Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Combining osteoporosis drugs produce no added benefit

22.09.2003


Combining two types of drugs prescribed for osteoporosis does not produce a synergistic benefit in treating the disease, according to a study headed by a UCSF researcher.



The study disproved a previously untested but widespread belief among bone researchers that combining the two types of drugs -- bone-building parathyroid hormone (PTH) and bone resorption inhibiting bisphosphonates -- should interact in a beneficial way for patients. The combination is no better than either drug alone and may even reduce the bone-building benefit, according to study results.

Black presented the findings at the American Society for Bone and Mineral Research in Minneapolis on September 20. The study results are also reported in the September 25 issue of the New England Journal of Medicine.


The randomized, double-blind trial measured the bone density of 238 postmenopausal women for one year as they took one of three daily treatments. Participants in the multi-site study took either parathyroid hormone (PTH 1-84); the bisphosphonate alendronate, marketed as Fosamax; or both. All the women began the trial with low bone mineral density.

Parathyroid hormone in the form of PTH 1-34 has been available for treatment of severe osteoporosis since its FDA approval in 2002. This trial evaluated the full-length molecule PTH 1-84 that contains 50 additional amino acids. Despite a wide-spread belief among bone researchers that bisphosphonates and parathyroid hormone would interact in a synergistic way to compound the benefit for patients, no benefit was demonstrated. Rather, the findings suggest that the concurrent use of alendronate may reduce the bone-building, or anabolic, effects of parathyroid hormone.

"We’re in the early stages of use for a whole new class of bone-building medications for osteoporosis," said UCSF Professor Dennis Black, PhD, principal investigator. "These anabolic agents offer an alternative, and, with decreased reliance on estrogen, new approaches to the treatment of osteoporosis are even more important," he added.

Black said that although bisphosphonates are currently used effectively by millions of women, physicians and patients alike would welcome alternatives, particularly for women with severe disease. Estrogen, once used as a first choice treatment for osteoporosis, has been shown to increase risk of breast cancer and, in women with heart disease, to increase the risk of stroke.

The cooperative, multi-site trial by the National Institute of Arthritis and Musculoskeletal and Skin Disorders, part of the National Institutes of Health, involved women in Minneapolis, Pittsburgh, Maine and New York.

Healthy bones exhibit a continual cycle of growth and resorption into the body. Parathyroid acts to both promote bone growth and accelerate its resorption and is initially more active in promoting bone growth, the researchers said. Thus they hypothesized that, as compared with parathyroid hormone therapy alone, the combination of parathyroid hormone with alendronate would induce larger increases in bone mineral density, preserve the increase in bone formation and minimize any increase in bone resorption. The study, however, found no evidence to support the hypothesis.

Black said parathyroid hormone deserves greater study, although its use may be limited by two factors: its current cost is about $7-8000 per year, and it is currently available only as an injectable medication. While this study suggested that the simultaneous combination of these two drugs is not more beneficial than either alone, the serial combination, particularly the use of bisphosphonates following PTH, has not been studied, Black said.

Osteoporosis is a condition resulting from bones that have lost calcium and thickness. Because of this thinning of the bones, a person with osteoporosis is at increased risk for fracture. It is responsible for 1.5 million fractures annually, according to the National Osteoporosis Foundation.


Additional authors are Susan Greenspan, MD, University of Pittsburgh; Kristine Ensrud, MD, MPH,University of Minnesota; Lisa Palermo, MA, UCSF; Joan McGowan, PhD, National Institute of Arthritis and Musculoskeletal and Skin Diseases; Thomas F. Lang, PhD, UCSF; Patrick Garnero, PhD, Synarc; Mary Bouxsein, PhD, Beth Israel Deaconess Medical Center; John Bilezikian, MD, Columbia University; Clifford Rosen, MD, Maine Center for Osteoporosis Research and Jackson Laboratory.

The study was funded by the NIH. Alendronate for the trial was provided by Merck. Parathyroid hormone (PTH 1-84) was provided by NPS Pharmaceuticals.

Eve Harris | EurekAlert!
Further information:
http://www.ucsf.edu/

More articles from Health and Medicine:

nachricht Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan

nachricht Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Tune your radio: galaxies sing while forming stars

21.02.2017 | Physics and Astronomy

Improved Speech Intelligibility and Automatic Speech-to-Text Conversion for Call Centers

21.02.2017 | Trade Fair News

36 big data research projects

21.02.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>