Posts Tagged ‘Teriparatide’

“Bisphosphonate Holiday” 2014

March 8, 2014 @ 8:56 pm
posted by Dr Ginther

“You are entering a Data-Free Zone”   That was unfortunately the messasge at the joint meeting of the International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) last month.  We simply do not have data from a study involving tens of thousands of patients.  We do know some things that are helpful.

Bisphosphonates build up in bone over time.  After about 5 years of Bisphosphonate therapy, you should have enough medication in your bones to last for additional years.  How many years?  That depends.  Different individuals lose Bisphosphonates from their bones at different rates.  Different Bisphosphonates tend to stay in bone longer or shorter than others.  We call the time you are able to stop taking medication for a while (because you have enough in your bones already) “Bisphosphonate Holiday”.

Beware of GIOP

April 1, 2013 @ 5:55 am
posted by Dr. Ginther

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?

No Human Osteosarcoma Linked to Forteo

December 29, 2012 @ 10:44 pm
posted by Dr. Ginther

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.

Fracture? Bone Health Evaluation!

November 15, 2012 @ 9:20 pm
posted by Dr. Ginther

I have been on the road with presentations in South Dakota and Southern Illinois recently.  SD is state # 10 for me.  I teach health care providers about the role for the Anabolic, Teriparatide (Forteo), in the treatment of specific patients.  However, I also present a very important message about ALL patients.

A fracture, ANY FRACTURE, means that the patient deserves a Bone Health Evaluation.  A fall from a standing height or other minor trauma is obviously a possible Fragility Fracture.  But even a fracture during sports deserves at least a check of Calcium in diet and supplements, and a blood test for Vitamin D level.