Osteoporosis Drugs for Stronger Bones – and Joints

At least two types of osteoporosis medications – bisphosphonates and strontium ranelate (a dual action bone agent approved in Europe but not in the United States) – have shown some promise in treating osteoarthritis. 

In an observational study of 55 patients taking bisphosphonates and 268 nonusers published in the April 2013 online issue of the Annals of the Rheumatic Diseases, researchers at Leeds University in the UK found that treatment with bisphosphonates over a period of two to three years was associated with both a reduction of osteoarthritis pain as well as less joint space narrowing – a sign of OA progression.

Findings of a randomized controlled trial published in the February 2013 issue of the Annals of the Rheumatic Diseases provided more convincing evidence for strontium ranelate. In the Belgian study of 1,683 patients with systemic knee OA, participants were randomly selected to receive one of two doses of strontium ranelate or placebo. Researchers followed all three groups over three years using X-rays to measure joint damage and questionnaires and other tools to gauge symptoms such as pain, stiffness and changes in physical function.

They found that strontium ranelate was associated with decreases in joint damage, as measured by joint space narrowing, compared to placebo. Decreases were greater with the higher (2 mg per day) than lower (1 mg per day) doses. Like bisphosphonates, strontium ranelate was effective in reducing pain and improving physical function. 

Researchers suggest a number of mechanisms by which osteoporosis medications could be useful against osteoarthritis. These include effects on both the cartilage and the bone underneath, says Jean-Yves Reginster, who led the study. As yet, he says, it is too soon to recommend osteoporosis medications as a treatment for OA.

Fighting Cartilage Loss with Fish Oil

While the use of nutritional supplements for osteoarthritis has focused largely on the duo of glucosamine and chondroitin, recent research on animals suggests that a popular supplement for heart disease and rheumatoid arthritis may help OA

In a study published in the October 11 issue of the journal Osteoarthritis and Cartilage, researchers at the University of Bristol found that in guinea pigs – which spontaneously develop osteoarthritis – a diet rich in omega-3 fatty acids reduced the occurrence of OA in half compared to a standard guinea pig diet. Omega-3 fatty acids are essential fatty acids – meaning our bodies need them to function properly. The best source of omega-3 fatty acids is fish oil.

John Tarlton, PhD, senior research fellow at the University of Bristol and his colleagues found that in guinea pigs fed the diet high in omega-3s, early signs of OA such as the breakdown of cartilage and the loss of molecules that give cartilage its shock-absorbing properties were both reduced.

Furthermore, the researchers found evidence that omega-3s influences the biochemistry of the disease, potentially slowing its progression.

“We examined the effects of fish oil on the biology of osteoarthritis development and progression, and were able to show that fish oil effects the same mechanisms known to be part of human disease,” says Tarlton. “So based upon the common biology between species, it is possible to confidently assert that fish oil would act in a similar way in human disease.”