Osteoporosis drug teriparatide or Forteo can boost bodies’ bone stem cell production to the point that adults’ bones appear to have the ability to heal at a rate typically seen when they were young kids, revealed by researchers.
Of the estimated six million fractures in the United States each year, approximately five percent will have slow or incomplete healing. According to J. Edward Puzas, Ph.D., who heads up orthopaedic bone research at the University of Rochester Medical Center and is the principal investigator of the clinical trial, a large portion of non-healing fractures tend to occur in older adults.
“In many people, as they get older, their skeleton loses the ability to heal fractures and repair itself,” Puzas said. “With careful application of teriparatide, we believe we’ve found a way to turn back the clock on fracture healing through a simple, in-body stem cell therapy.”
“It takes three to four months for a typical pelvic fracture to heal. But during those three months, patients can be in excruciating pain, because there are no medical devices or other treatments that can provide relief to the patient,” said Susan V. Bukata, M.D., medical director of the Center for Bone Health at the University of Rochester Medical Center Bukata. “Imagine if we can give patients a way to cut the time of their pain and immobility in half? That’s what teriparatide did in our initial research.”
The impetus for the research began in Bukata’s clinic, where she saw painful bone fractures in osteoporotic patients quickly heal within a few months of taking teriparatide. At the time, Bukata also served on a research team at the University’s Center for Musculoskeletal Research, and she began to advocate that the team direct its efforts in an entirely new direction based on the results she was seeing with patients who were taking teriparatide.
“I had patients with severe osteoporosis, in tremendous pain from multiple fractures throughout their spine and pelvis, who I would put on teriparatide,” said Bukata. “When they would come back for their follow-up visits three months later, it was amazing to see not just the significant healing in their fractures, but to realize they were pain-free ? a new and welcome experience for many of these patients.”
Bukata began prescribing teriparatide to patients with non-healing fractures, and was amazed at her findings: 93 percent showed significant healing and pain control after being on teriparatide for only eight to 12 weeks. And in the lab, Puzas began to understand how teriparatide stimulates bone stem cells into action.
According to Puzas, teriparatide significantly speeds up fracture healing by changing the behavior and number of the cartilage and the bone stem cells involved in the process.
“Teriparatide dramatically stimulates the bone’s stem cells into action,” Puzas said. “As a result, the callus forms quicker and stronger. Osteoblasts form more bone and the micromotion associated with the fracture is more rapidly eliminated. All of this activity explains why people with non-healing fractures can now return to normal function sooner.”
“The decreased healing time is significant, especially when fractures are in hard-to-heal areas like the pelvis and the spine, where you can’t easily immobilize the bone ? and stop the pain,” Bukata added. “Typically, a pelvic fracture will take months to heal, and people are in extreme pain for the first eight to 12 weeks. This time was more than cut in half; we saw complete pain relief, callus formation, and stability of the fracture in people who had fractures that up to that point had not healed.”
Eli Lily, manufacturers of Forteo, are providing the medication for the clinical trial. Both Drs. Puzas and Bukata are members of Eli Lily’s speaker bureau.
Source: University of Rochester Medical Center, USA