<<Disclaimer: Verify this information before applying it to your situation.>>
I am going to present this summary in 3 parts.
1. People asked me to clarify what I learned about Actonel and Fosamax
because I forgot to put the emails about them in my previous summary.
2. Emails I received about Forteo (the injection osteoporosis medicine I'm
going to take) which is a brand name for Teriparatide.
3. Articles about injection osteoporosis drugs. A study in rats showed
Forteo can cause bone cancer. There's an article about that. And also,
there is a new drug on the market that's injected, but you only have to take
it once a year There's an article about that.
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ABOUT ACTONEL & FOSAMAX
I developed severe adverse reactions to Actonel and can no longer take
Biphosphonates (Boniva, Actonel, Fosamax). I now use Miacalcin nasal spray
(protein like salmon protein), and take Tri-Boron Plus, exercise, etc., and
my lower back and hip are feeling better.
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I tried Fosomax which gave me terrible diarrhea, then I tried Actonel which
gave me acid reflux.
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EMAILS ABOUT FORTEO
My husband has begun Forteo and was told by our endocrinologist it has been
quite successful in adding bone density to men. Use currently is limited to
2 years but in that amount of time the "safe" period may have been extended.
Be sure the medication is chilled when you receive it as that is necessary
for it to be effective. It costs $800 for 28 days of drug.
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My osteoporosis had not been improving while on Fosamax weekly for two
years; it continued to get worse. If this year's results are not better,
then it was suggested I go on the injections BUT only for two years as there
is a high incidence of bone cancer. That info came from both my internist
and gynecologist and they were both emphatic about it.
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I suggest you take it very slowly! I had a severe reaction after taking the
injections for about 5 days. Very much like very bad case of the flu,
starting with achy muscles and progressed to nausea, tingling in my arms and
legs. I then began to have a hard time staying conscious, the more severe
symptoms arrived about 20 minutes after injection.
The prescribed dose is 20mg, my Doc and reduced the dose to 10mg 2 times a
week and then worked up to 10mgs every other day. The other problem I had
was with shipping, it must be refrigerated at all times and mine often
arrived without enough cold packs and I would have to wait another 3 days
for a new supply and would have to start over.
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The injections you are taking are parathyroid hormone. That's fine, if you
are not already prone to bouts of racing heart, and if there are no
parathyroid problems and none in your extended family.
In my case, there are parathyroid problems in my family, and I am prone to
bouts of racing heart, which is the most common side effect of the
injections.
I developed severe adverse reactions to Actonel, Fosamax, etc. when I took
such medicaitons (biphosphonates) over an 18-month period, so I now use
Miacalcin nasal spray (salmon protein).
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ARTICLE ABOUT FORTEO
Dr. Gustavo Duque, a bone mineral specialist at McGill University in
Montreal, said data on osteosarcomas in rats should not be extrapolated to
humans.
"This is a clear misunderstanding of a side effect found in rats," he said.
"Rats have a very different bone structure than humans."
Dr. Duque, who said he has no financial ties to Eli Lilly or its
competitors, says all vertebrates have a cartilaginous structure known as a
growth plate that is situated in distal and proximal segments of long bones.
This growth plate is the source of growth in bones. In humans, the growth
plate produces bone until the teen years and then is closed and mineralized;
in rats the growth plate stays active throughout their lives.
"This means that in rats the growth plate may become a source of cartilage
related neoplasm, which happened in the mentioned studies. We cannot
extrapolate this to humans," said Dr. Duque, a geriatrician and researcher
in the field of aging bone and senile osteoporosis at the division of
geriatric medicine, McGill University, and the Bloomfield Center for
Research in Aging in Montreal.
-----------------------------------------------------------------------------------Teriparatide's Black Box Warning"In male and female rats, teriparatide caused an increase in the incidenceof osteosarcoma (a malignant bone tumor) that was dependent on dose andtreatment duration. The effect was observed at systemic exposures toteriparatide ranging from 3 to 60 times the exposure in humans given a20-[micro]g dose. Because of the uncertain relevance of the rat osteosarcomafinding to humans, teriparatide should be prescribed only to patients forwhom the potential benefits are considered to outweigh the potential risk.Teriparatide should not be prescribed for patients who are at increasedbaseline risk for osteosarcoma (including those with Paget's disease of boneor unexplained elevations of alkaline phosphatase, open epiphyses [open boneplates], or prior radiation therapy involving the skeleton)."----------------------------------------------------------------------------------- ARTICLE ABOUT A NEW DRUGABC NewsMonday, June 25, 2007An Injection a Year May Keep Bone Loss at BayNew Study Finds Once-A-Year Infusion of Reclast May Be Effective AgainstOsteoporosisWhen it came to her treatment for the bone-weakening condition osteoporosis,69-year-old Diana Mahon of Pittsburgh took her pills diligently. But itwasn't always easy. Mahon was taking drugs called bisphosphonates -- pillssuch as Fosamax, Actonel and Boniva, which are currently the preferredtreatment options for osteoporosis. The drugs worked, but they came with alaundry list of considerations.The pills, taken either weekly or monthly, need to be ingested on an emptystomach while standing or sitting. Afterward, the patient must not lie down,eat, drink or take other medication for at least half an hour."The fact that you have to stand or sit for that time limit was inconvenientat times," Mahon said. Plus, these drugs have potentially seriousgastrointestinal side effects, such as ulcers, heartburn and otherproblems -- something that Mahon learned firsthand !
