Newer Osteoporosis Treatments Build Stronger Bones
Recent drugs help maintain or increase bone density and also prevent fractures.
Other Options to Stop Bone Loss continued...
Fortical and Miacalcin contain the active ingredient calcitonin, which is a naturally occurring hormone that inhibits bone loss. It is available as a nasal spray or injection. Undesirable side effects include nausea and skin rashes.
Prolia is a treatment approved for the treatment of osteoporosis in postmenopausal women who are at high risk for fracture. Prolia is a so-called monoclonal antibody -- a fully human, lab-produced antibody that inactivates the body's bone-breakdown mechanism. It's the first "biologic therapy" to be approved for osteoporosis treatment. It is given by injection twice a year. The most common side effects seen in patients taking Prolia are back pain, pain in the extremities, muscle and bone pain, high cholesterol levels, and urinary bladder infections.
The drug also appears to lower calcium levels. Patients with low blood calcium levels should not take Prolia until the condition is corrected.
What if you could not only slow the breakdown of old bone, but actually stimulate the body to build more new bone? That's what Forteo does. Approved by the FDA in December 2002, Forteo is the first in a new class of drugs called parathyroid hormones. They treat osteoporosis by stimulating bone-forming cells called osteoblasts.
It's an exciting drug, says Holick. "It has a dramatic effect on bone, increasing bone mineral density in the spine by as much as 13% in 18 months and reducing the risk of fracture by as much as 90%."
So why isn't every woman with osteoporosis taking it? Cost, mostly. Forteo costs about $600 a month, and it also must be injected every day. For those reasons, it's generally only prescribed for patients with severe osteoporosis, or who have already had one or more fractures.
But that may not always be the case. Holick notes that research on less expensive, easier-to-deliver versions of this drug is already in the works. "There are a huge number of potential new treatments on the horizon, actually, a number of which are already in phase III trials," he says. "Now that we better understand the mechanism by which our bone cells work, we have a better idea of the strategies that can be used to stimulate bone cells to make new bone, or inhibit the removal of calcium."