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In the journals: Study shows that a new type of osteoporosis drug reduces fracture risk

October 01, 2009

In the journals

Study shows that a new type of osteoporosis drug reduces fracture risk

Postmenopausal women who've had an osteoporotic fracture are usually advised to take an osteoporosis drug. Almost all such medications are antiresorptive — that is, they work by slowing the breakdown phase (resorption) of normal bone turnover. The most widely prescribed antiresorptives are oral bisphosphonates — alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva) — which are taken daily, weekly, or monthly. Bisphosphonates all improve bone mineral density (BMD) and reduce fracture risk, but many women dislike taking them because of side effects, including trouble swallowing, heartburn, and upset stomach. Soon, they may have another option — a new kind of drug taken in a different way.

Results from a large, industry-sponsored controlled trial published Aug. 11, 2009, on the Web site of The New England Journal of Medicine indicate that this drug, called denosumab, significantly reduces the risk of spine, hip, and other fractures (compared with a placebo) in women with osteoporosis. Denosumab targets a protein required for the development and proliferation of osteoclasts, the cells that break down bone. The protein is known as RANKL, for receptor activator of nuclear factor-kappaB ligand. Denosumab counters the activity of RANKL, preventing the formation of osteoclasts. (Bisphosphonates block the activity of osteoclasts but not their formation.)

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