Veverimer to Decrease Net Acid Excretion and Bone Resorption in Adults With Osteopenia

Inclusion criteria

• Community dwelling adults age 50 years and older (approximately equal numbers of men and women).
• Men should be sterile or agree to use contraception throughout the study.
• Women must be postmenopausal, defined as no menses in the last 5 years (to reduce variability in change in bone resorption since menopause prompts a rapid increase in bone resorption).
• Osteopenia will be defined as a bone mineral density (BMD) T-score at the lumbar spine, femoral neck, or total hip lower than -1 or higher than -2.5.
• On a prescreening interview, candidates must report a usual diet associated with an acid load by our validated short questionnaire.
• Estimated glomerular filtration rate (eGFR) must be 45 ml/min or greater.
• Participants must agree not to change their exercise pattern or medication use during the study.
• Participants must agree not to change their pattern of supplement use and not to use antacids during the study because most calcium supplements and other antacids add alkali.
• Participants must agree to not change their eating habits or intentionally change their weight.

Exclusion criteria

• Normal BMD T-scores at all spine and hip sites, osteoporosis based on BMD T-score of -2.5 or less
• Respiratory illness in last month
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Nausea/vomiting in last month
• Dysphagia
• Malabsorption
• Inflammatory bowel disease
• Chronic diarrhea (defined as loose bowel movements daily) or constipation (≤ 2 stools per week)
• Insulin-requiring diabetes or fasting plasma glucose >125 mg/dl
• Untreated thyroid disease
• Cirrhosis
• Current unstable heart disease
• Malignancy (except non-melanoma skin cancer) or cancer therapy in last year
• Alcohol use >2 drinks/day.
• Individuals who are unable to provide informed consent due to cognitive impairment.