when her drugs sent herto the emergency room with swallowing difficulties.However, Mahon and the 10 million others like her who have osteoporosis, mayhave a new, more convenient option to prevent fractures and further boneloss in the near future. And the therapy would require only a yearly visitto the doctor. But these benefits may not come without a cost. The studyfound that a certain kind of abnormal heart rhythm called atrialfibrillation was more common in patients receiving the drug. In the currentissue of the New England Journal of Medicine, a study of more than 7,700postmenopausal women found that a single 15-minute yearly intravenousinfusion of zoledronic acid, also known as Zometa or Reclast, reduced spinefractures by 70 percent and hip fractures by 41 percent over a three-yearperiod. These results are similar to those obtained from currentosteoporosis drugs. The new option may prove to be a godsend for patientswho simply cannot tolerate taking the oral pills.According to Dr. Steven Cummings, senior author of the study and emeritusprofessor of medicine and epidemiology at the University of California atSan Francisco, only 30 percent of patients continue to take the oralmedications for an entire year."Giving one infusion a year guarantees compliance, which, in turn, increasesthe effectiveness of treatment -- like an airbag instead of seat belts,"Cummings said.Dennis Black, professor of epidemiology and biostatistics at the Universityof California at San Francisco and lead author of the study, said that ifthe new treatment is approved, patients who are already on many medications,unable to take pills or stay upright, or have gastrointestinal problemswould likely be targeted first.According to the 2004 Report of the Surgeon General on Bone Health andOsteoporosis, half of women over 50 years old will break a bone due toosteoporosis in their lifetimes. While osteoporosis is a condition thatpredominantly affects women, the condition hits men as well. In total,osteoporosis and low bone mass are estim!
ated to affect approximately 44million Americans -- women and men -- aged 50 and older. And according tothe study's authors, the costs of medical care associated with osteoporosisare more than $18 million annually in the United States alone."Osteoporosis represents a major concern in public health," said Dr. JavadParvizi, joint specialist and director of orthopedic research at the RothmanInstitute at Thomas Jefferson University Hospital."This study provides an alternative route of treatment for a class ofmedications that has been found to be very helpful in osteoporosis care andmay be able to effectively treat men and women who have struggled on oraltherapy," added Dr. Susan Bukata, clinical director of the Center for BoneHealth at the University of Rochester.Bukata further emphasized that "this study is really important for men whodo not have many choices for therapy."The data show and experts agree that yearly infusions of Reclast appear tobe at least as effective as currently available osteoporosis treatments inpreventing all osteoporotic fractures, not just hip and spine fractures.Bukata said, "[Reclast's efficacy] certainly matches the standard set by theoral bisphosphonates and shows true fracture protection equivalent to thesedrugs." She also touts the benefits of a treatment that provides yearlongprotection."[Patients] are much more likely to comply when the dosing is tied into a[yearly] doctor's visit," she said, "especially if they have to do nothingin between visits except take their calcium and vitamin D."Mahon, who was in the study, couldn't agree more."I think it's marvelous," said Mahon, who does not know yet if she was inthe treatment [Reclast] or nontreatment [placebo] group. "The fact that youcan take something and it can last a year is a great incentive to go get itdone."Experts are especially enthusiastic about its potential to treat those who,like Mahon, have had trouble with or cannot take oral bisphosphonates.However, the study also found serious cases of atrial fibrillation to bem!
ore prevalent among the Reclast treatment group. Fifty patients in thetreatment group experienced this potentially dangerous heart condition,compared with 20 patients in the placebo group. This was an unexpectedfinding that Dr. Felicia Cosman, osteoporosis specialist at the Helen HayesHospital, said has never been observed in any of the previous clinicaltrials of this particular drug.Experts say this particular side effect may be common to allbisphosphonates, but it's too early to tell. Still, most experts such asDr. C. Conrad Johnston Jr., distinguished professor of medicine at theIndiana University School of Medicine, say these drugs, including Reclast,are quite safe with relatively few side effects. And there is evidence thatReclast may allow patients to avoid a rare but serious side effectassociated with the use of bisphosphonates. This condition, calledosteonecrosis of the jaw, can cause the jaw bone to die away, leading topain and dysfunction.For now, however, patients may have to wait. Dr. Juliet Compston, professorof bone medicine at the University of Cambridge in the United Kingdom andauthor of the accompanying editorial to the study, said, "I don't think itshould change clinical practice [at this time]." But, since Reclast wouldonly need to be given once a year, experts are encouraged that many morepeople will get it and stick with it if it is approved."It is an important addition to our armamentarium to fight osteoporosis,"Johnston said.
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