Introducing Abaloparatide (Eladynos): A New Option for Severe Osteoporosis
In August 2024, the National Institute for Health and Care Excellence (NICE) recommended abaloparatide (Eladynos) for treating osteoporosis in certain postmenopausal individuals at very high fracture risk. This decision offers a new alternative for patients who may not have responded to or cannot tolerate other therapies. The approval was based on evidence showing the drug's effectiveness and cost-effectiveness in reducing fracture risk.
How Abaloparatide Works to Build Bone
Abaloparatide is an 'anabolic' agent, meaning it stimulates bone-building cells (osteoblasts) to create new bone tissue. Unlike antiresorptive drugs that slow bone breakdown, abaloparatide is a synthetic peptide analogue of parathyroid hormone-related protein (PTHrP) that directly increases bone mineral density.
Who Is Eligible for This New Treatment?
NICE guidance recommends abaloparatide for specific individuals with postmenopausal osteoporosis at very high fracture risk. This includes women, trans men, and non-binary people registered female at birth. Eligibility is determined by healthcare professionals based on factors like prior fractures or very low bone mineral density, often using tools like the FRAX algorithm as detailed by the National Osteoporosis Guideline Group (NOGG).
Key Benefits and Administration
Abaloparatide is administered as a daily self-injection using a pre-filled pen, which can improve treatment adherence. Benefits include significant reduction in vertebral and non-vertebral fractures, offering an alternative for those who cannot tolerate or haven't responded to standard treatments, and potentially lower risk of certain side effects like hypercalcemia compared to some other anabolic treatments.
Abaloparatide vs. Other Anabolic Osteoporosis Drugs
Abaloparatide is one of several anabolic treatments for osteoporosis recommended by NICE, alongside romosozumab and teriparatide. The choice depends on individual patient circumstances and discussion with a healthcare provider. While abaloparatide is used for 18 months, teriparatide has a 24-month duration, and romosozumab is limited to 12 months.
Feature | Abaloparatide (Eladynos) | Romosozumab | Teriparatide |
---|---|---|---|
Mechanism | Anabolic (stimulates bone formation) | Anabolic & Antiresorptive | Anabolic (stimulates bone formation) |
Administration | Daily self-injection (pen) | Monthly injection (clinic) | Daily self-injection (pen) |
Treatment Duration | 18 months | 12 months | 24 months |
Storage | Does not require refrigeration after opening | No refrigeration specified | Requires refrigeration |
Post-Treatment | Requires follow-on antiresorptive therapy (e.g., alendronic acid) | Requires follow-on antiresorptive therapy | Requires follow-on antiresorptive therapy |
NICE Approval | August 2024 for severe osteoporosis (postmenopausal) | May 2022 for severe osteoporosis (postmenopausal) | Specified criteria for postmenopausal women and men |
Treatment Sequence and Maintenance
Anabolic therapies like abaloparatide are typically followed by an antiresorptive treatment to maintain bone density gains. Following this sequence, such as 18 months of abaloparatide followed by antiresorptive therapy, is crucial for long-term fracture protection. Healthcare professionals monitor patients to determine the optimal follow-up plan.
For more detailed information, the official NICE document is a valuable resource. You can find it here: Abaloparatide for treating osteoporosis after menopause.
Conclusion: A New Era for Severe Osteoporosis Management
Abaloparatide's recommendation by NICE provides a new and effective anabolic option for individuals with severe osteoporosis. Its bone-forming action, convenient administration, and suitability as an alternative treatment mark a significant advancement. Consulting a healthcare provider is essential to determine if abaloparatide is appropriate, but its availability offers a major step forward in managing severe osteoporosis and reducing fracture risk.