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OSTEOPOROSIS  

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NOF supports approval of revolutionary new therapy
The National Osteoporosis Foundation (NOF) has supported the recommendation by the Endocrinologic and Metabolic Drugs Advisory Committee of the US Food and Drug Administration (FDA) that the FDA should approve FortéoTM.

FortéoTM is a new therapy in the fight against osteoporosis that can stimulate bone formation, increase bone mass and reduce the risk of bone fractures.

Sandra C. Raymond, NOF Executive Director, said of the recommendation: "Fortéo offers a new choice of therapy for women and men suffering from this debilitating disease. The fact that this treatment actually builds bone can help those at risk, since more than 1.5 million bones fracture each year due to osteoporosis. The recommendation of this committee is an important step towards developing new treatments that reduce the risk of fracture, allowing people to remain active and strong throughout their lives."

Other medicines approved for osteoporosis prevention and treatment are classified as anti-resorptive drugs because they slow bone resorption or breakdown, the first step in the bone remodelling process. Rates of resorption increase with menopause and advancing age, and are associated with bone loss. Anti-resorptive medications slow the rate of bone remodelling to a more normal level and reduce the risk of some osteoporotic fractures.

Fortéo is a parathyroid hormone (PTH) treatment that stimulates bone formation.

PTH has been found to build bone in men with osteoporosis and in women on steroid treatment for a variety of conditions. Data also shows that PTH can reduce vertebral fractures in women by 65-69 per cent and also reduces fractures in other parts of the body.

"This would be the first treatment option to build substantial amounts of bone for those suffering osteoporosis by increasing bone formation," said NOF President C. Conrad Johnston, Jr., MD.

"This recommendation takes us closer to opening up a whole new mode of treatment that will increase bone mass dramatically in individuals with osteoporosis and reduce the risk of vertebral and other fractures more than any currently available treatment."

With more than 350,000 members, NOF is the only non-profit, voluntary health organisation dedicated to reducing the widespread prevalence of osteoporosis through programmes of research, education and advocacy.

New research underscores validity of bone density testing recommendations

Research published in The Journal of the American Medical Association has confirmed the effectiveness of recommendations made by the NOF in its Physician’s Guide to Prevention and Treatment of Osteoporosis as compared to two other instruments.

Scores from the Simple Calculated Osteoporosis Risk Estimation (SCORE), Osteo-porosis Risk Assessment Instrument (ORAI) were compared to NOF recommendations and little variation was found.

In fact, the three had similar rates of accuracy in identifying women who would benefit from DXA testing. The study did find, however, that two other instruments based on Age, Body Size, No Estrogen (ABONE) and "weight-only" were inadequate for identifying at risk women who should be screened.

"This important research makes clear that testing determinations cannot be made based solely on age, body size, estrogen status or weight," said Sandra C. Raymond, Executive Director of NOF.

"The findings demonstrate that osteoporosis experts are moving toward a consensus in determining which individuals are at greatest risk for this preventable and treatable disease."

Lawrence G. Raisz, MD, chairman of NOF’s Scientific Advisory Board, said: "Overall, the proportion of women recommended to be screened by the three different methods is more similar than different. In fact, the actual number of women screened according to NOF recommendations is only slightly higher than with SCORE and ORAI. And, is that so bad? Simple logic dictates that if you cut down on the number of tests, you are going to miss more women who actually have low bone density and are at significantly greater risk of serious fractures."

Raisz also pointed out that the ORAI and NOF both recommend DXA testing for all women over 65. He said: "It is very important to note that the research does not tie the recommendation to be tested to fracture risk. Therefore, you cannot say that one approach does a better job or is more accurate with respect to fractures." Determining fracture risk is vitally important since the nation spends nearly $14 billion per year on osteoporotic fractures - fractures of the hip, spine or other bones.

Ms. Raymond concluded: "BMD testing is a cost-effective tool that can identify the hundreds of thousands of men and women who would otherwise suffer life-threatening fractures. The Foundation’s goal is to reduce the number of individuals suffering unnecessarily from this preventable and treatable disease. NOF’s recommendations guarantee that a maximum number of people with low bone mass are identified and treated."

BMD screening project in Lebanon proving a success

In October 2000, a nation-wide BMD screening programme was launched in Lebanon by the Lebanese Osteoporosis Prevention Society (LOPS) in collaboration with the Lebanese Red Cross.

The objective was to provide diagnostic testing at Red Cross centres throughout the country for all those with a high risk of developing osteoporosis. Thanks to funds from The 206: A Fund in Trust, LOPS was able to purchase four small Achilles densitometers and one large Dexa densitometer.

The four small machines are presently being rotated around Red Cross centres in different regions of the country, while the larger machine has been installed at the new LOPS office in Beirut.

People considered at high-risk for osteoporosis are now being screened on the Achilles machines. Should they be diagnosed as appearing to have osteo-porosis, the Lebanese Red Cross would then transport the patients to Beirut for fuller evaluation on the large Dexa machine at the LOPS office.

The small machines are moved to different Red Cross centres around the country at regular intervals, so as to cover as much of Lebanon as possible.

The fees charged go towards technicians’ sal-aries and towards the cost of running the machines, transportation and other costs.

The tests are offered to the needy at much-reduced rates and by the end of May 2001, more than 2,000 tests had been carried out on the Achilles machines, while 133 tests were made by LOPS on the Dexa machine.

More recently, LOPS also began to offer medication to a limited number of needy patients who are diagnosed with osteoporosis.

Financing for this part of the project has been made possible by proceeds from a recent fundraising event.

In recognition of the hard work and commitment on the part of the entire LOPS team in establishing this project, LOPS was awarded one of the IOF-MSD “Invest in Your Bones” grants to the value of $10,000.

The Jordanian Osteoporosis Prevention Society has also been awarded a grant as part of the “Invest in Your Bones” scheme.

The country’s National Campaign Against Osteoporosis will benefit.

It is a wide-reaching project that aims to increase the awareness of the disease.


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