Webinar: Anabolic therapy: deciding the appropriate treatment sequence by MAH Conferences

Osteoporosis 2021

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About This Webinar

Romosozumab and teriparatide are the two anabolic drugs licensed for the treatment of osteoporosis in the UK. Teriparatide has been available in the UK since 2003 and due to its initial high cost was recommended for use by NICE as a second line option in patients at high risk of fracture who could not take, or had an unsatisfactory response to, oral bisphosphonates. However, the intervention trials confirming fracture prevention were conducted enrolling patients who were by and large treatment naive.

In addition, prior treatment with bisphosphonates demonstrated a blunting of the effect of sequential teriparatide on bone turnover with a potentially detrimental effect on hip bone density; results for romosozumab have been qualitatively similar although lower in magnitude. A positive effect on bone density is seen when antiresorptives are prescribed following anabolics. This has led to the concept of "anabolics first" and by targeting those at very high risk of fracture, together with the advent of teriparatide biosimilars, we now have the realistic concept of reconciling clinical aptness with health economics.

The handout for this session is available by clicking the handout icon in the bottom right-hand corner of the video player.

Presenter

Professor Mike Stone

Consultant Physician & Director of Bone Research, Cardiff and Vale University Health Board

Dr Michael Stone is a consultant physician in Cardiff and lead clinician for adult metabolic bone disease. He heads a long-established fracture liaison service, four bone clinics, and the denosumab self-injection program. He is also Director of the Bone Research Unit at University Hospital Llandough with research interests that include: the bisphosphonate acute phase response; bone loss in patients with respiratory disease; the use of high dose vitamin D in the frail elderly and treatment induced bone loss in prostate cancer.

He is Chairman of the Wales Osteoporosis Advisory Group, a member of the UK National Osteoporosis Guidelines Group, Clinical Committee of the Royal Osteoporosis Society and Royal College of Physicians Fracture Liaison Service Database Advisory Group. He is Visiting Professor to the School of Health at the University of South Wales.