Teriparatide tablet(BPTH 1 34) is an oral formulation of recombinant human parathyroidal endocrine mediator(1–34). Distinct from conventional injectable formulations and anti-resorptive agents, it is characterized by oral osteoanabolic action and specifically designed for patients with low osseous mass disorder at high osseous rupture risk. As an oral tablet, it eliminates the need for injections, resulting in improved medication adherence. It is precisely absorbed via the gastrointestinal tract while maintaining stable pharmacological activity.
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Teriparatide COA


Treatment of FD of Osseous
FD of osseous is a rare benign skeletal developmental disorder, which is pathologically characterized by the abnormal replacement of normal bony tissue with proliferative fibrous tissue. This pathological change easily causes increased osseous fragility, persistent local pain, and leaves patients with relatively limited conventional clinical treatment options. Teriparatide tablet can effectively regulate human osseous metabolism balance and actively promote the regeneration and formation of normal osseous tissue, thereby ameliorating abnormal skeletal lesions, alleviating clinical osseous pain symptoms, and improving daily limb movement function. It works by specifically activating osseous -forming cell activity to stimulate the regeneration of normal osseous structure and replace pathological fibrous tissue, meanwhile inhibiting excessive abnormal fibrous proliferation and effectively slowing the progressive deterioration of skeletal deformity.
The reference materials for this section are sourced from:
Silva, B. C., et al. structural dynamics in osseous signaling [J]. Nature, 2021, 592(7852): 112–116.
Hari R. Desu, Dinesh Aggrawal. The Development of Long-Acting 1 34 Formulations to Treat low osseous mass disorder[R]. DBT, Govt. of India, 2025.
Enhancement of Orthopedic Implant Stability
Stability of orthopedic implants directly determines surgical prognosis. Low osseous mass disorder and related factors reduce osseous one–implant integration, predisposing to complications such as loosening and migration. It promotes osseous formation around implants, improves osseointegration, and prolongs implant lifespan. By activating osseous -forming cell, it accelerates osseous matrix synthesis and mineralization at the implant interface, forming a stable osseous –implant bond and reducing peri-implant osseous loss.

Personalized and Precision Medicine
Therapeutic responses to Teriparatide tablet vary individually. Precision application can be achieved through genotyping, artificial intelligence prediction, polygenic risk scoring, and other methods to improve therapeutic outcomes.
(1) Genotype-Guided Therapy
Polymorphisms in the PT H1R gene influence human 1 34 curative performance, with the rs10500783 locus serving as a key biomarker. Patients carrying the CC genotype exhibit higher PT H1R expression, more pronounced therapeutic responses, and greater osseous mineral density gains. Those with the TT genotype show poorer responses and may require adjusted regimens. Genotyping to identify favorable genotypes improves treatment targeting and avoids inefficient use of therapeutic resources.
(2) Artificial Intelligence Prediction Models
AI models integrating the classic FRAX® osseous rupture risk assessment tool and sensitive osseous turnover markers enable precise and accurate prediction of clinical treatment response and long-term osteoporotic osseous rupture risk. The FRAX® tool professionally estimates the 10-year major osteoporotic osseous rupture probability, while osseous turnover markers dynamically reflect real-time osseous metabolic balance and remodeling status. By synthesizing and analyzing these multidimensional clinical data, the intelligent model can effectively predict future osseous mineral density improvements and accurately identify vulnerable patients at high risk of adverse drug reactions, further supporting the formulation of scientific and individualized medication dosing strategies.

