Emerging treatment for osteoporosis

What are the emerging treatment modalities for osteoporosis?

Jonathan Adachi: There is a number of emerging therapies that people are talking about now. One is combination therapy: we can look at starting somebody who is at high risk [of osteoporosis] on teriparatide and then moving them on to denosumab after 18 months’, 2 years’ worth of treatment.

There are newer therapies that are coming out. There are cathepsin K inhibitors, and it has been presented at international meetings that there were gains, significant reductions both in spine and hip fractures. That data will be presented, I believe, to the US Food and Drug Administration (FDA) sometime later this year and hopefully will get approval. There are other drugs that are actually anabolic, drugs that build bone, things like antisclerostins, which build new bone and also help prevent bone loss.

So there are newer therapies that are out there that will be coming down the road that I think will be of great benefit to us. We even have something called parathyroid hormone-related peptide (PTHrP) analogues that – like parathyroid hormone (PTH) – increase bone mass without perhaps causing as much in the way of hypercalcemia.