Most Read Articles
Pearl Toh, one year ago
Middle East Respiratory Syndrome (MERS) patients have more severe illness and a higher mortality rate than non-MERS severe acute respiratory infection (SARI) patients, according to a study presented at the recent American Thoracic Society (ATS) International Conference 2016 held in San Francisco, California, US.
one year ago
Sevelamer increases serum magnesium levels and reduces risk of hypomagnesemia in end-stage renal disease patients requiring haemodialysis, according to a study.
one year ago
In-centre distributed pulse oral calcitriol seems to be effective, safe, and economical as a treatment option for secondary hyperparathyroidism in patients on haemodialysis, based on a study.
one year ago
Kidney and bladder stones (urinary tract stones) are not risk factors for osteoporosis in postmenopausal women, according to the women’s health initiative.

Abaloparatide increases forearm BMD and lowers wrist fracture risk

Pearl Toh
2 months ago

Abaloparatide increases bone mineral density (BMD) at the ultradistal radius along with lower risk of wrist fracture compared with placebo and teriparatide in postmenopausal women with osteoporosis, according to a study presented at The Endocrine Society Annual Meeting (ENDO 2017) in Orlando, Florida, US.

The analysis was on a subset of 982 postmenopausal women from a total cohort of 2,463 women enrolled in the global, double-blind, phase III ACTIVE* trial who were randomized to subcutaneous abaloparatide 80 µg (n=321), open-label teriparatide 20 µg daily (n=327), or placebo (n=334) for 18 months. [ENDO 2017, abstract LB SUN 46]   

At the ultradistal radius, an anatomical site considered relevant to wrist fractures, BMD significantly increased from baseline with abaloparatide (mean percent change, +1.0 percent) compared with a decrease with placebo (-1.2 percent; p<0.0001) and with teriparatide (-0.5 percent; p<0.001) after 18 months.  

Measurements at the 1/3 radius, which is constituted of a substantial proportion of cortical bone, showed an overall BMD decrease from baseline in all three arms (-1.0 percent, -2.3 percent, and -0.6 percent, respectively for abaloparatide, teriparatide, and placebo). Although the difference between the abaloparatide and the placebo arms was not significant (p=0.19), the decrease was significantly greater in the teriparatide arm when compared with abaloparatide (p<0.001) and with placebo (p<0.0001).             

Compared with the abaloparatide arm (seven women [1.0 percent by Kaplan-Meier estimate]), there were more women who reported wrist fractures in both the teriparatide (17 [2.3 percent]) and the placebo arms (15 [2.2 percent]). This translates to a lower wrist fracture risk in the abaloparatide group compared with the teriparatide group (hazard ratio, 0.43; p=0.052), although the reduction was not statistically significant.

“These data are also consistent with the reduction in nonvertebral fractures, sites rich in cortical bone, with [subcutaneous abaloparatide] compared with placebo treatment observed during ACTIVE,” said lead author Dr Nelson Watts from Mercy Health Osteoporosis and Bone Health Services in Cincinnati, Ohio, US.  

Abaloparatide is an osteoanabolic agent currently under development for treating postmenopausal osteoporosis by selectively binding to and activating the parathyroid 1 receptor. The ACTIVE trial has previously shown significantly decreased risk of vertebral (VF) and nonvertebral fractures (NVF) compared with placebo, and lower risk of major osteoporotic fractures (MOF) compared with teriparatide. [JAMA 2016;316:722-733]

Also presented was a separate subanalysis of the ACTIVE cohort, which suggests that the beneficial effects of abaloparatide on reducing the risks of VF, NVF, and MOF were consistent across different geographic subgroups (including Europe, North America, South America, and Asia) compared with placebo. [ENDO 2017, abstract OR08-7]   

According to Dr Michael McClung of Oregon Osteoporosis Center in Portland, Oregon, US, who presented the subanalysis, the protective effects of abaloparatide are likely to be clinically meaningful for patients who are at a very high risk for NVF, but probably less so for lower-risk patients, for whom anabolic drug are also less likely to be considered.   

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Pearl Toh, one year ago
Middle East Respiratory Syndrome (MERS) patients have more severe illness and a higher mortality rate than non-MERS severe acute respiratory infection (SARI) patients, according to a study presented at the recent American Thoracic Society (ATS) International Conference 2016 held in San Francisco, California, US.
one year ago
Sevelamer increases serum magnesium levels and reduces risk of hypomagnesemia in end-stage renal disease patients requiring haemodialysis, according to a study.
one year ago
In-centre distributed pulse oral calcitriol seems to be effective, safe, and economical as a treatment option for secondary hyperparathyroidism in patients on haemodialysis, based on a study.
one year ago
Kidney and bladder stones (urinary tract stones) are not risk factors for osteoporosis in postmenopausal women, according to the women’s health initiative.