Teriparatide
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Teriparatide: From Osteoporosis to Duodenal Ulcer
One-Sentence Summary
Teriparatide is a parathyroid hormone fragment (PTH 1-34), originally used to treat postmenopausal osteoporosis and other forms of osteoporosis in patients at high fracture risk. The TxGNN model predicts it may be effective for duodenal ulcer, but this is a graph-based prediction only, with 0 clinical trials and 0 publications currently supporting it.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Postmenopausal osteoporosis; osteoporosis |
| Predicted New Indication | Duodenal ulcer |
| TxGNN Prediction Score | 99.86% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 5 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Teriparatide is the active fragment of human parathyroid hormone. Pharmacology data show it binds the PTH1 and PTH2 receptors. Its established role is bone-anabolic: it stimulates osteoblast activity and bone formation, which is why it is used in osteoporosis.
No plausible link between this bone-building signalling and duodenal ulcer healing is established in the available data. Duodenal ulcer is a gastrointestinal mucosal disease, driven mainly by acid, H. pylori and mucosal defence, and it is not a bone or calcium-metabolism disorder. The very high TxGNN score reflects a pattern in the knowledge graph rather than a demonstrated biological or clinical connection. No clinical or literature evidence was found to support it. This prediction should therefore be treated as a hypothesis only.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
Teriparatide is registered in Singapore as five valid single-ingredient injectable products.
| Authorization Number | Product Name | Dosage Form | Manufacturer |
|---|---|---|---|
| SIN12593P | FORTEO Injection 20 mcg/80 mcL | Injection, solution | Lilly France |
| SIN17052P | MEGAPTH-G Solution for Injection 20 mcg/80 mcL, pen + cartridge pack | Injection, solution | Gedeon Richter Plc. |
| SIN17051P | MEGAPTH-G Solution for Injection 20 mcg/80 mcL, cartridge pack | Injection, solution | Gedeon Richter Plc. |
| SIN17077P | TERIPARATIDE-TEVA Solution for Injection in pre-filled pen 20 mcg/80 mcL | Injection, solution | PLIVA Croatia Ltd |
| SIN16802P | SONDELBAY Injection 20 mcg/80 mcL | Injection, solution | Intas Pharmaceuticals Limited |
Safety Considerations
Package insert warnings and contraindications were not available in the data compiled for this report. Please refer to the package insert for these.
- Knowledge-graph contraindication signals (from disease-drug relationships, not label text): hypotensive disorder, hypercalcemia, nephrocalcinosis, phosphorus metabolism disease, bone osteosarcoma, Paget disease of bone (including juvenile), osteomalacia, rickets, urolithiasis, renal osteodystrophy, osteitis fibrosa, and hyperparathyroidism.
- Drug interactions (8 records found):
- Moderate: digoxin, digitoxin, topical calcitriol, topical calcipotriol
- Minor: hydrochlorothiazide, furosemide
Conclusion and Next Steps
Decision: Hold
Rationale: The duodenal ulcer prediction rests only on a model score. There are no clinical trials or publications, and no mechanistic rationale links a bone-anabolic PTH analog to ulcer healing. Teriparatide is already marketed in Singapore for osteoporosis, but that does not support this new use.
To proceed, the following is needed:
- A credible mechanistic hypothesis connecting PTH receptor signalling to duodenal mucosal healing
- Preclinical or early clinical evidence in duodenal ulcer
- Detailed mechanism of action data
- Package insert warnings and contraindications from the HSA
- A review of whether a bone-targeted, injectable, long-term-limited therapy suits a short-course GI indication
Note on other predictions: Among the other model predictions for teriparatide, pregnancy-associated osteoporosis is much better supported. It has about 20 publications, including teriparatide-focused cohort studies, systematic reviews and a 2026 position statement. It is rated L3 with a "Proceed with Guardrails" recommendation. It is an extension of the existing osteoporosis use rather than a true new mechanism, and it would be the more practical candidate to evaluate first.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.