The cellular effect of intermittent PTH treatment on bone remodeling and modeling in humans—a histomorphometry centered scoping review
Authors' conclusion
Contrary to early beliefs, modeling-based bone formation (MBF) is not a major contributor to PTH-induced bone formation. Rather osteoclast-initiated bone formations such as remodeling-based bone formation (RBF) and overflow remodeling-based bone formation (oRBF) are the predominate modes of bone formation
Study context
- Population
- Humans receiving intermittent PTH treatment for osteoporosis or hypoparathyroidism
- Outcome
- Cellular effect of intermittent PTH on bone remodeling and modeling
Methodological detailshistomorphometry centered
- Histomorphometry centered
Main finding
As reported in the abstract
- Intermittent PTH increases both osteoclast and osteoblast activity within the first 6 months of treatment
- Osteoporosis: activity of the individual osteoclast suggested to increase within the first 18 months
- Osteoporosis: osteoblast activation increases bone formation in the initial 6 months; bone formation returns to baseline after 7-18 months
- Osteoporosis, after 24 months: more osteoclasts populate bone surfaces, individual osteoclast potentially less active; osteoblastic bone formation appears reactivated
- Hypoparathyroidism: treatment up to 72-120 months increases bone formation and normalizes it to the level of matched healthy controls; osteoclast largely uninvestigated
- Increase in bone forming surfaces may partly be achieved by rejuvenating arrested eroded surfaces
- MBF is not a major contributor to PTH-induced bone formation; RBF and oRBF are the predominate modes
Original publication
The cellular effect of intermittent PTH treatment on bone remodeling and modeling in humans—a histomorphometry centered scoping review. Osteoporos Int. Published 9 September 2025. doi:10.
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