PatNJ
08-19-2005, 04:20 PM
Below is a link to an abstract of the NEJM August 11, 2005, article about the Helen Hayes Hospital study of potential benefits to taking PTH 1-34 daily vs in three months on/three months off cycles. Interestingly enough, the subjects in the study had been on prior Fosamax therapy and continued to take it during the course of the study.
Guess what: Daily vs cyclic administration made little difference in the end, if I understand the conclusions correctly. Early-on findings that bone resorption increased in the daily-treatment group suggested that cyclic administration was preferable.
Hmm...
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16093465&query_hl=2
Guess what: Daily vs cyclic administration made little difference in the end, if I understand the conclusions correctly. Early-on findings that bone resorption increased in the daily-treatment group suggested that cyclic administration was preferable.
Hmm...
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16093465&query_hl=2
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CrohnieToo
08-19-2005, 09:19 PM
Thanks for the URL, PatNJ!!!! I'm on my way to read this article now. I wasn't able to find it earlier.
CrohnieToo
08-19-2005, 10:19 PM
The key phrase I picked up on was:
"Among the women who were receiving cyclic parathyroid hormone, bone formation declined during cycles without parathyroid hormone and increased again during cycles with parathyroid hormone. Bone resorption increased in both parathyroid hormone groups but increased progressively more in the daily-treatment group than in the cyclic-therapy group."
However, they defined the difference as of "no significant difference". i.e. 6.1 percent in the daily treatment group and 5.4 percent in the cyclic therapy group. Those improvements were in comparison to the alendronate only group.
I would think those who encounter minor but troubling side effects from the Forteo would prefer the cyclic, 3 months on w/3 months off treatment regimen.
"Among the women who were receiving cyclic parathyroid hormone, bone formation declined during cycles without parathyroid hormone and increased again during cycles with parathyroid hormone. Bone resorption increased in both parathyroid hormone groups but increased progressively more in the daily-treatment group than in the cyclic-therapy group."
However, they defined the difference as of "no significant difference". i.e. 6.1 percent in the daily treatment group and 5.4 percent in the cyclic therapy group. Those improvements were in comparison to the alendronate only group.
I would think those who encounter minor but troubling side effects from the Forteo would prefer the cyclic, 3 months on w/3 months off treatment regimen.
PatNJ
08-19-2005, 10:59 PM
<<I would think those who encounter minor but troubling side effects from the Forteo would prefer the cyclic, 3 months on w/3 months off treatment regimen.>>
Very good point, Chronie. The difference in spinal BMD is way too close to call. Point seven percent (6.1 vs 5.4) could be attributed to the skill of the technician performing the follow-up DEXA tests. The last time I had my bone density scan done, the tech told me that it's not an exact science, that he could get different readings for the same patient on the same day.
Very good point, Chronie. The difference in spinal BMD is way too close to call. Point seven percent (6.1 vs 5.4) could be attributed to the skill of the technician performing the follow-up DEXA tests. The last time I had my bone density scan done, the tech told me that it's not an exact science, that he could get different readings for the same patient on the same day.
CrohnieToo
08-20-2005, 05:40 AM
That's interesting, PatNJ. I knew that there could be a very wide difference when having DEXAs done at various facilities and/or on different DEXA scanners and have even heard between between different "techs" on the same scanner, but had not known that there could be that much variance with the same equipment and "tech" on the same day!!! Sheesh! Kinda rattles your faith in the DEXA, doesn't it? Like it really would be nice if they would concentrate on coming up with a more specific and accurate test of our bone density and quality, wouldn't it?
:rolleyes:
:rolleyes:
PatNJ
08-20-2005, 11:11 PM
Well, to be fair, this was a different facility from the one I used for my three other DEXA's ("thanks" to a change in our ins. plan.) To my eye, and based on the amount of time the tech spent on me, it was a less expensive, older model than the one that had tested me previously. I know that it did not take the lateral view of my spine, which the other one did, nor did the machine rotate completely around my body, as had the other one. (Duh, I guess that's why I didn't have the lateral view! :rolleyes: )
Perhaps with outdated equipment, such huge variations in readings are the norm! Oh, and the tech himself didn't seem to know what he was doing. On my three previous scans, the tech spent a lot of time positioning my body just so, especially during the dreaded turning in of the left foot for the hip scan.
Scary, though, as you said. I have been concerned that my latest lumbar spine score of -3.1 could be way off, and maybe I shouldn't even be on Forteo! But I can't afford to pay for the test out of pocket to have it done at the original place, so I guess I'm stuck.
Perhaps with outdated equipment, such huge variations in readings are the norm! Oh, and the tech himself didn't seem to know what he was doing. On my three previous scans, the tech spent a lot of time positioning my body just so, especially during the dreaded turning in of the left foot for the hip scan.
Scary, though, as you said. I have been concerned that my latest lumbar spine score of -3.1 could be way off, and maybe I shouldn't even be on Forteo! But I can't afford to pay for the test out of pocket to have it done at the original place, so I guess I'm stuck.
CrohnieToo
08-21-2005, 01:01 AM
Have you checked the cost of a DEXA scan? You know, I was seriously considering paying myself to have one done at my "usual" place after that one done at the previous Endo's office earlier this year. I called our hospital and was quoted a price of $221 PLUS what the radiologist would charge which would be a separate charge from XXXX. They gave me the number of XXXX to call, which I did, and XXXX told me that the radiologist charge was included with the hospital billing quote. Not trusting the left hand to know what the right hand was saying or doing I decided against having the second DEXA done.