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New osteoporosis treatment offers better protection against fractures, study finds

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A new treatment for osteoporosis improves bone density and provides more effective protection against fractures than the current standard treatment, according to a study published in the New England Journal of Medicine.

Researchers in Sweden enrolled 4,093 postmenopausal women with osteoporosis and a previous fracture and randomly assigned them to receive monthly subcutaneous romosozumab (210 mg) or weekly oral alendronate (70 mg) for 12 months, followed by alendronate in both groups for a further 12 months.

Romosozumab is an antibody that blocks sclerostin, which slows the new formation of bone, thereby leading to rapid new bone formation.

Results showed that the risk of vertebral fracture during the course of the study was 48% lower for those who received romosozumab compared with the group that received alendronate for 24 months. The proportions suffering fractures in the two groups were 6.2% and 11.9%, respectively.

The risk of a clinical fracture, such as an arm or leg fracture, was 27% lower in the group that received romosozumab. The proportions suffering this type of fracture in the two groups were 9.7% and 13.0%, respectively.

Reports of side effects were similar in both treatment groups, although serious cardiovascular events, such as heart attack or stroke, occurred in 2.5% of the patients that received romosozumab compared with 1.9% in the group that received alendronate during the first 12 months of the study.

The safety aspects of the new medication need to be studied further, said co-author of the study Mattias Lorentzon, Professor of Geriatrics at the Institute of Medicine, Sahlgrenska Academy, and Senior Physician at Sahlgrenska University Hospital.

However, an earlier study of nearly twice the size showed that romosozumab was not associated with a greater risk of cardiovascular events compared with a placebo.

“With the new treatment, we could offer significantly better protection against fractures and could thereby help many patients with severe osteoporosis,” Dr Lorentzon said.