BONE FUNCTION  

The human skeleton is composed of bones that have several functions, the main ones being: support, protection, movement, mineral storage, blood cell synthesis and lipid storage. The muscles that are attached to the bones by tendons allow us to move different parts of the body in order to accomplish our daily tasks and to move around in our environment.

The rigid structure of the bones is essential in order to accomplish our various tasks; in conjunction with the muscles, the rigidity of the bones facilitates movement and allows us to support our body or simply to stand upright. The rigidity of the bones also has the function of protecting the internal organs and facilitates the movement of these organs such as the lungs, genitals, nervous tissue, etc. Bones are involved in blood cell formation, calcium metabolism, and mineral storage.


The rigidity of bones depends mainly on two tissue layers. A compact outer layer that is smooth and dense and dense and a spongy inner layer with a honeycomb structure and trabeculae. Of the people who suffer a hip fracture due to osteoporosis will die within 12 months of that fracture.


The bone is also covered by a double membrane called the periosteum, which is rich in neurofibers, lymphatic and blood vessels. The inner membrane of the periosteum contains several cells responsible for its rigidity.

Bone tissue is a metabolically active tissue that is continually in a state of degradation and reconstruction. It is the balance between these two processes that ensures its health.

  OSTEOPOROSIS  


Osteoporosis is a disease in which osteoclasts are much more active than osteoblasts, making bones more fragile and more prone to fracture. In fact, people with osteoporosis have thinner bones and a more porous spongy layer, which increases the likelihood of fractures.


Osteoporosis is a silent disease that gradually reduces bone density and quality. Over the years, they gradually become weaker. Meanwhile, the disease remains undetected since in most cases, no symptoms are identified until the first fracture occurs.

  OSTEOPOROSIS: FACTS  

Osteoporosis is a very serious disease; it is more common than stroke heart attacks and breast cancer combined. Osteoporosis is often related to age and decreases in ovarian activity, which leads to a decrease in estrogen levels. Other factors are also linked to the onset of osteoporosis, including certain cancers and the likelihood of being prescribed specific medications. Tragically, some people afflicted with hip fractures caused by osteoporosis succumb within a year of the fracture.

The seriousness of this problem is underlined by the statistics on hip fractures. A quarter of those who undergo surgery for a hip fracture face mortality within twelve months. Three out of four who choose not to undergo surgery face an equally grim fate within the same timeframe. 

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Osteoporosis is a serious disease. It affects more than 2 million people in Canada and 200 million worldwide. The disease costs the healthcare system more than $2.3 billion in Canada and nearly $500 US billion worldwide. A silent disease, osteoporosis is more common than stroke, heart attack, breast cancer and cancer combined.

Osteoporosis is a prevalent disease, particularly affecting women after menopause, with one in three women experiencing an osteoporotic fracture after the age of 50. However, men are not exempt, as one in four men over 55 will also suffer such fractures. The consequences are severe, with 20-30% of individuals with hip fractures dying within a year. As the population ages, the risk of fracture will double in the next 20 years, emphasizing the urgency of addressing this issue.

Osteoporosis is characterized by decreased bone mineral density, rendering bones brittle and highly susceptible to fractures. The classical form of the disease is most common in individuals over 50 and is influenced by factors like genetics, lack of exercise, smoking, alcoholism, poor diet, and certain medications. Fractures in the wrist, hip, and spine are common and significantly impact quality of life, leading to chronic pain, disability, and loss of independence.

Addressing osteoporosis is crucial due to its widespread impact and mortality risks associated with fractures. Strategies must be implemented to improve prevention, diagnosis, and treatment to reduce the burden of this debilitating disease.

  OSTEOPOROSIS AND CHRONIC KIDNEY DISEASE (CKD)  

The situation is even worse for people with osteoporosis related to severe chronic kidney disease. In these cases, the mortality rate from hip fractures is alarming (as high as 70%), underscoring the need for rapid intervention and concrete solutions.


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People with chronic kidney disease (CKD) are at increased risk of osteoporosis due to several factors.

Osteoporosis and chronic kidney disease (CKD) are two distinct medical conditions, but there is a close relationship between them. People with chronic kidney disease (CKD) are at increased risk of osteoporosis.

Chronic kidney disease can affect bone health in several ways, which can lead to the development of osteoporosis in patients with CKD.

Here are some of the factors that contribute to this association:

  1. Hormone imbalance: The kidneys play a crucial role in regulating hormone levels in the body. In CKD, the kidneys do not function properly, which can disrupt hormonal balance, including hormones involved in regulating bone metabolism. For example, the production of parathyroid hormone (PTH), which is essential for maintaining calcium balance in the body, can be disrupted. High levels of PTH can lead to increased bone degradation.
  2. Deregulation of calcium and phosphate metabolism: The kidneys play a key role in eliminating waste and maintaining the balance of minerals, such as calcium and phosphate. In CKD, this regulation can be impaired, leading to increased phosphate levels in the blood and decreased calcium levels. This can contribute to bone demineralization and osteoporosis.
  3. Metabolic acidosis: In CKD, the kidneys are not able to effectively eliminate acids produced by the body's metabolism. This can lead to metabolic acidosis, a condition where the pH of the blood becomes acidic. Metabolic acidosis can also contribute to bone loss and osteoporosis.
  4. Medications and treatments: Medications used to treat CKD, such as corticosteroids or some immunosuppressive drugs, can also affect bone health and increase the risk of osteoporosis.

