Harvard Women's Health Watch

Two osteoporosis drugs better than one

Combining two osteoporosis drugs—denosumab (Prolia) and teriparatide (Forteo)—increases bone mineral density (BMD) better than either drug alone, according to a study published online May 15 in The Lancet. Combinations of other osteoporosis drugs, such as Forteo and bisphosphonates, have been studied before, but they didn't improve outcomes over single-drug treatment. This study included nearly 100 postmenopausal women who were at high risk for a fracture based on bone density studies. Researchers randomly assigned the women to receive Forteo (which stimulates bone formation), Prolia (which prevents bone breakdown), or a combination of the two drugs. After 12 months, BMD of the lower spine increased 9.1% in the combination therapy group, compared with 6.2% in the Forteo group and 5.5% in the Prolia group. BMD of the hip and femoral neck (top of the thighbone) also increased more in the combination group than with either drug alone. The drug combination increased BMD more than any current therapy for postmenopausal osteoporosis. However, longer studies in larger groups of women are needed to determine the drug combination's long-term safety and its ability to reduce fracture risk.

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