Posts Tagged ‘GERD’

Aunt Henrietta’s Birthday

August 28, 2014 @ 9:11 pm
posted by Dr Ginther

This weekend is Aunt Henrietta’s 90th birthday.  I have just the right gift for her, Adora Premium Chocolates.  My Aunt Henrietta has been our posterchild since the beginning of Cedar Valley Bone Health Institute of Iowa.  Her adventures are well chronicled.

First, she broke one wrist when she was thrown down by a throw rug.  Then she broke the other wrist when her bifocals did her in.  Then she broke her shoulder when she thought all the ice had melted.  I had to tell her Endocrinologist about the Anabolic, Forteo.  She agreed to give herself a daily shot.  Then she proved that treatment had worked by falling down the stairs and not breaking anything.  Finally she locked in the gains of Forteo by starting the Antiresorptive that gets along with her severe GERD and aging kidneys, Prolia.

She can live alone in her own home because she Took Control of her bone health, with Calcium, Vitamin D3, Protein, Multiple Vitamins and Minerals, and Osteoporosis Medications.  They are all necessary.

Happy Birthday Aunt Henrietta!

Jay Ginther, MD

Denosumab – Prolia – OPG Analog

August 21, 2014 @ 8:17 pm
posted by Dr Ginther

Denosumab (Prolia) mimics the natural process that keeps OsteoClasts (the cells that gobble up bone) under control before menopause.  OsteoCytes release Osteoprotegrin (OPG) when Estrogen (or Testosterone) is on board.  OPG controls the formation and activation of OsteoClasts by blocking RANK-Ligand, which is necessary for OsteoClast formation and activation.  This decreases fracture risk.

Enteric Coated Atelvia

July 29, 2014 @ 7:57 pm
posted by Dr Ginther

The biggest problem with oral Bisphosphonates is GI upset, especially Gastro-Esophogeal Reflux Disease (GERD).  Another problem is that you must take them on an empty stomach – then eat nothing for 30 to 60 minutes.  Atelvia attempts to evade those issues with enteric coating.  Atelvia is Risedronate (Actonel) which does not disolve until in the small intestines.  It can be taken with food.  This is definitely more convenient.

Published studies show Atelvia to be as effective in decreasing fracture rates as daily Actonel (the orginal dosing of Risedronate).  That is good.

The enteric coating should make GERD much less common than with regular Actonel.  Surprisingly, there are no published studies to back up that obvious supposition.  Nor are there any studies about other GI problems common with regular bisphosphonates.  Fortunately, we do have some samples for patients to try in order to determine if they have any GI problems with Atelvia, before getting a paid-for prescription.

Atelvia is still new enough on the market that we have no long term experience.  It may acquire the niche market for an oral Bisphosphonate without GERD.

Having an additional osteoporosis medication option is good.

Jay Ginther, MD