fusion and bone formation in subjects with spinal fractures, deformities or instability in the spine. The method includes administering (e.g., subcutaneously or transdermally) a therapeutically effective amount of abaloparatide to the subject.
1 . A method of treating a subject having a spinal fusion surgery, the method comprising administering a therapeutically effective amount of abaloparatide to the subject after having the spinal fusion surgery, wherein the administration is daily subcutaneous administration of 80 μg abaloparatide; wherein the treatment enhances spinal fusion, bone formation, or both, without elevating bone resorption; and wherein the enhanced spinal fusion or bone formation is determined by a CT scan.
2 . The method of claim 1 , wherein the spinal fusion surgery involves implantation in the subject of a device comprising one or more of screws, spinal wires, artificial ligaments, vertebral cages, and artificial disks.
3 . The method of claim 2 , wherein the spinal fusion surgery is an anterior or a posterior surgery.
4 . The method of claim 3 , wherein the posterior surgery is a posterolateral fusion.
5 . The method of claim 1 , wherein the abaloparatide is administered daily for at least 2 months, 3 months, 4 months, 6 months, 12 months or 18 months.
6 . The method of claim 1 , wherein the administration enhances spinal fusion between two adjacent vertebrae, or between multiple vertebrae.
7 . The method of claim 1 , wherein administering the therapeutically effective amount of abaloparatide elevates bone formation markers without elevating bone resorption markers.
8 . The method of claim 7 , wherein the bone formation marker is selected from the group consisting of osteocalcin (OC), N-terminal propeptide of type I procollagen (PINP), and bone-specific alkaline phosphatase (BAP).
9 . The method of claim 8 , wherein the bone formation marker is osteocalcin (OC) or N-terminal propeptide of type I procollagen (PINP).
10 . The method of claim 7 , wherein the bone resorption marker is selected from the group consisting of tartrate-resistant acid phosphatase 5b (TRAcP-5b), hydroxyproline (total and dialyzable, Hyp), hydroxylysine glycosides, pyridinoline (PYD), deoxypyridinoline (DPD), carboxy-terminal cross-linked telopeptide of type I collagen (ICTP, CTX-MMP), bone sialoprotein (BSP), and cathepsins.
11 . The method of claim 10 , wherein the bone resorption marker is TRACP-5b.