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- $Unique_ID{BRK01395}
- $Pretitle{}
- $Title{Has the New Drug Etidronate Been Approved by the FDA?}
- $Subject{bones osteoporosis treatment musculoskeletal system connective tissue
- drug etidronate medication postmenopausal intermittent cyclic therapy ict
- osteoblasts osteoclastic treatments medications medicine medicines drugs}
- $Volume{M-17,R-17}
- $Log{
- Diagnosing and Managing Paget's Disease*0007801.scf
- Osteoporosis*0005702.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
-
-
- Has the New Drug Etidronate Been Approved by the FDA?
-
-
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-
- QUESTION: Recently I read about the new drug etidronate which is supposedly a
- real break through in treating osteoporosis with very minimal side effects.
- Our doctor seems to know nothing of this drug, but our pharmacist says with a
- prescription he can order it and have it in the next day. Could you please
- advise if and when this drug was approved by the Food and Drug Administration
- (FDA), and when it will be on the market? I am sure many people are eager to
- learn more about this important drug.
-
- ------------------------------------------------------------------------------
-
- ANSWER: Your letter brings up some important points that have been included
- in recent mail from other readers and so I am pleased to respond. The
- articles you have been reading about etidronate followed the publication of
- two reports about new research using this medication presented in the New
- England Journal of Medicine in May and July of this year. One study was
- conducted in Denmark, involved 66 patients and covered a three year period. A
- much larger study involved 429 women with postmenopausal osteoporosis was
- conducted over a two year period in centers in Cincinnati, Cleveland, Atlanta,
- Seattle, Honolulu, Denver and Columbus, Ohio. A method called "intermittent
- cyclic therapy" (ICT) was used in both studies. Contrary to the thinking of
- many people, bone is not a dead tissue, but a dynamic one, constantly being
- torn down and rebuilt by special cells. The osteoclasts are responsible for
- tearing down old bone, with the osteoblasts working to rebuild the bone and
- form new bony structures. During most of our adult life these two processes
- are pretty much in balance, but after menopause, the osteoclasts get the upper
- hand, with more destruction of bone than new building. The result is a
- thinner or more porous bone, thus the name osteoporosis. In these experiments
- etidronate was given to slow down the osteoclastic activity for a period of
- time (15 days), and then stopped, permitting the osteoblasts to function and
- rebuild bone. During the bone rebuilding portion of the cycle, calcium
- supplements were given to help the process. The entire cycle spanned a three
- month period and then was repeated. Both groups of researchers reported that
- bone mass improved (as measured by bone density techniques) during the
- therapy, and more important still, that the number of vertebral fractures (the
- type that cause the formation of a "dowager's hump" or spinal curvature) was
- significantly reduced in the group receiving etidronate when compared to the
- control group. Etidronate is not unknown to doctors practicing in the United
- States. It is currently marketed under the name Didronel by Norwich Eaton,
- and is already approved for use in treating Paget's Disease of the bone, and
- is considered safe and effective for this indication by the FDA. However,
- when a medication that has been approved for one indication is found useful
- for a new disease or indication, the manufacturer must submit evidence and
- scientific data to the FDA to prove that it is an effective treatment for the
- new disorder as well. The news is that the manufacturer has submitted the
- results of these two studies as well as other supportive data to the FDA at
- this time and is awaiting its decision. Just how long the process will take
- is unknown, but I will be happy to let you know when it occurs. So your
- pharmacist is correct, he can order the medication now, but I would strongly
- advise your physician to read these two articles before deciding to issue a
- prescription, because the medication must be taken in a very precise manner to
- obtain the same results as these investigations.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-
-