UPDATED: Might A Closely-Monitored Teriparatide Regimen Help Mrs. Graves?

I did a little follow-up research this morning, on my prior October 15, 2010 story on Forteo™, Lilly's branded version of the protein-complex teriparatide, in injectible form. It turns out that the prestigious New England Journal of Medicine ran a peer-reviewed journal article reporting a study on this particular topic, back in November 2007. Do go read that link.

And so, I still think this may be a promising approach (if carefully monitored, as it seems long-term use elevates risks of some cancers), that might be used to reverse osteonecrosis of the jaw in the patients with glucocorticoid-induced osteoporosis (like, it is alleged, Mrs. Juduth Graves). Mrs. Graves alleges, in Graves v. Merck, et al., that she developed ONJ after years of uninterrupted Fosamax^® use. Here again is one of last month's Reuters' stories on it:

. . . .The research, reported at the annual meeting of the American Society for Bone and Mineral Research in Toronto, suggests that the drug may spur growth in a damaged jaw, the researchers said.

Forteo™, known generically as teriparatide, cuts in half the risk of bone fractures in patients with thinning bones by stimulating the growth of new bone. But it is seldom given for more than two years out of fear that long-term exposure might lead to osteosarcoma, a type of bone cancer.

The first of two reports, also published in the New England Journal of Medicine, showed people whose severe periodontitis was damaging the tissue around the teeth developed nearly 10 times more bone with Forteo compared to those who received daily placebo injections. . . .

The other study, reported in a letter in the Journal, involved just one patient, an 88-year-old women whose jaw began to erode after a tooth was removed, a condition known as osteonecrosis. Conventional treatment did not help. . . .

Doctors said the problem may have been her 10-year use of alendronate, commonly known as the Merck osteoporosis drug Fosamax, following a hip fracture. While Forteo spurs the growth of new bone, Fosamax slows the normal absorption of exiting bone. . . .

After eight weeks of Forteo injections, the woman's pain disappeared and CT scans showed that bone cells had rebuilt that portion of the jaw. . . .

We'll keep you posted, as it is entirely possible that the "Universe of One" rule applies here -- it is after all an anecdote, not a study -- in the particular 88-year-old's case, above.