Imagine going to the doctor's office once a year for treatment of a chronic medical condition. No daily pills. No weekly therapies. Just 30 minutes or so in a clinic.
It could happen. A new osteoporosis drug called zoledronic acid has been shown to increase bone mineral density in rates similar to those achieved with medications taken daily or weekly. Now, a large study involving thousands of people will establish whether annual intravenous infusions can help prevent spine and hip fractures in people with osteoporosis.
If eventually approved by the Food and Drug Administration, zoledronic acid would be only one of several ways to treat bone loss. But doctors are exuberant at the prospect of having a long-lasting therapy in their bag of tricks.
"It will change the way we treat osteoporosis," said Dr. Stuart Silverman, a clinical professor of medicine at UCLA and an investigator in the phase-three clinical trial. "Right now, osteoporosis is under-recognized, under-diagnosed and under-treated."
About 55% of people over age 50 have low bone mass, and 10 million Americans have osteoporosis, according to the National Osteoporosis Foundation. The disease can lead to an increased risk of fractures and, sometimes, eventual death for elderly people who break a hip.
However, many elderly people with fractures are treated for the injury but don't receive medications or therapy to prevent additional fractures, Silverman said. That might change if zoledronic acid infusions could be given as part of a comprehensive treatment for a fracture. About 20% of people with one fracture will have another break.
With zoledronic acid on hand, he said: "We would fix [the fracture] and then give them their osteoporosis treatment before they leave the hospital. We'd know they were protected for the next year."
A once-a-year treatment would also benefit people who can't tolerate daily osteoporosis medications such as Fosamax and Actonel. Like zoledronic acid, these drugs are from a class of compounds called bisphosphonates. And though they're powerful protectors of bone, they're hard on the stomach, says Silverman.
Furthermore, many people have trouble sticking to a daily-pill regimen; studies have shown that the average person stops taking long-term medications after six months, he said.
