Forteo for osteoporosis

[Bacana]

Has anyone used Forteo for osteoporosis? My husband’s PCP recommended it. She said it builds bone. Any reason not to?

[GP24]

It works. You should not take it longer than a year, I think the "package insert" will have this information.

[God_Loves_Me in reply to GP24]

Agree

[kainasar]

Search and research. Other bone density meds may be more effective and have less side effects.

[maley2711]

I would ask the Doc for any other alternatives anda comparison of effectiveness and side effects......what studies provide the best evidence? If current Doc shows no mastery of the subject and willingness to thoroughly discuss, perhaps othopedists in the area have the needed expertise. Otherwise, we must be our own researchers..... a sad situation IMHO.

Sometimes clinic nurses can provide good direction re which Docs are better for certain things.

[janebob99]

I've used both Forteo (teraparatide) and estradiol (E2) for good bone health.

The cost of Forteo is about $200 US/day retail, versus $ 1-5 US/day for estradiol. Both are natural hormones. Estradiol patch therapy causes the bone mineral density (BMD) to increase by 6% over 1 year, according to the PATCH study in the UK, with minimal side effects. Insurance usually makes you try cheaper bisphosphonates for a few years before allowing you to go onto Forteo, because the cost is so high.

BMD vs time Ref: PATCH-II study

[mimgen in reply to janebob99]

Thanks so much for this graph Bob and sharing your experience. I love its succinctness. Something I can hand to my MO, RO, GP etc. in hope that it can convince a prescription so that I can avoid deteriorating bone health as I progress down the ADT road. So far I have had no luck with any MD I've been too. They are all concerned about stepping outside the bounds of their SOC regimen and risking their license. If anyone knows of someone who will/can prescribe estradiol please let me know!

[janebob99 in reply to mimgen]

Here are some ideas of how to get estradiol:

1. Ask your PCP or GP to prescribe E2 for hot flashes;

2. Order some E2 gel or cream/paste from Thailand (I don't think they require a prescription);

3. Ask your local compounding pharmacist for a list of doctors who regularly prescribe compounded hormones, and then contact one of them to write a script for compounded E2 gel or cream; and

4. Ask a woman-friend or wife to get some E2 patches for hot flashes and use them for yourself.

It's going to be a while until the USA approves it for men with PCa.

[mimgen in reply to janebob99]

Thanks for these good suggestions, Bob.

#1 - Lucky me, I haven't been getting hot flashes on my Orgovyx/bicalutimide regimen but could claim to. #2 - Thailand is a good suggestion but there is also Mexico. I actually have some Estradiol gel 0.1% that a friend picked up for me in Juarez, no prescription needed. I haven't got around to using it yet but plan to soon, after my next lab results. #3 I was given the name of an integrative physician in Las Cruces from a compounding pharmacist but have no plans to go that way to followup, yet. Of course, there is no guarantee that they will want to risk their license to provide me with a prescription. #4. My wife has a prescription for the 0.1% gel but she needs it. I gave her product carton to my friend who picked up the estradiol in Juarez. Palomas, Mx. is a lot closer to me than Juarez and the border crossings are easier so that will be my choice once I start trying it out and feel good about the dosing and effects.

My preference is to work with a physician who can help me with monitoring and treating any side effect and adjusting dose as necessary, initially for "add-back" estrogen but perhaps eventually for high-dose estradiol to replace the ADT drug. I have another lead on a doctor in Santa Fe that I will pursue the next time I'm up that way. In the meantime, I really appreciate what you and others have shared in this forum.

[janebob99 in reply to mimgen]

The greater concern from ADT is hidden osteoporosis, in addition to hot flashes. Getting a baseline DEXA scan is very important, with followups every 6-months while on ADT.

My wife has taken 0.1% estradiol gel for 2 years for osteoporosis, with no change in BMD. But, she recently switched from forearm application to jaw line application (based on a paper I discovered by Feldmann et al (1967), and she is now experiencing sore and enlarged breasts...indications that she is absorbing much more estradiol than before. Her serum E2 level jumped from 20 to 120 pg/ml after switching to jaw line application. She will get a new DEXA scan soon. That may be something for your wife to consider, if she's not getting a high enough serum E2 level to treat osteoporosis (a minimum E2 level of 60 pg/ml is needed to increase BMD in post-menopausal women).

If you send me an email request to "[e-mail]", I will send you the ESMO abstract of the results of the 14-yr PATCH phase-III trials comparing estradiol ADT to Lupron ADT, which you can give to your physician(s).

[dhccpa in reply to janebob99]

What's the best clinical study on low dose estradiol patches for bone strength? Something to hand to a doctor? Thanks!

[janebob99 in reply to dhccpa]

If you send me an email to "[e-mail]", I will send you a couple of .pdf articles that you can use.

[dhccpa in reply to janebob99]

Will do

[j-o-h-n]

From OOgle the GOOgle:

For patients at high risk for fracture due to osteoporosis

FORTEO (teriparatide injection) can help reduce your risk of having another fracture*

FORTEO is a prescription medicine used to treat postmenopausal women who have osteoporosis who are at high risk for having broken bones (fractures) or who cannot use other osteoporosis treatments. FORTEO can lessen the chance of broken bones (fractures) in the spine and other bones in postmenopausal women with osteoporosis. FORTEO is used to increase the bone mass in men with primary or hypogonadal osteoporosis who are at high risk for having broken bones (fractures) or who cannot use other osteoporosis treatments. FORTEO is used to treat both men and women with osteoporosis due to use of glucocorticoid medicines, such as prednisone, for several months, who are at high risk for having broken bones (fractures) or who cannot use other osteoporosis treatments.

*Only proven in postmenopausal women with osteoporosis. All women took calcium and Vitamin D daily.

Here is some important safety information you should know about FORTEO:

Possible bone cancer. During drug testing, the medicine in FORTEO caused some rats to develop a bone cancer called osteosarcoma. Studies in people have not shown that FORTEO increases your chance of getting osteosarcoma. There is little information about the chance of getting osteosarcoma in patients using FORTEO beyond 2 years.

Good Luck, Good Health and Good Humor.

j-o-h-n