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A new therapy for osteoporosis: Romosozumab

July 17, 2019

About the Author

photo of David M. Slovik, MD

David M. Slovik, MD, Contributor

David M. Slovik, MD, is an endocrinologist at Massachusetts General Hospital (MGH) who specializes in osteoporosis, and an associate professor of medicine at Harvard Medical School. He is currently chief of the division of endocrinology at … See Full Bio
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Deepak Sharma
September 7, 2019

Romosozumab is a welcome addition to our treatment options for postmenopausal women with osteoporosis who are at high risk of fracture. It results in rapid and profound increases in bone density and reduction in the risk of fractures after 1 year of treatment. Romosozumab is a humanized monoclonal antibody to sclerostin that is administered as once-monthly injections for a 12-month course to therapy. Treatment with romosozumab should be followed by an antiresorptive agent to maintain and enhance its therapeutic effect…(mygenericpharmacy)

Helene Cusack
July 26, 2019

Is magnesium not needed anymore with calcium and vitamin D?

July 19, 2019

This is from a prior post of this blog re: Fosamax “rompted by the Singapore findings, clinicians at New York’s Hospital for Special Surgery identified 70 patients who had suffered low-energy fractures between 2002 and 2007. (Low-energy fractures occur from a fall from standing height or less.) Twenty-five (36%) had been taking Fosamax. Of these, 20 had suffered a fracture across the femur, and 19 of those fractures occurred in patients who had been taking Fosamax the longest — on average, seven years. The researchers concluded that long-term Fosamax use is a significant risk factor for low-energy fractures of the femur.

The initial reports also drew letters to the editor of The New England Journal of Medicine, including evidence both supporting and refuting a link between bisphosphonates and nontraumatic fractures. The studies thus far have been small, retrospective analyses, and they haven’t taken into account other factors that could contribute to such fractures, including general ill health. But given what we know about the effects of bisphosphonates on bone remodeling, the findings seem plausible.

In the short term, slowing bone resorption increases bone density. But in the long run, it may impair new bone formation and reduce the bone’s ability to repair microscopic cracks from normal wear and tear. (There’s some evidence in animal studies that Fosamax can inhibit microdamage repair.) Over time, such microdamage might accumulate and cause a fracture. Also, while bone breakdown is suppressed, the mineralization process continues, potentially resulting in “hypermineralized” bone, which may be more brittle and less resilient to wear and tear. This is all largely speculative, as no studies have produced empirical evidence that such mechanisms actually lead to fractures.” That was in 2008, maybe the poster could’ve reviewed the research, any more recent studies before keeping Fosamax on the list?

Deepak Sharma
July 19, 2019

If osteoporosis therapy is needed after the 12 doses, patients should begin an osteoporosis treatment that reduces bone breakdown, according to the FDA. … In the first trial, 1 year of treatment with romosozumab lowered the risk for new vertebral fracture by 73% compared with placebo….(mygenericpharmacy)

richard f waters
July 18, 2019

Osteoporosis is a symptom not a disease. Fosamax and similar treat causes of osteoporosis as listed in the package insert and prescribing information. It is necessary to determine the cause of someone’s osteoporosis before you can treat the cause. If the cause is vitamin D deficiency then Fosamax and similar is not a treatment as stated in the prescribing information. A simple blood test will show your vitamin D level. When diagnosed with osteoporosis my D level was 22. Fosamax was prescribed and did nothing. I stopped Fosamax and raised my D to 35 increasing bone density by 30%. No drug will build bone without enough calcium and D, see the Fosamax package insert and prescribing information. These drugs treat specific conditions. They are not universal treatments for the symptom of osteoporosis.

Caroline Jones
July 17, 2019

I was curious if prior treatment with a teriparatide precludes using Eventiy?

David smith
July 17, 2019

Your post is awesome this will be definitely help us, thanks

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