5 Reasons to Pay Attention to Bone Health as You Age

It’s time to take control of your bone health.

There’s a reason people now say that “60 is the new 50” and “70 is the new 60,” and so on: Women today are living longer than ever before. It’s a positive and empowering testament to the shifts in both perceptions and realities of getting older; however, people often associate getting older with a laundry list of health conditions for which they may become at risk. One that should not be overlooked is postmenopausal osteoporosis. For women aged 50 and above, it’s time to take control of bone health. Here are five reasons why.

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At a certain point in adulthood, you may naturally begin to lose bone mass—without even realizing it

Throughout one’s life, bones are maintained through a continuous bone remodeling process in which cells break down old bone while other cells build the bone back up with new bone tissue.1 Estrogen helps to maintain balance in this bone remodeling process, but after menopause the natural loss of estrogen causes a disruption. Postmenopausal osteoporosis, a skeletal disorder affecting bone strength that can lead to fractures, usually occurs after menopause in women due to declining estrogen levels.1,2

The development or progression of postmenopausal osteoporosis can be “hidden” or “silent,” and often isn’t diagnosed until after a fracture, or bone break, occurs. Further, sometimes even after a fracture, the connection with the underlying disorder, or cause, namely postmenopausal osteoporosis, may not be made by the patient or healthcare provider.3 In this case, knowledge truly is power—it can lead to evaluation, diagnosis, and treatment, if the disease is recognized.

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A fracture doesn’t always occur due to a significant event

In fact, osteoporotic fractures may happen as a result of a seemingly small movement or fall—even sneezing!4 There are different types of fractures, including vertebral (spine) and non-vertebral fractures, which are not related to the spine and occur in places such as the wrist, hip and upper arm. When a postmenopausal woman falls, has a fracture, and visits her healthcare provider, the healthcare provider should pay careful attention to whether that fall was from standing-height or less. If bones are healthy, a simple fall from a standing position or lower usually doesn’t result in a broken bone.1,4,5

Once an initial osteoporotic fracture occurs, the risk of another fracture is higher6,7

Postmenopausal women who have had a low-impact fracture are six times more likely to have another fracture within one year.7 Enduring an osteoporotic fracture and the risk of refracturing can impact a women’s day-to-day life, including her mobility and ability to remain independent. In cases where a woman has multiple compression fractures within the spine, she may experience height loss, back pain and a “dowager’s hump,” or curvature of the spine.8,9

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There’s more to the story than bone mineral density

A bone mineral density (BMD) test is the gold standard for evaluating bone health and diagnosing postmenopausal osteoporosis. The test measures the mineral content of bone—the lower the bone density, the greater the risk for fracture.10 While a BMD test is very important and is something we can measure, it is only one part of the picture since bone strength is made up of not only bone density (the amount of bone that is present), but also bone quality (the underlying structure of the bone). It’s possible for a postmenopausal woman who has suffered a fracture to be diagnosed with osteoporosis, regardless of her BMD score, known as a T-score. Both bone density and bone quality are determinants of overall bone strength. 10

Two women of the same age may have the same BMD score—but one may have had an osteoporotic fracture because the quality of her bone is comparatively worse. Certain fractures, such as hip fractures, can also point to postmenopausal osteoporosis, regardless of T-score.10

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There are risk factors that you can control and treatment options are available

While there are risk factors for postmenopausal osteoporosis that are out of one’s control (such as gender, age, ethnicity), there are some that can be controlled including:

  • Getting enough calcium and vitamin D; women over 50 should ensure they have at least 1,200 mg of calcium (preferably from food, but including supplements if needed) and 800-1,000 international units of vitamin D daily11
  • Exercising regularly, including weight bearing and muscle strengthening exercises12
  • Avoiding smoking cigarettes and too much alcohol consumption13

Even after that first fracture, healthcare providers can assist in finding a postmenopausal osteoporosis treatment to help lower the risk of having another one. Prescription treatment options for postmenopausal osteoporosis fall into two general categories: antiresorptives and anabolics. Antiresorptive treatment can help slow down the process of bone loss, helping the body to preserve existing bone.14 Anabolic treatment works by stimulating the body’s natural bone-building cells to form new bone and increase BMD.15-17 Both types of medications help to reduce fracture risk.

