Bone health

New osteoporosis treatment can strengthen bones

 

Special to The Miami Herald

Maria Fernandez was just 49 when she was diagnosed with osteoporosis.

The South Miami mother of two had no symptoms and the bone disease was discovered during a routine check-up and bone density test. With an 88-year-old mother with osteoporosis who had broken her hip, Fernandez was at risk for developing the post-menopausal condition.

For several years, Fernandez was on the popular drug Fosamax, until recently the only drug approved to treat osteoporosis. But the medicine had no effect on her condition, so she stopped taking it.

A year ago, Fernandez began a newly approved drug for osteoporosis, Prolia, receiving an injection every six months. Her latest bone density test brought some good news: her condition has improved and her bones are becoming stronger.

“I’m so happy my doctor recommended this,’’ Fernandez said. “Since my mother has osteoporosis, they said I was at risk.’’

Approved in 2010 by the FDA, Prolia is the new generation of osteoporosis drugs, and is being warmly received by many doctors, who have been short on solutions for the common condition that they say appears to be on the increase.

Osteoporosis has traditionally been the disease of grandmothers, hitting one out of every two women in their twilight years. Diagnosed primarily through bone density tests, osteoporosis causes bones to became fragile and leads to fractures. Some 80 percent of patients are female, although men are increasingly being treated for the condition.

The condition is closely linked to the lack of estrogen production following menopause, and doctors say it is on the rise now that doctors are reluctant to prescribe post-menopausal estrogen treatment because of cancer concerns. Additionally, a sedentary lifestyle, poor diet and lack of sunlight are contributing factors, all leading to a troubling trend.

“You can lose 10 to 20 percent of your bone in the first five to seven years after menopause,’’ said Dr. Silvana Levis, director of the Osteoporosis Center at the University of Miami. “I encourage every woman to have a bone density test after menopause. It’s a very easy test ... and low in radiation.’’

Noted Dr. Juan Suarez, an orthopedic surgeon at Cleveland Clinic Florida: “Osteoporosis is very prevalent not only because of less estrogen therapy but because of people drinking more alcohol, being less active, smoking — all these things come into play. It’s also being recognized more in men these days.”

Like all diseases, early detection is key, so many doctors routinely screen for osteoporosis in all post-menopausal women. Dr. Bernard Brijbag, a Miami internist with Baptist Hospital, also recommends the bone density test every other year. However, he noted, there can be false positives with the test. Therefore, Brijbag screens for osteoporosis in other ways, looking for low weight and changes in height, doing a nutritional and exercise evaluation as well as a blood test to check vitamin D levels, magnesium levels and to see if the parathyroid is elevated — all of which could be signs of the disease.

“We are looking for such risk factors as being post-menopausal, small frame, low weight and decreased activity level,’’ he said.

Like many doctors, Brijbag uses a computer program called Frax to rate a patient’s potential for having osteoporosis. Frax assigns a score based on such criteria as age, sex and height.

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