New drug hopes to offset effects of bone disease
ONE IN two Western women over the age of 50 suffer some sort of osteoporotic fracture in their lifetime, putting them at greater risk of fracture and permanent disability, reduced independence, and even death.
Despite the alarming information, studies reveal only one in four women believes their fractures are osteoporosis related.
“Patients do not make the connection between fractures and osteoporosis,” Dr Socrates Papapoulos said.
The Professor of Internal Medicine, Consultant Physician and Director of Bone and Mineral Research at Leiden University Medical Centre in the Netherlands was speaking to reporters at a news conference in Nicosia yesterday on osteoporosis, its consequences and treatments.
Osteoporosis is a “systemic skeletal disease characterised by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture,” Papapoulos said.
Risk factors involved a low-calcium diet, sedentary lifestyle, and smoking. However hereditary and medical factors beyond patients’ control also have an impact, the doctor added.
In fact in the Netherlands the chronic condition was classed as a category 4 health condition resulting in a reduction of quality of life on par with breast and intestinal cancer, heart failure, rheumatoid arthritis, and traffic accidents.
Only lung cancer, coronary artery disease, and strokes – classed as category 5 conditions – were considered worse. Moreover the risk of osteoporotic fracture was five to six times greater as compared to heart attack, stroke or breast cancer, he said.
Papapoulos said the most common fracture sites were the spine, hip and wrist, and that mortality following osteoporotic fractures was always higher compared to the general population of the same age with no fractures, particular during the first year of injury.
The costs involved in the number of “bed days” related to the disease were also much greater than costs for respiratory disease, stroke, breast cancer and myocardial infarction, he added.
But despite these facts patients with osteoporosis did not receive sufficient treatment, the doctor said.
Papapoulos said: “The aim of osteoporosis therapy is the prevention of fractures in patients who have not yet fractured or prevention of the progression of the disease in patients who have already sustained a fragility fracture.”
But the problem was like all chronic diseases, osteoporosis patients were often unable to stay on treatments for the crippling bone tissue deterioration disease due to their inconvenient dosing requirements available in either daily or weekly form, he said.
Despite the effectiveness of the bone strengthening medications, known as bisphosphonates, 84 per cent of new patients on daily treatments discontinued within 12 months and 69 per cent discontinued weekly treatments.
Nevertheless this could soon change with the recent launch of a once-monthly dose of the same treatment. Papapoulos said experts remained hopeful the more convenient dose, marketed as Bonviva and which contains the active substance Ibandronic acid, would increase patients’ adherence to the treatment.
The benefits of the new GlaxoSmithKline product are that it allows patients to change their routine only once a month, postpone their coffee and breakfast once a month, and adjust medication schedules once a month, advertisers said.
“When you take this medication you have to take it with a whole glass of water and can’t eat beforehand and you can’t eat for an hour afterwards. You also have to remain standing during that hour. This is much easier to adhere to once a month, rather than every day or weekly,” Katia Gritzali, Research & Development Pharmaceutical Companies Association president said.
Papapoulos said the adherence factor to osteoporosis treatment was very significant.
“Like all chronic diseases osteoporosis is an incurable condition. The aim is to reduce as much as possible the risk of fractures and as a result the incidence of fractures,” Papapoulos said.
In fact by taking the medication patients reduced their risk of fracture by up to 50 per cent, he said.
The doctor said unfortunately people often had the misconception that patients with severe osteoporosis were beyond help.
He said: “If you see someone in a wheelchair that has already suffered two fractures, they’re not going to suddenly going to get up and run about, but what we can do is reduce the chance of those fractures increasing to four…
“Our aim is improve and maintain the quality of life. It is never too late to intervene and treat patients with osteoporosis.”
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