As with patients with classical osteoporosis, it is important to take steps to prevent and treat osteoporosis in patients with CKD. This may include:

  • A balanced diet rich in calcium and vitamin D to maintain bone health.
  • Regular physical activity, including muscle-strengthening exercises and weight-bearing exercises, to promote bone density.
  • The use of specific medications for osteoporosis, such as bisphosphonates, when appropriate and under the supervision of a healthcare professional.
  • Regular monitoring of bone density through tests such as bone densitometry.
  • Proper management of CKD, including control of hormonal imbalances and blood calcium and phosphate levels.

In some cases, medications used to treat osteoporosis may be contraindicated in people with chronic kidney disease (CKD) because of their impact on kidney function. Some drug classes may require dose adjustments or close monitoring in patients with CKD.

  1. Bisphosphonates: Bisphosphonates are commonly used to treat osteoporosis, but they can build up in the kidneys and cause kidney toxicity in people with CKD. Oral bisphosphonates, such as alendronate and risedronate, are generally avoided in patients with severe CKD.
  2. Denosumab: Denosumab is an injectable medication used to treat osteoporosis. It is not metabolised by the kidneys and can lead to hypocalcaemia (low levels of calcium in the blood), which can be problematic in patients with CKD.
  3. Hormonal therapy: Estrogen-based hormone therapy is often used to treat osteoporosis in postmenopausal women, but it can increase the risk of blood clots in patients with CKD. The decision whether to use hormone therapy should be made with caution, taking into account the potential benefits and individual risks.
  4. Calcimimetics: Calcimimetics, such as cinacalcet, are used to treat calcium metabolism disorders in patients with CKD. They may help reduce high levels of calcium in the blood, but their use in people with osteoporosis and CKD should be evaluated with caution due to the complex interactions between calcium and bone metabolism.

It is crucial that patients with CKD consult with a nephrologist and rheumatologist to assess their condition, discuss treatment options, and decide on the most appropriate osteoporosis management plan. Treatment recommendations will be personalized based on the severity of CKD, individual medical history, and risk factors specific to each patient.

According to our KOLs (key opinion leaders) and scientific advisors, OSTAAT™ low-intensity electrical stimulation technology may indeed be a promising approach to stimulate bone growth and help reduce the risk of fractures in people with osteoporosis, including those with chronic kidney disease, for whom medication is contraindicated.

The advantages of OSTAAT™ technology include the absence of systemic side effects and the possibility of using it in conjunction with other drug treatments for osteoporosis. OSTAAT™ will address an unmet need in medicine.

  MEDICATION AND SIDE EFFECTS   


Osteoporosis is also associated with an increased risk of death. Complications associated with osteoporotic fractures, such as infections and blood clots, can be fatal. In addition, osteoporosis can also lead to a reduction in the size and curvature of the spine, which can result in compression of internal organs.

These pills are also very complicated to take (taken on an empty stomach and at least 30 minutes before a meal, standing or sitting and not lying down). The patient cannot take other medications a few hours before or half an hour after, some medications require walking for a while after taking the pill, etc.

For all these reasons, 25% of patients diagnosed with osteoporosis refuse to start the treatment recommended by their doctors. In addition, 52% of patients who start treatment drop out within the first 24 months. This means that overall, 64% of the population diagnosed with osteoporosis is not receiving treatment. This huge market is all up to us to take, in addition to the other 36% taking medications that could switch to our option.

For people with osteoporosis associated with severe chronic kidney disease, there are no drugs available in pharmacies that can treat the disease, as their use is currently contraindicated. This is a serious problem not solved by medicine that OSTAAT™ technology aims to solve.

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Here are some of the most common side effects of bisphosphonates:

  1. Gastrointestinal irritation: Bisphosphonates can cause abdominal pain, nausea, vomiting and diarrhea.
  2. Esophageal ulcers: Bisphosphonates may cause esophageal ulcers, which are painful lesions in the lining of the esophagus.
  3. Osteonecrosis of the jaw: Bisphosphonates can cause osteonecrosis of the jaw, a rare but serious condition that can lead to the death of jaw tissue.
  4. Atypical fractures: Bisphosphonates may increase the risk of atypical fractures, which are unusual fractures that occur without obvious trauma.
  5. Myalgia (muscle pain): Bisphosphonates can cause muscle pain, cramps, and weakness.
  6. Allergic reactions: Bisphosphonates may cause allergic reactions, such as skin rashes, itching and breathing difficulties.
  7. Visual disturbances: Bisphosphonates may cause visual disturbances such as eye pain, redness, swelling and blurred vision.

It is important to note that not all patients experience these side effects, and that side effects may vary according to dose, duration of treatment and other individual factors. If you are taking bisphosphonates to treat osteoporosis, it is important to discuss your concerns with your doctor and to carefully monitor any potential side effects.