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May 16, 2013  | 

Combination of denosumab and teriparatide produces greatest reported increase in bone density

 

BOSTON, MA - A combination of two FDA-approved osteoporosis drugs with different mechanisms of action was found to increase bone density better than treatment with either drug alone in a small clinical trial. As reported in The Lancet, Massachusetts General Hospital (MGH) investigators found that treatment combining denosumab (Prolia) and teriparatide (Forteo) was superior to single-agent treatment in a 12-month trial in women with postmenopausal osteoporosis. The authors note that additional study is required before their findings should be put into clinical practice.

"We found that giving both of these drugs together increased bone mineral density more than treatment with just one drug and more than has been reported for any currently available therapy for postmenopausal osteoporosis," says Benjamin Leder, MD, of the MGH Endocrine Unit, corresponding author of the Lancet report. "This is particularly important since previous attempts to combine teriparatide with bisphosphonate drugs like Fosamax did not show any additional improvement."

While several types of drugs that increase bone density – teriparatide, which stimulates bone formation, and several that block bone resorption – have been approved for the treatment of postmenopausal osteoporosis, none can reliably restore normal bone strength in most patients or eliminate osteoporosis-related fracture risk.

Previous trials combining teriparatide with bisphosphonates, which block breakdown, did not show improvement over treatment with a single drug. But some animal studies combining teriparatide with denosumab, which blocks resorption using a different mechanism, suggested a possible benefit, leading the MGH team to design the current trial. They enrolled 100 postmenopausal women determined to be at high fracture risk, based on their bone density and other risk factors, who were randomly divided into three groups. Continue>

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