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TYMLOS® (abaloparatide) injection is an anabolic prescription medicine used to decrease the chance of having a fracture of the spine and other bones in postmenopausal women with thinning and weakening bones (osteoporosis), and to treat osteoporosis in postmenopausal women who are at high risk for bone fracture.18

TYMLOS may cause side effects, including feeling dizzy, low blood pressure and increasing calcium in your blood and urine. It may also cause serious side effects, including possible bone cancer, which was seen in animals; however, it is unknown if it will cause bone cancer in people and should only be taken for up to two years as directed by one’s healthcare provider.18

These are just five reasons postmenopausal women should start taking control of their bone health. Women should feel empowered to proactively start a conversation about their bone health with their healthcare providers and can visit TYMLOS.com for more information about this treatment option for postmenopausal osteoporosis in women at high risk for fracture.

Dr. Andrea Singer Disclosures:

Grant funding:

  • Radius Health
  • UCB

Consulting:

  • Agnovos
  • Amgen
  • Eli Lilly
  • Merit Medical
  • Radius Health
  • UCB

Speaker’s Bureau:

  • Amgen
  • Eli Lilly
  • Radius Health

INDICATIONS AND IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about TYMLOS?

TYMLOS may cause serious side effects including:

  • Possible bone cancer (osteosarcoma): During animal drug testing, TYMLOS caused some rats to develop a bone cancer called osteosarcoma. It is not known if people who take TYMLOS will have a higher chance of getting osteosarcoma.
    • Tell your healthcare provider right away if you have pain in your bones, pain in any areas of your body that does not go away, or any new or unusual lumps or swelling under your skin that is tender to touch.

Before you take TYMLOS, tell your healthcare provider about all of your medical conditions, including if you:

  • have Paget’s disease of the bone or other bone disease
  • have or have had cancer in your bones
  • have or have had radiation therapy involving your bones
  • have or have had too much calcium in your blood
  • have or have had too much of an enzyme called alkaline phosphatase in your blood
  • have or have had an increase in your parathyroid hormone (hyperparathyroidism)
  • will have trouble injecting yourself with the TYMLOS pen and do not have someone who can help you
  • are pregnant or plan to become pregnant. TYMLOS is not for pregnant women
  • are breastfeeding or plan to breastfeed. It is not known if TYMLOS passes into your breast milk. You and your healthcare provider should decide if you will take TYMLOS or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of TYMLOS?

TYMLOS can cause serious side effects including:

  • Decrease in blood pressure when you change positions: Some people may feel dizzy, have a faster heartbeat, or feel lightheaded soon after the TYMLOS injection is given. These symptoms generally go away within a few hours. Take your injections of TYMLOS in a place where you can sit or lie down right away if you get these symptoms. If your symptoms get worse or do not go away, stop taking TYMLOS and call your healthcare provider.
  • Increased blood calcium (hypercalcemia): TYMLOS can cause some people to have a higher blood calcium level than normal. Your healthcare provider may check your blood calcium before you start and during your treatment with TYMLOS. Tell your healthcare provider if you have nausea, vomiting, constipation, low energy, or muscle weakness. These may be signs there is too much calcium in your blood.
  • Increased urine calcium (hypercalciuria): TYMLOS can cause some people to have higher levels of calcium in their urine than normal. Increased calcium may also cause you to develop kidney stones (urolithiasis) in your kidneys, bladder or urinary tract. Tell your healthcare provider right away if you get any symptoms of kidney stones which may include pain in your lower back or lower stomach area, pain when you urinate, or blood in your urine.

