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Osteopenia Jan/Feb 2016
May 25, 2016

May Osteopenia/Osteoporosis 2016 news

A long time ago, I decided that I would NOT send out a newsletter - just for the sake of 'sending one'. I wanted every newsletter to have enough information to make reading it worthwhile. Why there was no newsletter for the past 2 months.... But now I have news..interesting news.
There is a NEW Osteoporosis drug coming to market. One that I find really interesting. It is produced by Merk. Its name? Odanacatib. . . This drug really is new. It is not a bisphosphonate (the class of drugs that increases bone density by slowing the body's removal of 'old bone' - something that can lead to bones that are dense but weaker.) And it is not a hormone replacement therapy either. Instead.... .

Odanacatib is a "cathepsin K inhibitor". So what does that mean? Katepsin K is the primary enzyme that removes old bone via your Osteoclasts, the cells that break down bone. Odancatib 'selectively inhibits' Katepsin K. ie, it slows it down. . . As a result of this slowdown there is an increase in bone density since slowing the work of osteoclasts means that the balance of work between bone building cells (osteoblasts) and bone removing cells (osteoclasts) is tilted in favor of your osteoblasts. . . If you recall Osteoblasts dominated when you were young and growing. They made it possible for you to get taller; your arms and legs lengthened etc. because you were experiencing an increase in bone formation. Then with the shift in hormone (or any of the other CAUSES OF BONE LOSS ), you were not making much new bone...and soon 'bone removal' became dominate and you began to lose bone density. So when this Odanacatib was created many thought 'this is GOOD NEWS'. . .

And the clinical trials seem to bear that out. The research says: "odanacatib significantly reduced the risk of three types of osteoporotic fractures compared to placebo in the primary efficacy analysis, and also reduced the risk of the secondary endpoint of clinical vertebral fractures. Specifically, compared to patients receiving placebo, patients who received odanacatib had a: 54% risk reduction of new and worsening morphometric (radiographically-assessed) vertebralfractures (p<0.001), 47% relative risk reduction of clinical hip fractures (p<0.001), 23% relative risk reduction of clinical non-vertebral fractures (p<0.001), and 72% relative risk reduction of clinical vertebral fractures (p<0.001). Surely good news. .

But then as always there are the side effects and these seemed to be cardiovascular in nature. There were slightly more incidents of Atrial Fibrillation in the Odanatib group (92) 1.1% vs (80) 1.0% placebo group and there slightly more strokes also (3.8 vs 3.6%).

Studies.

There have been a number of papers published about this drug. Here is a link with asummary of one of the newer studies. It was published in Osteoporosis International June 2016, Volume 27, Issue 6, pp 2099-2107.

http://link.springer.com/article/10.1007%2Fs00198-016-3503-0

But a recent (May 2016) search of the FDA web site does not find Odantacib listed among its approved drugs. So I am not sure what is going on. It is listed 'in trials' in the UK....

Of course only time will tell if this drug, which prevents the body from discarding some of its 'old bone' will have the same problem as the bisphosphonates which also increase bone density by slowing the removal of 'old bone'. Still, I have promised to bring the latest news...so here it is.

I will be adding a page about this drug to the web site sometime in the next week or so.

Thanks for reading,

Kate

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