In osteoporosis, the net rate of bone resorption exceeds that of bone formation, resulting in frail bones. Most osteoporosis drugs currently approved by the Food and Drug Administration, focus on reducing bone resorption. Forteo® is currently the only FDA approved bone forming (anabolic) drug. However, when it was approved in 2002, the FDA mandated that it carry a black-box warning because it was associated with an increased risk of osteosarcoma, or bone cancer, in rats. Researchers at Duke University and the Medical University of South Carolina developed a new therapeutic that could overcome some of the drawbacks of Forteo®.
Forteo® (recombinant human parathyroid hormone (PTH-1-34)) binds to the type I PTH/PTH-related peptide receptor (PTH1R). It stimulates osteoblastic activity, as well as osteoclastic activity. Intermittent treatment with PTH-1-34 by daily injection is necessary to stimulate more bone formation than bone resorption (Figure 1).
Dr. Diane Gesty-Palmer (Duke University), Dr. Louis Luttrell (Medical University of South Carolina), and Dr. Robert Lefkowitz (Duke University) recently discovered a compound that selectively stimulates the PTH1R-mediated pathway leading to bone formation, without stimulating bone resorption.
Advantages over Forteo®
Since the lead compound does not stimulate bone resorption, it may have a more favorable side effect profile over Forteo®. For instance, the lead compound will likely not produce hypercalcemia, hypophosphatemia and hypercalciuria in patients. In addition, this treatment will likely be effective in continuous administration, which would allow a more convenient, less frequent and shorter dosing regimen compared to Forteo®.
Availability
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