In the November 2007 issue of the New England Journal of Medicine, the drug Forteo more than doubled osteoporosis patients’ bone density measurements and significantly reduced the risk of new spinal fractures when compared to those taking Fosamax. The study was lead by Kenneth Saag, M.D., M.Sc., a professor in the UAB Division of Clinical Immunology and Rheumatology.
International guidelines currently recommend a class of drugs called bisphosphonates, which includes Fosamax, for patients diagnosed with and at risk for glucocorticoid-induced osteoporosis. Forteo, however, is a part of a class of drugs called parathyroid hormone, which scientists hope is part of the next wave of medicines that work to build back bone, reduce bone loss and minimize fracture risks in arthritis patients.
At the time of the study, Forteo was only approved for use in postmenopausal women with osteoporosis, and in certain cases for men with hormonal-linked osteoporosis.
For the study, 428 adults with glucocorticoid-induced osteoporosis were chosen to receive either a once-daily Forteo injection or a once-daily Fosamax pill. Their spine and hip bone density measurements were taken at the start of the trial and at the end using a DEXA scan, a low-level X-ray machine that detects slight changes in bone density. The study looked at changes in bone density over the course of 18 months.
Forteo was found to increase spine density by 7.2 percent compared to 3.4 percent for Fosamax, and it boosted hip density 3.8 percent compared to 2.4 percent for Fosamax. In terms of side effects, the differences between Forteo and Fosamax were found to not be significant.
Saag et al concluded that because parathyroid hormone appears to trigger the growth of bone-forming cells called osteoblasts, Forteo may effectively counteract the negative effects of glucocorticoid use in bones via a different cell pathway than Fosamax.
Forteo’s Bone-building Power Shown In Arthritis Patients, site accessed on 12/03/07