No Human Osteosarcoma Linked to Forteo

December 29, 2012 2 Comments

A reader has asked about bone cancer and Forteo.

Osteosarcoma is a rare bone cancer.  Lilly has endowed a 15-year independent study (suggested by the FDA) of all Osteosarcoma patients in Cancer Registries, looking for individuals who have taken Forteo.  The halfway point results from June 2004 through Sept 2011 were published in JBMR in Dec 2012.  Of the 1448 persons who had Osteosarcoma during that time period, not one had taken Forteo.

The “black box” warning on the Forteo (Teriparatide) label refers to studies of rats, not humans.  These rats very commonly get osteosarcoma without any medication.  The rats were given doses 3 to 20 times the human dose for the equivalent of 70 human years.  Rats’ bones never stop growing.  Growing bones are particularly vulnerable to osteosarcoma.  Humans are different from rats.

Few humans get osteosarcoma.  The rate is about one person in every 250,000 over the age of 50.  Many of those individuals have had radiation treatments (usually for other cancers).  Some have Paget’s Disease or Multiple Myeloma.  We avoid giving Forteo to people with those condtions.

We also avoid giving Forteo to individuals with open growth plates (growing bones), which includes some in their twenties.  We avoid pregnant and nursing women for the sake of their children.

Good news.  If you need an Anabolic medication for your osteoporosis, Forteo (Teriparatide) is likely to be safe.

No link has been found between Forteo and Osteosarcoma in Humans.

Jay Ginther, MD

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  • JoAnn Wilburn

    Three of my TScores that put me in the Osteoporosis range were spine -2.5, Hip -3.6, Femur – 3.7. I have never had broken bone in my life. I’m 70. Does that put me in the range of having to go with Forteo instead of one of the Bisphosphonate drugs.

    • First you need a Complete Bone Health Evaluation. The labs and lateral spine VFA will help with the decision. At -3.7, Forteo should be considered, depending on the rest of the story

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