Combining Bone-Building Drugs Makes Bones Stronger

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Two drugs used to treat osteoporosis may be better than either alone in maintaining bone density.

Dr. Benjamin Leder and his colleagues atMassachusettsGeneral Hospital found that combining teriparatide (Forteo)and denosumab (Prolia) improved bone density tests among a group of post menopausal women withosteoporosis after a year better than any benefits that currently available drugs provide on their own.

Maintaining bone strength is about managing the creation and destruction of bone; teriparatide works by both stimulating bone formation and preventing bone decay, while denosumab primarily inhibits bone loss, so the dual actions may have contributed to the combinations success.

Prior studies that combined the popular bisphosphonates, which include Fosamax, with teriparatide have been unsuccessful, but the researchers, who reported their findings in thejournal Lancet, believe that denosumab may work better with teriparatide because it can block teriparatides bone decaying activity more effectively. Bisphosphonates, like denosumab, also blocks the destruction of bone but through a different pathway.

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Osteoporosis is more common among women following menopause, since the cells that break down or cause resorption of bone, called osteoclasts, and the cells that form new bone, called osteoblasts, become more active. However, over time, the osteoclasts tend to overtake the bone-building processes, which leads to lower bone density and a higher risk for fractures.

In the study, the researchersseparatedthe 94 female study participants into three groups. One receivedthecombinedteriparatide and denosumab therapy while the other two groups took one or the other medication alone.

The participants had their bone density measured and blood tests conducted at three months, six months and at the end of the year-long study. Those with the combined drug therapy showed a 9.1% increase in bone density of the lumbar spine compared to a 6.2% increase among theteriparatide only group, and a 5.5% increase among thedenosumab only group. They also showed similar increases in bone density of the hip.

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Combining Bone-Building Drugs Makes Bones Stronger