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May is <\/em><\/em>Osteoporosis Awareness and Prevention Month<\/em><\/em><\/a>. <\/p>\n Ben Swanson is a dentist by trade, but bone health has his heart. <\/p>\n As the CEO and co-founder of the drug development company Skeletalis<\/a>, Swanson and his team are developing a bone-targeted technology that will protect and rebuild bone in people with musculoskeletal diseases like osteoporosis<\/a>. <\/p>\n \u201cThe core logic behind what we’re doing is taking musculoskeletal skeletal health broadly into the era of precision medicine that we’ve seen across a number of other diseases,\u201d Swanson said. \u201cWith a biology-focused approach to understanding how the disease happens, we\u2019re designing a platform that enables us to get drugs there in a very targeted way, and the end result is we create drugs and therapies that enable freedom from fractures.\u201d<\/p>\n And this is really important because most people don\u2019t even know they have the bone disease until a fracture or break happens. And about 1 in 3 women over 50 will fracture a bone because of osteoporosis<\/a>. <\/p>\n \u201cBone disease hides in plain sight. It doesn’t often hurt, but it is a disease \u2014 and fractures are something that affects everyone. Everybody has a family member or someone they’re close to who has suffered from a fracture, and the consequences are tremendous,\u201d Swanson said. \u201cIt could be a life-ending event, and we don’t really have therapies that have kept up with the rest of science.\u201d<\/p>\n We talked with Swanson about the need for advancements in treatment options for osteoporosis, the pros of precision therapy and how biotechnology is changing the way we treat bone disease. <\/p>\n This interview has been edited for clarity and length.<\/em><\/em><\/p>\n HealthyWomen: As co-founder of Skeletalis, what was your inspiration to start a company that focuses on treating musculoskeletal diseases? <\/strong><\/p>\n Ben Swanson: <\/strong>I think my inspiration was really the fascination with the idea that bone is an organ that is constantly remodeling \u2014 it’s constantly changing and adapting. And as someone who was studying bone treatments, it became clear there was a tremendous opportunity to make a drug that’s more specific and precise to musculoskeletal diseases like osteoporosis, given that it impacts so many people.<\/p>\n The idea is that, if you can get a drug to the place where the disease happens on the skeleton, on the physical surface of the skeleton, you may be able to improve both the efficacy and the ability to treat disease and reduce unwanted side effects.<\/p>\n HW:<\/strong> Advancements in treatment options for osteoporosis haven\u2019t seen the same level of innovation as other areas of medicine. Why has progress been slower regarding treatments for osteoporosis and bone health?<\/strong><\/p>\n Swanson: <\/strong>Osteoporosis is not a disease where we can see a change in a simple blood test, like lowering cholesterol. We can’t measure a tumor changing shape or survival necessarily. We’re trying to prove strength and reduce fractures, but fractures are not happening every day, and in fact, fractures are the failure of treatment, and we don’t study a lot of other drugs in terms of their failure. <\/p>\n Research has been historically slow in this field because of the requirement to have long clinical trials, and one of the things that we are very excited about in osteoporosis is a recent change in the regulatory framework called the SABRE initiative<\/a>, which has made trials much faster and cheaper and really opens the doors to modern development. <\/p>\n The other thing that\u2019s really important here is that, historically, osteoporosis therapies work by shutting down the bone. With recent advances in our understanding of why bone degenerative diseases happen and how we go from normal maintenance mode into some degenerative or imbalance mode, we can design much more precise therapies. For the first time, we have that combination of exciting new science and new understanding of why these diseases happen and the regulatory environment that enables us as a small company to make a meaningful difference. <\/p>\n HW: Tell us how the company\u2019s Osteoclast-Activated Skeletal Intervention System (OASIS) approach is different from traditional osteoporosis treatments. <\/strong> <\/p>\n Swanson: <\/strong>If we think about traditional drugs \u2014 and that could be any drug \u2014 they often affect the whole body, so it requires more of the drug and there’s exposure to other sites. The way we think about treatment with our OASIS technology is to localize therapy in a precise and thoughtful way in the skeleton and to the places where osteoclasts \u2014 the cells that are responsible for osteoporosis \u2014 are actually forming.<\/p>\n We think about this not just as an osteoporosis medication but really as a platform technology for precision skeletal medicines across diseases. We see a tremendous opportunity across a woman’s lifespan as different skeletal diseases manifest and all of those require safety in a precise or targeted approach. <\/p>\n HW: What role does screening play in the prevention of bone loss before fractures occur?<\/strong> <\/p>\n Swanson: <\/strong>Fractures are the failure of the skeleton, and for many people fractures are the beginning of the end. Some people will die within the first year of their fracture, and an overwhelming number of patients will never return home. It\u2019s a tremendous cost burden \u2014 we’re taking people out of their communities, out of their families, out of their jobs. The biggest opportunity that we see is to prevent that first fracture from ever happening. <\/p>\n We have the opportunity as a clinical community to shift osteoporosis care from reactive treatment to prevention and thinking about how we stop or reverse the disease before entering that fracture cascade because after the first fracture the likelihood of the second is even higher.<\/p>\n We also have to make screening available to women earlier and more often. If we’re only looking at late stages to someone who’s 10 to 15 years beyond menopause<\/a>, we can only intervene at that time, so we have to be thinking about earlier screening and earlier detection awareness to empower patients to be asking for these things. That really is what will enable prevention, but it also becomes a normal part of perimenopause or even premenopause. <\/p>\n HW: Some women are hesitant to take existing osteoporosis medications because of potential side effects. How might the next generation of therapies improve safety and confidence in treatment?<\/strong> <\/p>\n Swanson: <\/strong>When we think about a safe and effective drug, the ideal is a drug that’s more precise \u2014 the side effects of many of the current medications are largely due to the lack of precision both to the disease process and to the tissue. <\/p>\n The next generation of drugs have to be designed for real world use and in the journey that these patients will face. What that looks like is therapies that are easier to stay on \u2014 they fit into your normal lifestyle, they’re suitable for long-term care and avoid complications. <\/p>\n When we think about a new therapy for a patient, it’s not just a matter of making sure it works \u2014 that of course matters \u2014 but it\u2019s also about ensuring that they can live with the treatment over a long period of time and that it will make a meaningful difference for the rest of their healthy years.<\/p>\n HW: Bone density testing and treatment are underutilized. What are your thoughts on the changes that need to be made to improve access to these services for women?<\/strong><\/p>\n Swanson: <\/strong>Osteoporosis, unfortunately, is still mainly diagnosed in the emergency room at a time when you\u2019re not thinking about chronic disease management. And emergency medicine healthcare providers are not able to manage you long-term, so care becomes very fragmented for patients. <\/p>\n Bone health needs to move much earlier in the care conversation as a part of team prevention. I would liken it to the changes that we’ve made in diagnosing breast cancer with earlier mammograms. Bone health has to be treated as mainstream healthcare. <\/p>\n