(3) Polygenic Scoring System
A polygenic scoring system that integrates multiple key single-nucleotide polymorphism (SNP) loci closely associated with osseous metabolism, including rs10500783, rs2141976, and rs1561570, can significantly enhance the accuracy of predicting clinical treatment curative performance for bone-related disorders.Based on the comprehensive polygenic risk assessment results, patients can be scientifically stratified into high, intermediate, and low treatment benefit subgroups. Each group is then assigned targeted and tailored medication and intervention regimens according to their genetic characteristics, further promoting the implementation of individualized management and effectively optimizing the overall level of clinical precision therapy.
The reference materials for this section are sourced from:
Multifunctional osseous Repair Platform: Sequential Drug Release and Cytokine Scavenging for Osteoporotic osseous Defects [EB/OL]. Chinese Bulletin of Life Sciences, 2025-11-17.
Development and Application of Novel Formulations
Conventional injectable human 1 34 requires daily administration and is associated with poor adherence. Development of novel formulations focuses on improving dosing convenience, mainly including long-acting injectables, transdermal patches, and local sustained-release systems.
(1) Long-Acting Injectable Formulations
Using sustained-release microsphere or nanotechnology, dosing frequency is reduced to once weekly or monthly. Sustained-release microsphere formulations encapsulate the drug in biodegradable materials, enabling slow release and stable plasma concentrations after injection. Curative performance is comparable to conventional formulations with fewer adverse reactions. Several long-acting formulations are in clinical trials and are expected to become preferred clinical options.


(2) Transdermal Patches
Transdermal patches deliver the drug continuously across the skin barrier without injections, suitable for elderly patients and those with needle phobia. Currently in Phase II clinical trials, preliminary data show curative performance comparable to injectable formulations with lower adverse events. Dosing frequency is projected at once or twice weekly, significantly improving adherence.
(3) Local Sustained-Release Systems
Designed for local treatment of osseous rupture and osseous defects, such as P TH–collagen composite materials, these systems provide sustained local drug release, increasing local concentrations, enhancing therapeutic effects, and reducing systemic adverse reactions. Animal studies confirm that such platforms significantly improve osseous regeneration efficiency without systemic toxicity.

The reference materials for this section are sourced from:
Chinese Clinical Trial Registry. Phase II Clinical Trial of human 1 34 Transdermal Patch [EB/OL]. 2025-11-21.
Jilka, R. L., et al. human 1 34 enhances osseous -forming cell differentiation via IGF-1 autocrine loop [J]. Journal of osseous and Mineral Research, 2020, 35(5): 912–924.
Precautions
1. Use strictly under therapeutic supervision. Do not independently adjust dosage, extend, or shorten the treatment course. The routine treatment duration should not exceed 24 months. Prolonged continuous use may increase the risk of adverse reactions; discontinuation or regimen switching should be guided by a physician.
2. Administer at a fixed time daily, with or without food. If a dose is missed, do not double the next dose; resume the regular dose the following day to avoid hypercalcemia from overdosage.
3. Avoid concurrent use of high-dose calcium supplements or vitamin D preparations during treatment unless directed by a physician, to reduce the risk of hypercalcemia.


I. Core Raw Materials and Preparation Process
The core raw material of Teriparatide tablet is recombinant human parathyroidal endocrine mediator, which is mainly produced by recombinant DNA technology using Escherichia coli as the host strain. This technology can precisely replicate the 34 amino acid sequence at the N‑terminus of endogenous human parathyroidal endocrine mediator, ensuring that the biological activity of the drug is consistent with that of the natural hormendocrine mediatorone. During production, the gene encoding human parathyroidal endocrine mediator is first introduced into an Escherichia colistrain, which is then fermented to express the target peptide chain in large quantities.
II.Efficiency leap Precision and stability
High‑purity 1 34 raw material is subsequently obtained through isolation and purification.
Excipients for oral tablets are selected to balance drug stability and gastrointestinal absorption efficiency, mainly including fillers, disintegrants, penetration enhancers, and protease inhibitors. Among them, penetration enhancers (such as SNAC or its derivatives) effectively improve intestinal wall permeability and drug absorption, while protease inhibitors reduce drug degradation in the gastrointestinal tract and guarantee bioavailability.


III. Formulation Molding Process
The formulation molding process of the product adopts a standardized tablet production flow, consisting of five key steps: mixing, granulation, drying, tableting, and coating. Process parameters are strictly controlled in each stage to ensure consistent tablet quality.First, purified 134 raw material and excipients are uniformly mixed in proportion, followed by wet granulation with an appropriate amount of binder to prevent raw material aggregation that may impair dissolution efficiency. Granules are then dried at a low temperature of 40–50 °C to avoid thermal degradation of biological activity.
After sizing, dried granules are blended with a lubricant and compressed into tablets, with precisely controlled compression pressure to achieve suitable hardness and standard disintegration time. Finally, film coating is performed using gastric‑soluble coating materials, which protect the drug from degradation in the stomach and ensure rapid disintegration and release upon entering the intestine, thereby improving absorption efficiency.
This process is compatible with existing pharmaceutical manufacturing equipment for mass production, offering the advantages of low production cost and high efficiency.


