Odanacatib
Withdrawn or never marketedMeasured in people, not heightBy mouthSmall moleculeAlso MK-0822
A pill that blocks the enzyme an osteoclast uses to cut the collagen out of bone. In 16,071 older women it roughly halved spine and hip fractures. It was never approved anywhere, and the company that made it dropped it.
An oral, selective inhibitor of cathepsin K, the lysosomal cysteine protease an osteoclast secretes into the sealed resorption lacuna to cut collagen. It lowers resorption while bone formation carries on. Merck took it to a 16,071-patient fracture trial in postmenopausal women aged 65 and over, where it met every endpoint: radiographic vertebral fractures 4.9% against 9.6%, hip 1.1% against 2.0%, non-vertebral 6.4% against 8.4%, all p<0.0001. No regulator anywhere approved it.
Risks. Strokes were more common on the drug than on placebo, 2.3% against 1.7%, and so were heart deaths, heart attacks and strokes counted together. No child was ever given it, and children born without this enzyme are short.
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