Novel Receptor Improves Bone Density in Older Women With OA, OP

Findings from a post hoc analysis presented at the Endocrine Society’s ENDO 2019 meeting suggest abaloparatide may be effective in treating women with concurrent osteoarthritis (OA) and postmenopausal osteoporosis (OP).

The determination comes after the drug—a novel, selective activator of the PTH1 receptor signaling pathway—conferred significant improvement in bone mineral density (BMD) and reduced risk of new vertebral fracture.

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The researchers reviewed data on 888 participants with ongoing OA previously randomly assigned to double-blind daily abaloparatide, 80 µg (n=291); placebo (n=303); or open-label teriparatide, 20 µg (n=294) for 18 months.

At baseline, 22% of participants presented with prevalent vertebral fractures, 23% reported 1 or more prior nonvertebral fracture within the last 5 years, and 42% had no prior fractures.

Overall, no participants in the abaloparatide group experienced a vertebral fracture compared with 5.1% of participants in the placebo group and 0.4% of participants in the teriparatide group. The cumulative incidence for other fracture endpoints appeared comparable across treatment groups.

Compared with baseline BMD, at 18 months, the researchers observed a significant increase in the percent mean change in BMD among participants in the abaloparatide group compared with the placebo group for total hip (3.17% vs -0.35%), femoral neck (2.81% vs -0.36%), and lumbar spine (8.78% vs 0.86%).

The most common treatment emergent adverse events in the abaloparatide group vs the placebo group were hypercalciuria (11.0% vs 10.2%), dizziness (10.7% vs 6.6%), increased creatinine clearance (8.9% vs 10.6%), upper respiratory tract infection (8.6% vs 6.9%), and back pain (7.9% vs 11.6%).

“Among postmenopausal women with OP enrolled in ACTIVE [Abaloparatide Comparator Trial In Vertebral Endpoints], in a subpopulation with prevalent OA, abaloparatide resulted in significant reduction in risk of new vertebral fracture as well as significant improvements in BMD, vs placebo,” the researchers concluded. “Results suggest abaloparatide may be useful in the treatment of women with postmenopausal OP and concurrent OA, at high risk for fracture.”

—Colleen Murphy

Reference:

Lane NE, Mitlak BH, Weiss RJ, Wang Y, Valenzuela GJ, Bilezikian JP. The effect of abaloparatide on bone mineral density and fracture incidence in postmenopausal women with osteoporosis and osteoarthritis. Paper presented at: ENDO2019; March 23-26, 2019; New Orleans, LA. https://www.abstractsonline.com/pp8/#!/5752/presentation/15633. Accessed April 1, 2019.

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