New osteoporosis treatments offer diagnosis incentives

More options to prevent brittle bones and multiple fractures add imperative for treatment.

By Victoria Stagg Elliott, AMNews staff. April 1, 2002.

Osteoporosis specialists say a revolution is just around the corner.

Treatment for what was long considered an inevitable result of aging is about to be turned on its head.

"There are a bunch of new developments," Robert P. Heaney, MD, an internist and distinguished chair at Creighton University in Omaha, Neb. "There was a time when we didn't have anything, but now we have lots of choices. And that's always good."

For instance, the Feb. 28 issue of the New England Journal of Medicine published positive results of a study examining the effectiveness of a once-a-year intravenous infusion of a bisphosponate drug. Physicians speculate it could be given in the hospital setting to patients who suffered a fracture or had surgery and are at high risk for broken bones. It could also be given during the annual physical.

An advantage of this approach is that it may result in better patient compliance than daily or weekly oral medications because of convenience. It is also less likely to cause gastrointestinal complications. "Compliance with the oral medications is spotty, and many people given prescriptions for these things don't fill them," said Dr. Heaney. "This way, you know that patients will get the dose at least for the next year, and then the problem is getting them back into the office. But it'll be time for a checkup anyway so it shouldn't be that hard."

Meanwhile, synthetic parathyroid hormone may become the first available treatment before the end of the year to actually build new bone, rather than just preserve what's left. This therapy would involve a daily injectable used for a year or two to rebuild bone to its pre-osteoporosis condition. Once this is achieved, the patient would switch to another drug for maintenance. For now, however, the Food and Drug Administration has expressed concern about a link to possible bone tumors. [...]