Nitroglycerin Ointment Modestly Raises BMD

“The possibility that different preparations, doses, or schedules of administration would reduce the frequency of headaches without diminishing the effects on bone should be explored in future studies,” the researchers said.

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Next Step: Assess Fracture Rate

When added to previous research, the findings reported by Dr. Jamal and her associates suggest that nitroglycerin both inhibits bone resorption and stimulates bone formation, which no single drug can do. These results “should set the stage for an adequately powered, larger study using nitroglycerin ointment, with fracture as an outcome,” said Dr. Sundeep Khosla.

“If such a study demonstrates efficacy for reducing fractures, clinicians would have a novel and inexpensive therapy for osteoporosis.”

The results of the current study also should spur development of other agents that act as nitric oxide donors, preferably drugs with better adverse effect profiles that don't cause so many headaches.

Future research also should report data on any blood pressure changes associated with nitroglycerin therapy, which Dr. Jamal and her associates did not report on, he added.

DR. KHOSLA is in the endocrine research unit at the Mayo Clinic, Rochester, Minn. He reported serving on a scientific advisory board for Amgen. These remarks were taken from his editorial accompanying Dr. Jamal's report (JAMA 2011;305:826-7).