| Summary: | Ahmed A Abdulelah,1,* Bassem I Haddad,2,* Abdulrahman A Alhajahjeh,1 Lina M AlQirem,1 Layla El-amayreh1 1School of Medicine, the University of Jordan, Amman, Jordan; 2Department of Special Surgery, Division of Orthopedics, School of Medicine, the University of Jordan, Amman, Jordan*These authors contributed equally to this workCorrespondence: Ahmed A Abdulelah, School of Medicine, the University of Jordan, Queen Rania Street, Amman, 11972, Jordan, Tel +962799699348, Email ahmadalhassani99@gmail.comAbstract: Teriparatide is a recombinant human parathyroid hormone analog with anabolic mechanism of action utilized in the treatment of osteoporosis with well-established clinical efficacy. Its use is significantly hindered due to label warnings resulting from pre-clinical rat studies demonstrating an increased risk of osteosarcoma. However, clinical trials and post-marketing surveillance studies did not demonstrate any increased risk of osteosarcoma, even after prolonged periods of surveillance reaching up to 15 years, with most of the identified cases of osteosarcomas being solitary and predominantly attributed to other factors. This systematic review provides a comprehensive overview of the currently available literature and provides the highest level of clinical evidence towards demonstrating the lack of any substantial evidence towards osteosarcoma development in patients utilizing TPTD.Keywords: recombinant parathyroid hormone, osteoporosis, bone tumor, malignancy
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