Objective: The objective of this meta-analysis was to compare the efficacy and safety of teriparatide versus salmon calcitonin for the treatment of osteoporosis in Asian patients and to investigate whether the results of global studies could be applicable to Asian patients.

Methods: PubMed, OVID, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE up to December 2018 were searched. Eligible randomized controlled trials (RCTs) that compared teriparatide versus salmon calcitonin in Asian osteoporosis population were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for data synthesis, and Cochrane Collaboration software Review Manager 5.3 was used to analyze the pooled data.

Results: Three RCTs involving 529 patients were included (mean age 68.7 yr; 93.4% females; mean follow-up 6 months); outcome measures included bone mineral density (BMD) of the femoral neck, total hip and lumbar spine; bone markers and adverse events. We found that the period of 6-months of teriparatide treatment was helpful for the improvement of the BMD of lumbar vertebra, however, the improvement of BMD was not significant in the femoral neck and total hip joint. There was a positive correlation between bone-specific alkaline phosphatase (BSAP) and osteocalcin (OCN) and the response of Asian patients to subcutaneous injection of 20 micrograms per day of teriparatide. The proportion of the occurrence of adverse effects was more obvious in the teriparatide group compared with salmon calcitonin, but there was no significant difference.

Conclusion: Results suggested that the use of teriparatide could improve the lumbar BMD by shortterm (six months) application in Asian osteoporosis patients, which is beneficial to the patients who cannot tolerate adverse events of long-term treatment. The BSAP and OCN bone markers could be useful to monitor the responses of Asian osteoporosis patients to teriparatide treatment. Finally, both of teriparatide and salmon calcitonin were well tolerated by Asian patients.

目的：本荟萃分析的目的是比较特立帕肽与鲑鱼降钙素治疗亚洲患者骨质疏松症的疗效和安全性，并调查全球研究的结果是否适用于亚洲患者。

方法：检索了截至 2018 年 12 月的 PubMed、OVID、Cochrane Central Register of Controlled Trials (CENTRAL) 和 EMBASE。纳入了在亚洲骨质疏松症人群中比较特立帕肽与鲑鱼降钙素的合格随机对照试验 (RCT)。系统评价和元分析首选报告项目 (PRISMA) 指南用于数据合成，Cochrane 协作软件 Review Manager 5.3 用于分析汇总数据。

结果：纳入了涉及 529 名患者的三项 RCT（平均年龄 68.7 岁；93.4% 女性；平均随访 6 个月）；结果测量包括股骨颈、全髋和腰椎的骨矿物质密度 (BMD)；骨标志物和不良事件。我们发现6个月的特立帕肽治疗有助于腰椎BMD的改善，但股骨颈和全髋关节BMD的改善不显着。骨特异性碱性磷酸酶 (BSAP) 和骨钙素 (OCN) 与亚洲患者对每天 20 微克特立帕肽皮下注射的反应呈正相关。与鲑鱼降钙素相比，特立帕肽组不良反应发生的比例更明显，但无显着差异。

结论：结果提示，亚洲骨质疏松患者短期（6个月）应用特立帕肽可改善腰椎BMD，对不能耐受长期治疗不良事件的患者有益。BSAP 和 OCN 骨标志物可用于监测亚洲骨质疏松症患者对特立帕肽治疗的反应。最后，亚洲患者对特立帕肽和鲑鱼降钙素的耐受性良好。