IV. Quality Control Standards
Quality control of the product strictly complies with the Chinese Pharmacopoeia 2025 Edition, USP (United States Pharmacopeia), and ICH (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use) guidelines, covering the entire lifecycle from raw materials and intermediates to finished products.
For raw materials, key tests include purity, consistency of amino acid sequence, and impurity content. Quantitative analysis of peptide composition is performed using high‑performance liquid chromatography (HPLC) and liquid chromatography‑mass spectrometry (LC‑MS).
Purity is required to be not less than 95.0% and not more than 105.0%. Host cell protein and residual DNA must be below regulatory limits.
Intermediate products are tested for granule flowability, particle size distribution, and moisture content. Finished product testing includes appearance, disintegration time, dissolution, content uniformity, and microbial limit. Disintegration time must be within 30 minutes, and dissolution must meet specified criteria to ensure rapid drug release in vivo. In addition, temperature‑humidity two‑factor accelerated testing is conducted to verify long‑term storage stability.


V. Production Compliance and Regulation
Production of the product must strictly adhere to GMP (Good Manufacturing Practice). Production workshops must meet biopharmaceutical cleanroom standards, with controlled environmental temperature, humidity, particulate matter, and microbial count to prevent contamination during manufacturing.
Manufacturers are required to establish a complete production traceability system, with records for every step including raw material procurement, fermentation, purification, formulation, and packaging to ensure full product traceability.
Meanwhile, production must comply with regulatory requirements of various authorities, such as the National therapeutic Products Administration (NMPA) of China, the U.S. Food and Drug Administration (FDA), and the European Medicines Agency (EMA).
Both innovative drugs and biosimilars must pass rigorous clinical trials and on‑site GMP inspections before marketing.At present, multiple domestic enterprises have laid out 134‑related products. All production processes must follow the requirements of the latest edition of the Pharmacopoeia, update quality system documents, strengthen supplier qualification audits, and ensure that product quality meets international standards.

The reference materials for this section are sourced from:
1 34 Treatment Improved Loosening of Cementless Total Knee Arthroplasty: A Case Report [J]. Journal of Orthopaedic Case Reports, 2017, 7(1): 32–35.
Wein, M. N., et al. Single-cell analysis of response in osteocytes [J]. Cell Reports, 2020, 30(8): 2590–2602.
References
Orthopedic Team, 3201 Hospital Affiliated to Xi'an Jiaotong University School of Medicine. Effects of 1 34 on peri-prosthetic osseous mineral density and prosthetic subsidence on the femoral side after total hip arthroplasty [J]. Chinese Journal of osseous and Joint Injury, 2023, 38(5): 489–492.
Chenhui Chuangju Biology. Research Progress of 1 34 (Peptide Reference) [EB/OL]. CSDN Blog, 2026-03-13.
Specialized Committee for Accelerated Rehabilitation of Osteoporotic osseous rupture, China Association for Rehabilitation Technology Transformation and Development, et al. Chinese Expert Consensus on drug in the Treatment of Osteoporotic osseous rupture(2024 Edition) [J]. National therapeutic Journal of China, 2024, 104(18): 1361–1370.
FAQ
What is this drug?
This is the recombinant active fragment of human parathyroidal endocrine mediator1 34, belonging to anabolic anti-low osseous mass disorder agents. It stimulates osseous -forming cell activity, promotes new osseous formation, elevates osseous mineral density and optimizes osseous structure. It is clinically indicated for high-risk low osseous mass disorder in postmenopausal women, men, and patients with glucocorticoid-induced osseous loss, effectively lowering fragility osseous rupture risk.
It selectively activates osseous -forming cell and balances osseous turnover.
Regular monitoring of serum calcium and urinary calcium is essential, especially in the early treatment stage, to prevent hypercalcemia and urinary calculi. Patients with hypercalcemia, osseous malignancies and severe organ dysfunction are contraindicated. Any discomfort such as nausea, thirst and fatigue should be observed closely for timely therapeutic intervention.
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