after Forteo-Denosumab? - Osteoporosis Message Board

trail · 04-05-2007, 10:19 AM

Hi all
Like many of you, I am approaching the end of my treatment with Forteo and am starting to think about options. A while ago, I read something about the infusion drug Denosumab and wondered if it might be a good alternative to bisphosphonates. Anyone have any current information about it, i.e. studies, articles, etc.? I know there were a few comments in the past on this board, but nothing that had enough information for me to make a decision. Is it FDA approved in the US, or is it still in the trial phase? I think it works in a different way that the bisphosphonates, but I'm not sure. I would appreciate any words of wisdom at this point. Thanks so much.
Trail

DesertBloom · 04-05-2007, 10:24 AM

Hi: Denosumab isn't approved yet. You can go to Amgen and see what they say about the med. I read that "if" it gets approval, it won't be till sometime around 2009.

Good luck, I hope you find something good to follow the Forteo.

osteoblast · 04-19-2007, 12:21 PM

Hi-It seems that there are a number of regulars on this board who are going to end their two years on forteo soon. And, it seems that for now there really are no new options that mainstream drs. are considering. Does anyone know what is the basis for a dr. to advise actonel v. boniva v. fosamax?

Is one or another more active at a particular site-hip v. spine? Is one or another less irritating to the esophagus and/or stomach?

Also I would like to know if anyone's dr. has made an educated guess as to when denosumab may come out? I realize that there has been no final fda approval so it's not a certainty it will ever come out. I did try calling Amgen and they cannot/will not give out such information.

Thanks for any input.

PikaB · 04-19-2007, 02:24 PM

"Reclast" (zoledronic acid) was recently approved by the FDA for Paget's disease, and there are currently promising Phase III studies underway for use as an osteoporosis drug. I don't know whether "off label" use for osteoporosis is permitted now.

It is administered by spinal infusion, once per year. It is still a bisphosphonate, but the adverse effects were no more frequent than were experienced by placebo.

DesertBloom · 04-19-2007, 02:58 PM

Hi osteo... Based on a 12 month study, conducted at the Univ of Cinncinati Bone Health and Osteoporosis Center, actonel users had 43% fewer hip & 18%fewer non-spine fractures than those taking fosamax. Based on these findings they believe that actonel works faster than fosamax for preventing fractures. You might be able to find out if there are any other differences between these 3 drugs by reading the studies done on each. Some users claim that actonel has less g.i. effects, but I have no idea what they are basing that info on, other than comparisons. The problem I have with the above study, is what if you are more worried about spinal fractures, which drug is better, since they only mention that it prevents hip and non spine fx's.

I asked my Dr about the half-life on actonel, and she believes that even though actonel has an extremely shorter half-life than fosamax or boniva, there is no way to know for sure if the testing done was equal across the board on all 3 meds to determine this information. If this testing varied from company to company, then we wouldn't be able to assume that one drug has a shorter half-life than the others. Of course this is her opinion, and if you read the trials on all 3 meds, you will see the differing info on this question.

If you want to take the varying info on face value, then fosamax, and boniva have a longer half-life.

I don't know when or if denosumab will be approved, but according to Forbes, they will not reach pivotal testing stages until 2009. All of the dates on this drug are just projections and guessing whether or not the FDA will approve it, so your guess is as good as anyones.