Abaloparatide outperforms teriparatide in protecting against alveolar bone loss in experimental periodontitis

Abstract Background The aim of this study was to compare the effects of two osteoanabolic drugs, abaloparatide (ABL) and teriparatide (TPTD), on protecting alveolar bone in experimental periodontitis. Methods Twenty‐four 9‐week‐old, male, Sprague‐Dawley rats were placed with silk suture around the right maxillary second molar, and then were randomly divided into three groups, that is, the ABL, TPTD, and saline group, receiving intermittent subcutaneous injections of ABL (80 μg/kg), TPTD (80 μg/kg) or saline respectively every other day for 4 weeks. Samples on both sides were assessed through micro‐computerized tomography, histological, and immunohistochemical analysis. Mouse pre‐osteoblast MC3T3 cell was cultured with lipopolysaccharide (LPS) and treated with ABL or TPTD, before assays of cell proliferation, alkaline phosphatase (ALP) activity and real‐time polymerase chain reaction. Results On the ligature side, both ABL and TPTD significantly reduced alveolar bone loss, and ABL had significantly better effects with higher expression of runt‐related transcription factor 2 (RUNX2) and Bglap (formerly called osteocalcin); meanwhile, the ligature induced osteoclastogenesis and down‐regulation of osteoprotegerin (OPG) was affected by neither drug. On the non‐ligature side, ABL also showed better osteoanabolic effects. In vitro studies revealed that, in the presence of LPS, ABL, and TPTD similarly promoted MC3T3 proliferation, whereas ABL induced higher ALP activity and osteoblastic gene expression compared to TPTD. Conclusion Both ABL and TPTD protect and regenerate alveolar bone in experimental periodontitis, and ABL behaves even better than TPTD at the same dose, attributed to its stronger osteoanabolic effects in this context.