WEDNESDAY, May 20, 2026 (HealthDay News) -- Among adults with osteogenesis imperfecta, teriparatide plus zoledronic acid does not reduce fracture risk compared with standard care, according to a study published online May 14 in the Journal of the American Medical Association.Jannie Dahl Hald, Ph.D., from Aarhus University Hospital in Denmark, and colleagues examined whether the parathyroid hormone analogue teriparatide followed by zoledronic acid reduces the risk for fractures in adults with osteogenesis imperfecta in a multicenter randomized clinical trial. Participants were randomly assigned to receive 20 μg of teriparatide daily by subcutaneous injection for two years, followed by 5 mg zoledronic acid infusion (176 participants), or to standard care, in which bisphosphonates and other bone-targeted medicines could be used (174 participants).Most of the participants had type I osteogenesis imperfecta caused by pathogenic variants in the type 1 collagen genes. The researchers found that 36.9 and 36.4 percent of patients in the teriparatide plus zoledronic acid group and the standard care group, respectively, had incident fractures. There was significantly more of an increase in lumbar spine and total hip bone mineral density with teriparatide plus zoledronic acid than standard care. Teriparatide plus zoledronic acid was favored in several quality-of-life measures. The groups reported similar adverse events."We have been using drugs to increase bone density for decades in the hope that they might prevent fractures but the TOPaZ trial clearly shows that these medicines simply do not work," lead author Stuart Ralston, M.D., from the University of Edinburgh Institute of Genetics and Cancer in the United Kingdom, said in a statement.Several authors disclosed ties to the biopharmaceutical and medical device industries.Abstract/Full Text.Sign up for our weekly HealthDay newsletter