Posts Tagged ‘Forteo’
GIOP is Glucocorticoid Induced OsteoPorosis. Cortisone, Prednisone, and many Inhalers for Asthma or COPD are glucocorticoids. Therefore, Glucocorticoid Induced OsteoPorosis is a particularly aggressive form of osteoporosis that affects all ages, not just older adults.
Glucocorticoids suppress OsteoBlasts, the cells that make new bone. Even the normal rate of bone turnover required for good bone maintenence and repair of microcracks becomes a problem when new bone formation is suppressed. Persons with GIOP have a rapid decline in bone quality and strength. What can be done?
This week I spoke to doctors and nurses who run Pain Clinics. The obvious connection is Vertebral Fractures requiring Kyphoplasty or Vertebroplasty. If you only do the procedure, you have not solved the problem. You must treat the Osteoporosis too, preferably with the Anabolic, Forteo, if you want to avoid further fractures.
Vitamin D is the other connection. Successful treatment of chronic pain often requires enough Vitamin D3 to bring the 25-hydroxy Vitamin D level to at least 40ng/ml. This is not yet widely known. Not all clinics are testing for Vitamin D levels. They should be!
A reader has asked about bone cancer and Forteo.
Osteosarcoma is a rare bone cancer. Lilly has endowed a 15-year independent study (suggested by the FDA) of all Osteosarcoma patients in Cancer Registries, looking for individuals who have taken Forteo. The halfway point results from June 2004 through Sept 2011 were published in JBMR in Dec 2012. Of the 1448 persons who had Osteosarcoma during that time period, not one had taken Forteo.
The “black box” warning on the Forteo (Teriparatide) label refers to studies of rats, not humans. These rats very commonly get osteosarcoma without any medication. The rats were given doses 3 to 20 times the human dose for the equivalent of 70 human years. Rats’ bones never stop growing. Growing bones are particularly vulnerable to osteosarcoma. Humans are different from rats.