Latest bone health information Jan 2014

Novel Osteoporosis Drug Could Change Treatment: Study  “A new medication for osteoporosis prompts the body to rebuild bone and could potentially strengthen the skeleton against fractures, researchers report. The experimental drug, romosozumab, frees the body’s ability to stimulate bone production by blocking biochemical signals that naturally inhibit bone formation, explained Dr. Michael McClung, founding director of the Oregon Osteoporosis Center in Portland, Ore.”

Comment: Researchers have been interested in looking at more ways to treat osteoporosis, particularly through therapies that are able to build bone in addition to stopping bone loss. This promising new drug offers the advantage of increasing bone density better than the only bone-building medication currently available to osteoporosis patients (teriparatide, marketed as Forteo). But this was a phase 2 clinical trial, where the main aims of the trial are to determine how effective the drug is as a treatment and also to check how safe the drug is and whether there are any major side effects. The number of participants in a phase 2 trial is not very large — this study had just over 400 patients. And the trial lasted only for 12 months, which may not be enough time to monitor for side effects and the effects of long-term treatment (it is important to know how the drug will behave if patients are taking it for several years). Also crucial to osteoporosis patients, is whether the drug can prevent fractures. Patients were not eligible to participate in this study if they had suffered from previous fractures so we also don’t have any data on how well this drug works in osteoporosis patients who have already had a fracture and are at high risk of future fractures. In conclusion, more studies need to be done before this drug can be safely prescribed as a  treatment for osteoporosis and data from larger phase 3 and phase 4 trials will help answer some of these questions. (This graphic gives a good overview of the different phases of a clinical trial.)

Childhood Fractures May Indicate Bone-Density Problems “A recent study at Mayo Clinic, published in the Journal of Bone and Mineral Research, indicates that certain types of fractures may have implications for a child’s long-term bone health. The study found evidence that children and adolescents whose forearm fractures occurred due to mild trauma had lower bone strength compared to other children. Lower bone strength may predispose children to fractures resulting from weakened bone (osteoporotic fracture) later in life.”

Comment: This is an important study which suggests that low bone strength in childhood may not only have negative consequences later in life, but can also result in fractures during childhood itself. Healthy bone development during our early years is vital to preventing osteoporosis later in life. We don’t know for certain whether low bone density in childhood can predispose someone to osteoporosis, but this is an area that needs more attention and should be studied. This study also calls upon health professionals to recognize that not all fractures in children and young adults are normal and it is important to investigate fracture causes, especially when the fracture results from mild trauma.

Walk More to Cut Heart Attack and Stroke Risk, Study Suggests “Walking more is a simple way for people at high risk for type 2 diabetes to greatly reduce their risk of heart disease, a new study suggests.”

Comment: In our previous news roundup we posted about exercise intensity and how increasing the intensity of exercise offers the most benefit in terms of optimal health. But don’t be discouraged if you have trouble increasing the intensity of your exercise — any exercise is better than none. This new study in people with pre-diabetes shows that walking helps to decrease risk of heart disease.  Simply increasing the amount of time you walk will lower your risk even further. So if you are unable to increase the intensity of your exercise, gradually increase the amount of exercise that you do instead. And remember that walking is one of the best exercises for maintaining bone strength as well.