Add a medicine for osteoporosis patients

Currently, the market for osteoporosis drugs has a new drug, mainly for women during menopause.

Special brand forteo, a new drug for osteoporosis treatment, is primarily for women during menopause.(Photo: pharm.cch.org.tw)

Osteoporosis has become a major public health problem. The majority (80%) of people affected by osteoporosis are women.

In 1990, the world had about 1.7 million cases of femoral neck fracture due to osteoporosis. It is expected that this ratio will increase to 6.3 million by 2020 and 50% of this figure will belong to Asian countries. Osteoporosis is the result of an imbalance between bone formation and bone destruction, so osteoporosis medications can be divided into two broad groups: Medications that help build bones and fight bone resorption.

In the group of drugs that help build bones, there are drugs that increase anabolic agents, which are prepared from the conduct of male sexual hormones or parathyroid hormone (PTH).

A new drug, a PTH derivative called Teriparatide (brand name Forteo), has just been approved for use in treatment. PTH is a protein with 84 amino acids, but only 34 amino acids have hormonal activity.

Teriparatide is actually a recombinant protein because it is prepared by recombinant DNA (genetic material) technique of genetic technology. The composition of teriparatide consists of 34 amino acids, the amino acid sequence of teriparatide that has PTH parathyroid activity.

The mechanism of action of the drug is when inserted into the body it will attach to the receptor of PTH in bone to stimulate the creation of more bone-forming cells to increase bone formation.

Teriparatide is used as a subcutaneous injection with a bioavailability of 95%. After 30 minutes of injection, the concentration of the drug in the blood reaches the maximum. The half-life of plasma drugs is 5 minutes and after 3 hours of subcutaneous injection, the concentration of the drug decreases at the level of no detectable drug.

Teriparatide is presented as a 3ml syringe (placed into the injection pen), injected under the skin in the abdomen or thigh area. The recommended dose is 20 micrograms once a day. The person injected with the drug is advised to sit or lie to avoid hypotension where standing posture may occur.

Before being approved for treatment, teriparatide underwent more than 20 clinical trials with a total of 2,800 participants including menopausal women and men with osteoporosis.

This drug has been reported to stimulate bone formation, reduce the risk of vertebral fractures, increase bone density in postmenopausal women with osteoporosis treated for 19 months.

Teriparatide is indicated for the treatment of menopausal women at high risk of fractures, to increase bone density in men with primary osteoporosis, or for those who do not respond to other treatments for osteoporosis.

Side effects of this drug are causing headache, nausea, back pain, drowsiness, dizziness, cramps. Teriparatide can cause hypercalcemia, hypercalciuria, blood uric acid, . and reduce blood magnesium.

Dr. Nguyen Huu Duc (HCMC University of Medicine and Pharmacy)