Treating osteoporosis by targeting parathyroid hormone to bone

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Over 300,000 hip fractures per year can be attributed to osteoporosis, resulting in direct patient care costs of over 18 billion dollars in 2005. As the population ages, this cost is anticipated to rise to approxi- mately 25.3 billion dollars by 2025

Osteoporosis is a major public health problem despite widespread use of bisphosphonate therapy. PTH(1–34) is a more effective treatment; but its use has been limited by side effects (hypercalcemia, tumor risk) and inconvenient dosing (daily injection). Long-acting forms of PTH are also effective but cause severe hypercalcemia, presumably from effects in kidney. The authors hypothesized that targeted delivery of PTH to bone using a collagen binding domain (PTH-CBD) could reduce hypercalcemia. PTH-CBD is cleared from serum within 12 hours after subcutaneous administration. In ovariectomized rats, monthly administration of PTH-CBD increased spinal BMD by 14.2% with no associated hypercalcemia. Such bone-targeted anabolic agents may ultimately allow the superior efficacy of anabolic therapy to be obtained with the dosing convenience of bisphosphonates.

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