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Combining osteoporosis treatments does not produce better results

Combining two currently available types of osteoporosis drugs does not improve bone density, according to a study by researchers at Massachusetts General Hospital (MGH). Their report, appearing in the September 25 New England Journal of Medicine, describes how men with osteoporosis who received both alendronate and parathyroid hormone (PTH) actually had lower bone density at the end of the almost three-year study than did men receiving PTH alone. The journal is releasing this study and related articles early to coincide with presentations being made at the American Society for Bone and Mineral Research meeting in Minneapolis.

Maintaining healthy bone density requires a balance between two natural processes, the breakdown or resorption of old bone and the formation of new bone. When this balance shifts toward breakdown, bones become less dense and more prone to fracture. Although this condition, called osteoporosis, is seen most frequently in postmenopausal women, it also occurs in men, sometimes as a result of medications that interfere with normal hormone production.

Alendronate, one of a type of drugs called bisphosphonates, is FDA approved to treat osteoporosis in men and women and works by slowing bone resorption. Injections of PTH, a treatment initially developed through MGH research, increase bone formation and were approved by the FDA in December 2002 to treat osteoporosis in men and women. Since the two medications work in complementary fashion to increase bone density, a treatment strategy combining both drugs appeared promising.

"While it seemed likely that combining these two medications would increase bone density more than giving either medication alone, animal studies investigating combination therapy gave conflicting results," says Joel Finkelstein, MD, the MGH endocrinologist who led the study. "Still, we did expect that the combination group would do best, so the actual outcome was a surprise."

The MGH resear
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
20-Sep-2003


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