HEART MEDICINE FOR BONES
Osteoporosis and low bone mass are a major public health threat for about 44 million Americans age 50 and older. While diet and exercise can help prevent the development of the condition in many, others need more help. How a common heart medication may be what it takes to keep bones strong.
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This is a healthy bone, and this is the bone of a woman with osteoporosis.
Sunil Wimalawansa, M.D., Ph.D.
Endocrinologist
Robert Wood Johnson Medical School
New Brunswick, NJ
"It's a tremendous public health problem. The most important thing is it's preventable."
Each year, the condition causes one and a half million fractures with nearly 20 billion dollars spent on medical care.
Approved medications, hormone therapy or calcium can slow the natural breakdown of bone. Doctor Sunil Wimalawansa hopes the heart medication nitroglycerin will do even more.
Sunil Wimalawansa, M.D., Ph.D.
"This is the only drug that seems to have an effect on the formation at the same time. No other drug has both functions at any given time, so this is unique."
And it has other benefits.
Sunil Wimalawansa, M.D., Ph.D.
"It's about 20-times cheaper than any of the approved drugs right now so economically, it's good for the patient. Secondly, there are very little adverse effects."
Patients like Judy Hanes are excited to have an alternative to hormones.
Judy Hanes
Osteoporosis study participant
"I think this method is a little bit healthier than the hormone replacement."
200 study participants will rub the ointment on their body once a day and take calcium supplements. Regular bone density scans will show how well it works.
This health conscious physical education teacher does what she can to keep herself well.
Judy Hanes
"I do exercise a little bit with the students by helping them to stretch and become more aware of healthy eating habits, which I do try to follow as well."
And if studies continue to show success, she'll have another way to keep her bones strong.
The study will continue for 3 years and will enroll 200 women between the ages of 40 and 60. The robert wood johnson medical school in new jersey is the only study center.
BACKGROUND: Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures. The areas most likely to fracture are the hips, spine and wrists. Bone goes through a natural process of formation and resorption. In osteoporosis, the breakdown occurs at a faster rate than the new bone formation. Osteoporosis is a major public health threat for an estimated 44 million Americans. In the United States today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. Of the 10 million Americans estimated to have osteoporosis, 8 million are women. While the breakages may not sound like a big deal, in the elderly, broken hips are associated with a high risk of mortality. Fractures also cost the health care system $17 billion a year or $47 million a day. Many people do not know they have osteoporosis until they experience a broken bone.
TREATMENT: Currently, there are a few approved medications for osteoporosis and experts recommend women start early to build up strong bones while they are still young by taking in more calcium and vitamin D. Hormone replacement therapy has been found to help improve bone strength as have drugs like bisphosphonates (Fosamax, Actonel), calcitonin (Miacalcin), SERMs (Evista) and parathyroid hormones. These medications, with the exception of parathyroid hormones, prevent the breakdown of bones. Parathyroid hormones work on the formation of bones. While these drugs have all proven effective, they can be very costly for the patient.
A NEW OPTION: Sunil Wimalawansa, M.D., at the Robert Wood Johnson Medical Center in New Jersey, is studying a commonly used heart medication as a new way to treat osteoporosis. Two hundred patients are taking part in the study called NOVEL (Nitroglycerin as an Option: Value in Early Bone Loss). The participants will use either a placebo ointment or a nitroglycerin ointment daily to determine the impact this treatment has on bone density. Participants will also be given calcium and vitamin D to take daily. Nitroglycerin is the most commonly prescribed drug to treat angina. It is known to dilate blood vessels to improve circulation. Early studies suggest it may also keep the body from reabsorbing bone, thereby slowing the bone-thinning process.
Dr. Wimalawansa says if this proves effective, it will have a number of major benefits to patients. For one, it not only affects breakdown, but improves bone formation as well. Also, it is about 20 times cheaper than other approved medications. Finally, it offers women an alternative to hormone replacement therapy, which has been associated with a number of negative side effects as well.
WHERE: Robert Wood Johnson is currently the only study center participating in the study that is funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
The NOVEL Study Group
UMDNJ - Robert Wood Johnson Medical School
125 Paterson St., CAB - 5200
P.O. Box 19
New Brunswick, NJ 08903-0019
(732) 235-8938
novelweb@hotmail.com
www2.umdnj.edu/novelweb/NOVEL
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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