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Bones About It – Good News For Women With Osteoporosis
For
women who suffer with osteoporosis, the news is good: A new medication
promises to revolutionize treatment for the bone-thinning disease, particularly
in women with the most severe problems.
The
drug, a synthetic version of human parathyroid hormone called PTH, works
by helping the body build new bone—even after dramatic loss has
occurred.
New
Drug Actually Helps Build New Bone
"Unlike
other treatments for osteoporosis, which can help stop bone loss, parathyroid
hormone actually helps the body build new bone, so that a woman has
a chance to put back what her skeleton has lost over time to osteoporosis,"
says endocrinologist Dr. Loren Wissner Greene, co-director of the Bone
Density Center at New York University Medical Center.
Although
most of us stop growing in height in our late teens, our skeleton actually
remains a work in progress for most of our lives, continually breaking
down and re-building bone mass at a fairly steady rate.
When
osteoporosis sets in, however, bone loss begins to occur faster than
the rebuilding process can take place. And that means instead of being
strong and solid, bones become porous, filled with little holes or craters.
As
the disease progresses, there is less bone "mass" and more bone "holes"—turning
a strong skeleton into one that can be weak and vulnerable.
For
women, who comprise the vast majority of persons with osteoporosis,
the problems generally become extremely apparent after menopause, a
time when levels of the hormone estrogen drop dramatically.
Why
Is This Important?
Estrogen
helps to regulate factors involved in bone formation, Greene says. When
estrogen levels fall, so does the production of new bone cells, she
adds.
For
women who start out with less bone mass to begin with, even a tiny loss
can spell trouble.
"The
end result can be weaker bones, and a dramatically increased risk of
fracture, particularly of the hip, spine and wrist," says Greene.
Facts
About Osteoporosis
There
are 10 million Americans who have osteoporosis, eight million of whom
are women. According to the National Osteoporosis Foundation,
another 34 million women have low bone density, which is a precursor
to osteoporosis.
Although
there are a variety of medications available to treat osteoporosis,
they all work in pretty much the same way -- to stop the bone loss.
PTH,
however, stimulates new bone cell production. The results, according
to endocrinologist Dr. John Adams, are nothing short of astounding.
"This
drug is remarkable in the fact that while all of the other [osteoporosis]
drugs are designed to inhibit bone loss, this is completely different
in that it stimulates the bone forming cell, the osteoblast," says Adams,
the director of the endocrinology, diabetes, and metabolism division
at Cedars-Sinai Medical Center in Los Angeles.
When
combined with drugs that stop bone loss, like Fosamax (aldendronate),
parathyroid hormone becomes the ultimate way to increase skeletal strength,
Adams says.
Drug
Receives Physicians' Support
"I'm
planning on putting every single one of my patients on this medicine
as soon as it becomes available. I feel that strongly about it," says
Adams.
As
good as it sounds, there are some caveats to consider. First, the drug
must be injected daily, which could be problematic for some women.
More
important, however, while human trials as long as 20 months showed no
serious side effects, a rat study found parathyroid hormone has the
potential for causing an extremely rare but life-threatening form of
bone cancer.
Although
the rats received doses far above the human equivalent and were treated
with the drug for an entire lifetime, the US Food and Drug Administration
(FDA) was concerned enough to request that the manufacturer,
Eli Lilly, conduct studies on larger animals using dosages equal to
that proposed for humans.
Those
results are expected soon and all indications are the drug will be considered
safe enough to get the FDA's nod of approval.
Other
Treatment Options For Osteoporosis
Until
then, Greene says another new treatment option is Evista (raloxifene),
a medication known as a SERM, or selective estrogen receptor modulator.
Often
referred to as a "designer estrogen," SERMs work on a variety of diseases
"by offering the benefits of estrogen without the side effects of estrogen
replacement therapy, such as increased risk of breast and uterine cancer,"
says Wissner Greene. In osteoporosis, Evista works much like estrogen
to help ensure that bone production is not outpaced by bone loss.
Also
available are drugs known as bisphosphonates -- medications such as
Fosamax, Didrocal (Etidronate), and Actonel (risedronate). They work
specifically to slow down bone loss. Although they can be hard on the
gastrointestinal tract, a new intravenous form is being tested, with
a one-time treatment offering protection for up to a year.
A third
alternative is the drug Miacalcin (calcitronin), a synthetic version
of a hormone made in the thyroid gland that is involved in the breaking
down of old bone cells. Available as a nasal spray, it also works to
reduce the rate of bone loss.
A
Natural Approach To Preventing Bone Loss
Finally,
for those who wish to take a more natural approach, boosting vitamin
D intake along with 1,500 mg of calcium daily is the way to go.
What
can also help: Weight-bearing exercises such as brisk walking, which
can increase the production of new bone.
Always
consult your physician for more information.
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