Osteoporosis is the most common form of metabolic bone disease. It is fairly common and often debilitating. While the disease can affect anyone, it is most prevalent in postmenopausal women. With osteoporosis, bone mass is severely decreased leaving bones weak and susceptible to fracture.
Osteoporotic postmenopausal women don’t need to fall or sustain injury to break their fragile bones. Normal movements in their daily lives can produce fractures in wrists, hips, ribs, and vertebrae. There is no cure for osteoporosis but there are different types of treatment methods available.
With age comes an increased risk of osteoporosis and fracture. If the bones are not dense or strong enough to withstand the natural occurrence of bone loss that comes with age then a break is almost inevitable. The challenge then is to find something that can make up for bone loss and restore bone strength.
That is where bone-forming medications come in. Parathyroid Hormones are the primary regulators of calcium and phosphate metabolism in bones. Unlike other therapies that reduce bone resorption, ParaThyroidHormone, or PTH increases bone mass that results in greater bone mineral density, or BMD. BMD is thought to be the most important factor in osteoporosis.
Teriparatide is a man-made form of PTH that exists naturally in the body. Teriparatide is the first FDA approved agent for the treatment of its kind. Teriparatide increases bone density and increases bone strength to help prevent fractures.
It is used to treat osteoporosis in men and women who have a high risk of bone fracture. Drugs approved to treat osteoporosis must be shown to preserve or increase bone density and maintain bone quality. Teriparatide is administered by injection once a day in the thigh or abdomen.
The recommended dose is 20 mcg per day. The effects of Teriparatide on bone mineral density and fractures were studied. Patients treated with 20 mcg of Teriparatide per day, along with calcium and vitamin D supplementation, had statistically significant increases in bone mineral density (BMD) at the spine and hip when compared to patients taking only calcium and vitamin D supplementation.
As with any medical treatment there are potential risks and benefits. The FDA released a black box warning because in animal studies with Teriparatide, there was an increase in the number of rats developing osteosarcoma, a rare but serious cancer of the bone. There were no reported cases in humans, however the possibility cannot be ruled out.
Further studies are needed since there have been no studies done lasting more than two years to find out any long term effects.
Studies have shown that the medicine is well tolerated and that adverse drug events were similar to that of placebo with the exception of dizziness and leg cramps. Side effects, or adverse drug events that may be associated with this type of medication may include headache, neck pain, nausea, dizziness, constipation, depression, vertigo, and hypercalcemia.
The benefits for those who are in need are believed to outweigh the risk. Those that should not be prescribed this kind of treatment are children and people with Pagets disease due to their already slightly elevated risk of cancer.