New Drug To Prevent Bone Fractures In Postmenopausal Women: What We Know

In a significant win for women's health, the National Health Service (NHS) in England is set to offer a new drug, Abaloparatide, to help prevent bone fractures in postmenopausal women. This treatment, expected to be available within three months, could potentially benefit over 14,000 women who are particularly vulnerable to osteoporosis-related fractures.

Understanding Osteoporosis and Its Impact

Osteoporosis is a condition that weakens bones, making them more susceptible to fractures. It affects approximately 3.8 million people in the UK, with older women being particularly at risk. The condition is closely linked to menopause, a time when the body’s production of oestrogen—a hormone crucial for maintaining bone density—significantly decreases. This reduction in oestrogen levels leads to a decrease in bone density, making bones more fragile and prone to fractures.

The impact of osteoporosis is widespread and profound, contributing to over half a million fractures each year in the UK. These fractures not only cause significant pain and loss of independence but are also associated with increased mortality. The financial burden is considerable as well, with costs exceeding £4.5 billion annually.

Current Treatments and Their Limitations

Until now, treatment options for postmenopausal women at high risk of fractures have included drugs like romosozumab or teriparatide, often followed by bisphosphonates such as alendronic acid. While these treatments have been effective for many, they are not suitable for all patients. Some women either do not respond well to these medications or are unable to tolerate their side effects, leaving a gap in effective treatment options.

The Introduction of Abaloparatide

The National Institute for Health and Care Excellence (NICE) recently announced the approval of a new drug, Abaloparatide, which will soon be available through the NHS in England. Marketed under the name Eladynos and produced by Theramex, Abaloparatide represents a new hope for those at high risk of osteoporosis-related fractures.

Abaloparatide works by stimulating the cells responsible for bone formation, thereby increasing bone density. This mechanism is particularly important for women who have gone through menopause and are at elevated risk for fractures due to weakened bones. The drug is administered via a pre-filled pen, allowing patients to inject themselves once daily at home.

Expert Opinions on the New Treatment

Healthcare professionals and patient advocacy groups have welcomed the introduction of Abaloparatide. Prof Jonathan Benger, Chief Medical Officer and Deputy Chief Executive of NICE, highlighted the importance of this new treatment in improving patients' quality of life, as reported by The Guardian. He emphasized that osteoporosis can be debilitating, often leading to a fear of simple activities like walking due to the risk of fractures. By reducing the risk of fractures, Abaloparatide could help restore independence, and improve both mental and physical health for many women.

The Royal Osteoporosis Society (ROS) has also expressed its approval. Craig Jones, Chief Executive of the ROS, pointed out the scarcity of new osteoporosis treatments over the past decade and a half, which has been a significant concern given the prevalence of bone fractures in women over 50. The introduction of Abaloparatide, he noted, is likely to have a positive impact on thousands of lives across the country.

A New Option for GPs and Patients

General practitioners (GPs) will now have an additional treatment option to offer patients who have not responded to existing osteoporosis therapies. Prof Kamila Hawthorne, Chair of the Royal College of GPs, noted the importance of having multiple treatment options available, as the effectiveness of therapies can vary depending on individual patient factors. The approval of Abaloparatide provides GPs with a valuable new tool in managing osteoporosis in their patients.

A Call for Earlier Intervention

While the introduction of Abaloparatide is a significant step forward, some experts argue that more needs to be done to prevent osteoporosis before it becomes severe. Menopause expert and campaigner Kate Muir stressed the importance of early intervention. She pointed out that while new treatments like Abaloparatide are beneficial, they address the problem after significant bone loss has already occurred.

Muir advocates for greater awareness and use of hormone replacement therapy (HRT), which studies have shown can increase bone density by up to 8% and reduce the risk of fractures. She emphasized that the public health message about the safety and effectiveness of body-identical transdermal HRT is not reaching enough women. By informing women early on about the benefits of HRT, it may be possible to maintain bone health and prevent osteoporosis from developing in the first place.

The introduction of Abaloparatide by the NHS marks a major win in the treatment of osteoporosis for postmenopausal women. As this new drug becomes available, it offers hope to thousands who have struggled with the limitations of existing treatments. However, the conversation about osteoporosis prevention continues, with experts calling for broader awareness of early interventions like HRT to protect bone health before fractures occur.