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Posts Tagged ‘Zolendronate’

Recently I wrote about our participation in a clinical trial offering the anabolic Tymlos (Abaloparatide) to men.  Now we have been approved for participation in another Tymlos (Abaloparatide) trial – this one for women.  Currently Tymlos is available to women as a daily shot.  The new delivery system is a patch applied to the skin for 5 minutes daily.  That is far more convenient than a shot.

The FDA compliant trial is being run by the Northeast Iowa Family Practice Center.  They have years of experience with clinical trials.  Clinical trials always have strict inclusion and exclusion criteria requiring extensive screening, interviews and multiple testings.  All screening is free to the participant.  If you are accepted into the trial, all treatment is also at no charge.

All participants will receive the FDA approved anabolic (increases bone matrix) medication Tymlos (Abaloparatide).  Participants are randomized to the standard injection or the new patch.

Our participation in the study is that Bone Health will be doing all screening and quarterly study DXAs and ADI (Advanced Diagnostic Imaging of Iowa) will be doing the spine x-rays.  We are also screening our own patients for potential to be study participants.

Remember that anabolic medications Forteo (Teriparatide), Tymlos (Abaloparatide), and Evenity (Romosozumab), primarily stimulate new bone formation.  Antiresorptives Fosamax (Alendronate), Actonel/Atelvia (Risendronate), Boniva (Ibandronate), Reclast (Zolendronate), Evista (Raloxifene), and Prolia (Denosumab), primarily preserve bone.

Of course, all medications require proper nutrition to work well.

Jay Ginther, MD

Androgen Deprivation Therapy – ADT

August 1, 2014 @ 5:16 pm
posted by Dr Ginther

Androgen Deprivation Therapy is used to treat Prostate Cancer.  ADT is usually effective against Prostate Cancer, adding years to a man’s life.  However, ADT can cause Osteoporosis and Fractures, UNLESS we treat to Prevent Fractures.

The good news is that we can decrease Fracture Risk by more than half.  Plus, the medication which preserves bone can help treat the cancer!  We can usually delay, and sometimes prevent, metastases to bone.  Occasionally we can shrink the original prostate cancer tumor.  Amazing!  You can Take Control.

Acute Phase Reaction

July 26, 2014 @ 6:12 am
posted by Dr Ginther

An Acute Phase Reaction can occur the first time a person is exposed to a new class of medication.  With each subsequent dose, half as many people have the reaction.  The symptoms are like mild flu for 3 to 5 days.  The treatment is lots of fluids, and Tylenol (Acetaminophen) if needed.

Persons who have never taken any bisphosphonate before, can experience an acute phase reaction the first time they take Reclast (Zolendronate in osteoporosis dose).  This happens in about one-third of persons who have not taken Fosamax (Alendronate), Boniva (Ibandronate), Actonel (Risedronate), or Atelvia (enteric coated Risedronate) before their first dose of Reclast.  This happens in about one-sixth of persons after their second dose.  Third dose is down to one-twelfth.

Acute phase reaction is a significant nuisance.  However, a Fracture is a significant problem.  Reclast will reduce Fracture Risk by more than half compared to no osteoporosis medication at all.  See the visuals for fracture risk in women and men without osteoporosis medication.  Remember to check for good enough kidney funtion (GFR at least 45) before each dose.

It’s all about avoiding Fractures.

Jay Ginther, MD

Bisphosphonates are the most commonly prescribed Antiresorptive medications used to prevent or treat Ostoeporosis.  We know them as Fosamax (Alendronate), Boniva (Ibandronate), Actonel (Risendronate), Atelvia (enteric coated Risendronate), and IV Reclast (Zolendronate).  All but the last are pills taken weekly or monthly.

If your bone is strong enough that preserving it is sufficient to prevent fractures, then Antiresorptive medication is what you need.  If you are able to follow the protocol of taking the pill on an empty stomach, followed by one or more full glasses of plain water, and eating or drinking nothing else for at least 30 minutes (60 for Boniva) while remaining upright, Oral Bisphosphonates are the medication for you.