Osteoporosis: Innovative osteoporosis medicines that transform the lives of postmenopausal women | Pune News

Pune: Meera, a 52-year-old woman, began experiencing debilitating back pain and joint discomfort soon after menopause. Although she initially attributed her symptoms to aging and the stress of daily life, she soon realized that her condition was much more serious.
After a thorough examination and basic x-ray, Meera was diagnosed with spinal fracture at the endplate of the first lumbar vertebra (L1), which is located in the lower back due to osteoporosis — a silent condition that affects many women during menopause, worsened by hormonal changes, especially after a hysterectomy.
Menopausal women and those who have had hysterectomies are particularly vulnerable to spinal health problems due to hormonal fluctuations, as are elderly men (people over 60).
According to the Indian Menopause Society, around 50 million women in India are affected by osteoporosis, with the risk increasing significantly after menopause. Menopausal syndrome often manifests as joint pain, muscle pain, and significant back discomfort.
Experts emphasize the importance of proactive measures for women approaching menopause or facing the consequences of hysterectomy.
Regular DXA scansrecommended around the age of 50, it can help assess bone health, while essential blood tests – such as those that measure levels of vitamin D, calcium and parathyroid hormone – are crucial for identifying deficiencies that can lead to osteoporosis.
“Women like Meera face a higher risk of osteoporosis during menopause, leading to weakened bones that can break under pressure from even minor falls. Osteoporosis is a silent killer,” Sancheti Hospital said.chief spine surgeon, Dr. Shailesh Hadgaonkar.
Dr Hadgaonkar sees around 40-50 patients diagnosed with osteoporotic spine every month, and the spine department at Sancheti Hospital sees around 1,200 patients every year. In addition to women with menopause and hysterectomies, these are also elderly patients with other comorbidities.
Fractures caused by osteoporosis can seriously affect quality of life, with studies showing that women over 50 are at an increased risk, in addition to elderly men.
“Postmenopausal osteoporosis is a growing concern in India, with an estimated 46 million women over the age of 50 affected by the disease. A significant trend is the increasing use of diagnostic tools such as DEXA scans to detect early bone loss and the adoption of the FRAX tool to assess the risk of fracture in postmenopausal women” said spine surgeon Dr Bhavuk Garg, professor in the department of orthopedics, All India Institute of Medical Science (AIIMS), New Delhi.
At AIIMS, New Delhi, research is moving in several directions to address the unique challenges faced by the Indian population. “Notably, a clinical trial is underway at AIIMS for an oral medicine that shows promising results as an affordable and effective alternative to teriparatide, which is currently the gold standard for severe osteoporosis,” said Dr. Garg.
Historically, treatment options for osteoporosis have included antiresorptive medications designed to slow bone loss. However, new therapeutic advances are providing hope for better management. One such medication is teriparatide, a hormonal treatment that promotes the formation of new bones. “This drug is like delivering calcium and vitamin D directly into the bones,” said Dr. Hadgaonkar.
Another significant advancement is Romosozumab, a USFDA-approved drug recently introduced in India. Administered once a month, this injectable treatment offers a more convenient alternative to the daily injections required by teriparatide.
“Romosozumab is a game-changer as it not only helps form new bone, but also reduces the risk of fractures,” he added.
For women who prefer less frequent treatment, Denosumab is another viable option, requiring injections only twice a year. This medication works by preventing bone resorption, making it suitable for many patients reluctant to commit to regular injections.
Dr. Hadgaonkar emphasizes the importance of proactive measures for women approaching menopause or dealing with the aftermath of hysterectomy. Regular DXA scans, recommended around age 50, can help assess bone health, while essential blood tests – such as those measuring vitamin D, calcium and parathyroid hormone levels – are crucial for identifying deficiencies that can lead to osteoporosis.
The theme for World Spine Day on October 16, 2024, is “Support Your Spine”. This campaign aims to raise public awareness about spinal health and disability, encouraging individuals of all ages to adopt practices that promote spinal well-being.