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New drugs, better communication critical in treatment of osteoporosis
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DESTIN, Fla. – New drugs and more effective physician-to-patient communication are critical in the treatment of osteoporosis, according to a speaker at the Congress of Clinical Rheumatology.
According to Michael McClung, MD, founding director of the Oregon Osteoporosis Center, current drugs for treating osteoporosis are effective and well tolerated, and clinical trials have been safe. However, there are some limitations, he said.
“There is real or perceived intolerance and concerns about safety, especially the long-term safety of bisphosphonates. There are inconvenient dosing regimens, poor adherence to therapy, no agent that restores skeletal structure or strength to normal levels, and expense-related concerns,” he said. “We set out review new and emerging therapies, including the status of three drugs in late stage clinical development, and to discuss how new agents could alter the osteoporosis paradigm.”
Michael McClung
After review of current treatment guidelines from the National Osteoporosis Foundation, and series of phase 2 and phase 3 clinical trials, researchers found beneficial effects of new medications.
McClung said that abaloparatide can be used in the same patients as teriparatide, although more data are needed before it can be concluded as an advantage over teriparatide. Odanacatib can be effective when combined with teriparatide, and can be useful in patients who have previously taken bisphosphonates, he said. Additionally, the researchers have found that romosozumab should be used sequentially with or without intervening anti-remodeling drug therapy, and can be used as a treat-to-target method of care.
“However, we need more than just new drugs,” McClung said. “Most patients who would benefit from osteoporosis therapy are not being offered treatment. Many refuse effective therapies because of concerns about very rare side effects…[and] others discontinue therapy because of intolerance, inconvenience of dosing, or lack of perceived effect.”
McClung added that physicians need to engage more effectively with the osteoporosis community.
“It is critical to educate physicians and at-risk patients about the effects of osteoporosis. Communication should more clearly state the effectiveness of current treatments and encourage more involvement an all ends. Only then, will current treatment match current need.” – by Shawn M. Carter
Reference:
McClung M. New and emerging therapies: How could they change our current guidelines of osteoporosis treatment? Presented at: Congress of Clinical Rheumatology; May 12-15, 2015; Destin, Fla.
Disclosure: McClung reports he serves on the global advisory boards and receives honoraria from Amgen and Merck.