A drug used to treat severe osteoporosis promotes healing of hard-to-mend fractures in the elderly and others, reducing pain and time spent in nursing homes, researchers said Tuesday.
In preliminary studies, 93% of 145 patients who had unhealed bone fractures -- some for as long as six months -- had significant healing after only eight to 12 weeks on the drug, called teriparatide, or Forteo.
An estimated 5% of the 6 million fractures suffered by Americans each year are slow to heal or do not heal at all, and as many as a quarter of the elderly with pelvic and hip fractures die within a year as a result of their injuries.
Others with such injuries are forced to go into nursing homes, so the drug has great promise for reducing medical costs and improving quality of life, said Dr. Susan V. Bukata of the University of Rochester Medical Center, lead author of the study.
"This is a drug with a good clinical track record that has proved to be remarkably safe, and it could have great utility," said Dr. Richard S. Bockman, chief of the endocrine service at the Hospital for Special Surgery in New York, who was not involved in the study.
Bukata and her colleagues reported their findings at a February meeting of the Orthopaedic Research Society and are now submitting a report to a major journal.
Teriparatide is a fragment of parathyroid hormone, containing 34 amino acids compared with the 84 in the intact hormone. Studies as early as the 1930s showed that parathyroid hormone injections increase bone density and healing in animals. But because the hormone could not be patented, pharmaceutical companies were loath to expend money on clinical trials.
In 2003, however, Eli Lilly & Co. received approval to market teriparatide under the brand name Forteo for treatment of severe osteoporosis. An estimated half-million people have been treated with the drug.
Many physicians have reported observing accelerated healing of fractures in the elderly given Forteo for osteoporosis, and some doctors are now using the drug off-label for such purposes, Bockman said.
Bukata and her colleagues studied 145 mostly elderly patients with fractures at a variety of sites. All the fractures had proved resistant to healing, some for more than six months. The researchers found that 135 of the patients given teriparatide had complete healing of their fractures after eight to 12 weeks. Six had only partial healing, "but they were much more comfortable and happy with the results," she said. Only four patients received no benefit.
