Osteoporosis, which literally means “porous bone” is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become less dense and weaker and so are prone to fracture. This common disease affects approximately 30% of post-menopausal women. There is no cure for osteoporosis but there are effective treatments.
Around two decades ago, a range of anti- resorptive agents were developed that inhibit bone re-absorption, or loss, and so help to increase bone density and reduce the risk of bone fracture. However, they do not stimulate new bone formation.
The primary group are the so-called bisphosphonates, such as alendronate and risedronate. They are inexpensive and generally safe in the short-term and therefore they can be prescribed for anyone with osteoporosis. They are usually taken in tablet form.
Building stronger bones
Unfortunately, post-menopausal women often seek medical treatment only after osteoporosis has already become established. Therefore, new therapies that actually stimulate bone formation and so restore bone quality, known as anabolics, have been the focus of more recent research and development. These compounds are synthetic versions of the parathyroid hormone family, which occur naturally in the body. One such drug is teriparatide, which is administered in a daily injection. However, in the UK it is only available on the NHS for those people who have failed treatment with the bisphosphonates and have very low bone density.
A new bone anabolic called abaloparatide, which has shown excellent anti-fracture effects, is also going through the regulatory processes at present. In a recent phase III clinical study involving nearly 2500 post-menopausal women with osteoporosis, it was shown to reduced the risk of new vertebral and non-vertebral fractures over 18 months and the incidence of hypercalcemia, where there is too much calcium in the body, was lower with abaloparatide than teriparatide.
Consultant Rheumatologist and specialist in the treatment of osteoporosis, Dr Stephanie Kaye-Barrett commenting on the study said, “It is important that people with osteoporosis should be able to get access to the latest and best treatments. The new anabolic therapies fall into this category and I hope that that they will become more readily available in the UK.”
