Mercilessly lethal osteoporosis - the withering of a body's bone mass - may finally have met its match
AS PEOPLE, particularly women, grow
old, they shrink. The humped back is
the result of osteoporosis - a potentially lethal disease in which the bone mass
withers. But now, a new generation of
drugs, bone "paste" and hormones may
soon bring relief.
Osteoporosis affects
200 million people worldwide. In its advanced
stages, bones become so
brittle that even a cough
or a sneeze could lead to a
fracture. Osteoporosisinduced hip fracture kills
about 20 per cent of
affected women. It is an
expensive disease to treat.
It costs the us between us
$7410 billion every year. Current treatment can help prevent further loss of
bone but not even a miracle can reverse
bone loss once it has occurred.
Recently, Norian, a California-based
company, announced that it had invented an artificial bone paste, the Norian
SRS, that could help fill the gaps in osteoporosis-weakened bones. The. com-
pound - a mixture of phosp , oric acid
and sodium phosphate - is undergoing
human trials in the US.
"Think of it as being the mortar
between bricks," says the
paste's inventor, Brent R
Constantz. The paste is
injected into fractures
with a syringe. In about 10
minutes, it sets into a kind
of internal cast to stabilise
the realigned bones. In
another 12 hours, it
becomes as strong as the
bone itself, before gradually disappearing as the
patient's own bone cells
grow to replace it.
Another us-based pharmaceutical
company, Merck, also claims to have
developed a drug - alendorate - for
osteoporosis treatment. This drug,
which focuses on building up bone mass
rather than preventing bone loss, is
awaiting us Food and Drug Administration's (FDA) approval.
Calcium regulatory drugs are being
developed by NPS Pharmaceuticals, a
Utah-based company, in collaboration
with SmithKline Beecham. While one
mimics the effect of calcium to
suppress resorption of bone into
the body, the other increases
natural secretion of calcitonin, a
hormone that reduces resorption. Calcitonin, earlier injected,
is now available as nasal sprays.
A recent study at the
University of California in San
Francisco (UCSF) claims to have
fo@nd that laboratory animals
treated with naturally-occurring
parathyroid hormone - which
aids calcium metabolism, regain
bole mass lost.
"'The treament with this hormone ... is the first found to be
successful in reversing the damage caused by osteoporosis," says
Nancy Lane, UCFS assistant professor of medicine and lead
author of the study.
In a related development,
the us-based Eli Lilly, which has
developed a synthetic hormone
raloxifene - hopes to file it with the
FDA by year end. Researchers believe that
raloxifene is more an overall health
drug; it targets oestrogen receptors in
the heart and bone but not the reproductive system, thus curing heart disease as well as osteoporosis. Its advantage over oestrogen is that women do
not experience a return of their menstrual cycle.
So far, osteoporosis could only be
detected by comparing x-rays taken
over a number of years to check bone
mass loss. A new diagnostic test called
Biomarkers, will speed up the process by
detecting degraded bone in blood or
urine. But it will not be able to assess
bone mass or identify the person at risk.
Oestrogen therapy has very low rates
of compliance. Patients are also
concerned that the drug may be linked to
breast cancer, although studies have so
far been inconclusive.
Compliance is a major factor in
osteoporosis treatment. Drugs are to be
taken much before the disease becomes
apparent. Unfortunately, the absenci of
symptoms leads people to truncate the
drug course, and by then it is much too
late to prevent the disease.
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