The most common side effects of TYMLOS include:

  • dizziness
  • nausea
  • headache
  • fast heartbeat
  • feeling very tired (fatigue)
  • upper stomach pain
  • vertigo

These are not all the possible side effects of TYMLOS. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

  • If you take more TYMLOS than prescribed you may experience symptoms such as muscle weakness, low energy, headache, nausea, dizziness (especially when getting up after sitting for a while) and a faster heartbeat. Stop taking TYMLOS and call your healthcare provider right away.

What is TYMLOS?

TYMLOS is a prescription medicine used to:

  • decrease the chance of having a fracture of the spine and other bones in postmenopausal women with thinning and weakening bones (osteoporosis)
  • treat osteoporosis in postmenopausal women who are at high risk for bone fracture

It is not known if TYMLOS is safe and effective for children 18 years and younger.

It is not recommended that people use TYMLOS for more than two years during their lifetime.

TYMLOS should not be used in children and young adults whose bones are still growing.

Please see Full Prescribing Information, including Boxed Warning.

1Bone Health and Osteoporosis A Report of the Surgeon General. Department of Health and Human Services. 2004.

2Osteoporosis Prevention, Diagnosis and Therapy. JAMA. 2001;285(6): 785-795.

3Brenneman, RD. Osteoporosis the Silent Disease. The Journal of Lancaster General Hospital. 2016; 11(4): 112-116.

4National Osteoporosis Foundation. What is Osteoporosis and What Causes it? Available at https://www.nof.org/patients/what-is-osteoporosis/. Accessed April 8, 2019.

5Anderson P, Reitman C, et al. Own the Bone: Spine Practitioners’ Opportunity in Managing Patients with Fragility Fractures. Spineline. 2015.

6Lindsay R, Silverman SL. Risk of New Vertebral Fracture in the Year Following a Fracture. JAMA. 2001;285(3):320-323.

7Simonelli C, Chen Y, et al. Evaluation and Management of Osteoporosis Following Hospitalization for Low-Impact Fracture. J Gen Intern Med. 2003;18:17-22.

8NAMS continuing medical education activity. Menopause. 2010;17(1):23-24.

9Katzman W, Wanek L, et al Age-related hyperkyphosis: its causes, consequences, and management. J Orthop Sports Phys Ther. 2010;40(6):352-360.

10 Camacho PM, Petak SM, et al. American Association Of Clinical Endocrinologists And American College Of Endocrinology Clinical Practice Guidelines For The Diagnosis And Treatment Of Postmenopausal Osteoporosis — 2016. Endocrine Practice. 2016;22(4):1-42.

11 National Osteoporosis Foundation. Calcium/Vitamin D. Available at: https://www.nof.org/patients/treatment/calciumvitamin-d/. Accessed April 8, 2019.

12National Osteoporosis Foundation. Osteoporosis Exercise for Strong Bones. Available at:  https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/. Accessed April 8, 2019.

13National Osteoporosis Foundation. Are You at Risk? Available at:  https://www.nof.org/preventing-fractures/general-facts/bone-basics/are-you-at-risk/. Accessed April 8, 2019.

14Boyle WJ, Simonet WS, Lacey DL. Osteoclast differentiation and activation. Nature. 2003;423(6937):337 342.

15Baron R, Hesse E. Update on bone anabolics in osteoporosis treatment: rationale, current status, and perspectives. J Clin Endocrinol Metab. 2012;97(2):311-325.

16Girotra M, Rubin MR, Bilezikian JP. Anabolic agents for osteoporosis. What is their likely place in therapy? Treat Endocrinol. 2006;5(6):347-358.

17Khan AW, Khan A. Anabolic agents: a new chapter in the management of osteoporosis. J Obstet Gynaecol Can. 2006;28(2):136-141.

18 TYMLOS® [prescribing information]. Waltham, MA: Radius Health, Inc; 2018.

TYM-US-02554

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