Osteoporosis is one of the main diseases affecting people around the world. One in three women over the age of fifty will suffer fractures due to osteoporosis and for men the statistics are one in five. With such figures, the search for treatments and preventative measures are a must. At the recent International Osteoporosis Foundation (IOF) World Congress, highlights included research into the use of strontium ranelate (a compound formed from ranelic acid), bisphosphonates and hormone therapy in the treatment of osteoporosis.
Osteoporosis causes bone mineral to dissolve away. As a result, bones lose their density and break easily. Treatments aim to increase a patient’s bone mass and strength.
Research Teams Show Promising Results
The ranelic acid compound has been found to strengthen and protect bones, thereby preventing fractures. Georges Boivin and his team at INSERM, France, investigated this. They found that the compound does not affect existing bone, but its benefits are seen in any new bone that is formed. It does not alter the bone minerals, but it changes the bone structure which results in an increase of bone density. These findings were corroborated by a group of researchers led by J. Yebin Jiang at the Universities of California and Michigan.
Jean-Yves Reginster, University of Liege, Belgium and his team looked at the effectiveness of the compound. When patients took the treatment for four years the risk of vertebral fractures was reduced by around 30 percent. Over a five year period, the reduction in risk of vertebral fractures was around 25 percent and for non-vertebral fractures it was about 15 percent.
However, the downfall of this compound as a treatment for osteoporosis lies in the fact that it acts only on new bone, so, when treatment is discontinued, the affects soon subside. This is where bisphosphonates come to the fore.
These are currently the most commonly prescribed treatment for osteoporosis. They work in the same way as the ranelate compound; however, they remain present in the body for years after treatment is stopped. A team led by Socrates Papapoulos at Leiden University reported that traces of bisphosphonate pamidronate can still be found in patients for up to eight years after they have stopped taking the medication. Furthermore, even after treatment has been stopped, there has been a reduced loss in bone density.
Hormone therapy as a treatment for osteoporosis is where the uncertainties come in. In a recent trial for tibolone, an estrogen hormone therapy, results were good; however, the study was stopped as participants showed an increased occurrence of strokes.
Another hormone replacement therapy that has received attention is that of parathyroid treatment. This treatment actually causes bone to develop which is not the case in the majority of other therapies. However, in most countries parathyroid treatment is only allowed for up to two years. After this period treatment options are uncertain. Through his research, Silvano Adami, University of Verona, Italy found that follow-up treatment with Selective Estogen Receptor Modulator (SERM) raloxifene can maintain the increased bone density.
Trials found that if SERMs are used for one year after a one-year program of parathyroid treatment, in women they will increase bone density at the hip by 2.3 percent. These studies are to be continued in order to determine the longer term effects.
If the current growth rate of the older sector of the population continues, by 2050, osteoporosis-induced hip fractures of men and women will have increased by 210 and 240 percent respectively. At least there are top research teams around the world working to discover new treatments as well as means to prevent the disease.