Pharmaceutical Industry Websites

The following sites are sponsored by the manufacturers of these pharmaceutical agents:

Christmas Blue Zones

January 1, 2018 @ 8:10 pm
posted by Dr Ginther

Grandkids are Blue Zones.

We visited the younger set (Trevor and Isabel) through Christmas morning in Chicagoland.  Isabel is just learning to crawl.  Trevor has forgotten how to walk and runs all the time.  Both went bonkers over the packages under the tree.

We arrived in the Pacific Northwest Christmas evening to see the older set.  Gwen at 4 is now a Big Girl full of chatter on all topics.  She thoroughly enjoyed a very good Nutcracker (Balanchine choreography).  RJ at 7 is a hockey fanatic.  We watched him practice and watched the World Juniors (under 21) with him on the TV.  He knew all the US players and many others who play in the NHL.  Children’s museum, etc too.

Now work starts again tomorrow

Jay Ginther, MD

Healthcare Reform 2018

November 2, 2017 @ 8:27 pm
posted by Dr Ginther

Lots of new regulations go into effect 1 Jan about what additional data must be recorded for every patient visit and about how it is to be formatted.  Our group has to purchase an entirely new Electronic Medical Record system in order to be in compliance for 2018.  We have already been very busy preparing new templates to meet the new requirements.  “Go live” is the end of the month.  That is when the real fun will begin.

Most of the new reporting requirements are about conditions I do not treat.  Therefore, their utility in treating the issues for which I am seeing the patient will be limited.  We hope that some day the public health information potential of the additional data can be realized.  But first we need to be able to share data across systems.  Even within the ACO we belong to, that is challenging.

We hope to have things under control in early 2018.

Jay Ginther, MD

Iowa Bone Club Fall Meeting

October 22, 2017 @ 7:38 pm
posted by Dr Ginther

Iowa Bone Club met for the third time this past Friday, 20 October.  Ritu Munjal, MD was the program chair and hosted the meeting at PCI in Cedar Rapids.

Great program for those attending.  Guest CME topic was hypophosphatasia, which can be a cause of poor bone and increased fracture risk.  Low alkaline phosphatase and elevated B6 are the key labs.  The condition can be made worse by bisphosphonates, and probably other antiresorptives.

Spring 2018 meeting will be Friday 1 June in Spirit Lake.

Jay Ginther, MD

A New Anabolic – Tymlos

September 24, 2017 @ 8:53 pm
posted by Dr Ginther

The FDA approved Tymlos (Abaloparatide) in June for use in women diagnosed with osteoporosis.  Unfortunately most patients are unlikely to obtain insurance coverage for Tymlos until January or February 2018.

Tymlos is an anabolic, which means that it can stimulate osteoblasts, the cells that make new bone matrix.  Until now only Forteo (Teriparatide) has been available to do that.  Having a second option will be helpful.

Tymlos is similar to Forteo, yet there are distinct differences.  Tymlos is almost pure osteoblast stimulation which means that BMD rises faster in areas with cortical bone, such as the hip.  This potentially makes it a better choice for women never exposed to antiresorptive bisphosphonates like Fosamax (Alendronate), Actonel (Risedronate), Boniva (Ibandronate), and Reclast.

Tymlos is a daily shot (like insulin), but does not require refrigeration.  It is approved for up to 24 months use and must be followed by an antiresorptive in order to not lose the benefits gained.

Patients with a single fracture of hip, or multiple fractures of other bones including spine, or with a BMD well below -2.5, or a FRAX score well above 20%and 3.0%, should be considered for an anabolic.  Now we have another choice available.

For now Tymlos is approved for women only and osteoporosis only.  We look forward to the FDA adding men and other indications in coming years.

Meanwhile, we wait for insurance coverage to make it affordable.

Jay Ginther, MD