Thursday, March 20, 2008

Sham: Long Term Use of Osteoporosis Drugs Starting to Show Hidden Danger

New research has shown that long-term use of the osteoporosis drug Fosamax may weaken the bones in a group of people taking the drug. Unfortunately, scientists have not yet discovered how to determine who will be affected by these drugs that are meant to strengthen bones instead of weakening them further.

This unusual side effect results in some patients suffering broken legs after minor falls. It's likely that other drugs in the same class as Fosamax may have the same potential side effect. It is now showing up in a small number of patients who have taken Fosamax for more than five years.

Joseph M. Lane, MD, chief of the metabolic bone disease service at New York/Presbyterian Hospital reports 15 cases of unusual bone fractures in postmenopausal women who had been taking Fosamax for more than five years. All had fractures along the length of the femur, the long bone in the thigh, after falls. This side effect was noted in a letter to the March 20 issue of The New England Journal of Medicine.

This problem appears to lead to a distinct and very unusual fracture pattern. A number of the patients that Lane and his colleagues from Weill-Cornell Medical College reported on had been taking Fosamax for more than seven years; the other five patients averaged less than three years of Fosamax use.

Prolonged use of these drugs, classified as bisphosphonates, may lead to this unusual fracture pattern as a side effect. Other bisphosphonates include Aredia, Didronel, Skelid, and Zometa. Fosamax is the only one in which problems have been seen so far, most likely because it was first to market in this category of drug.

Dave

1 comment:

Jeffrey Dach MD said...

Questioning Bisphosphonates

There are obvious similarities between bisphosphonate adverse side effects and the genetic disease, Pycnodysostosis, namely Jaw Necrosis, Phossy Jaw, spontaneous femur fracture, and severe bone pain.

Pycnodysostosis was Toulous Lautrec’s genetic disease, causing a cathepsin K deficiency in the osteoclasts, which are the bone cells resposible for bone resorption. Similarly, the mechanism of bisphosphonates is to impair the osteoclasts.

Are the bisphosphonate drugs creating a population of women with Toulous Lautrec's Bone Disease?

Increased Fracture Rates

The fracture rates for women with osteopenia (T greater than -2.5) actually increases for women on bisphosphonates. Cummings JAMA 1998 (FIT) Fracture Intervention Trial.

The following is a quote from John Abramson's book, Overdosed America from: Excerpts From Overdosed America Chapter 13

"What about using these drugs to prevent osteoporosis? The study of Fosamax published in JAMA in 1998 also included women with osteopenia. Did Fosamax reduce their risk of fracture? The results show that the risk of hip fractures actually went up 84 percent with Fosamax treatment. The risk of wrist fractures increased by about 50 percent." JAMA.1998;280:2077-2082.Cummings. Quote attributed to John Abramson MD.

Sally Field and the Boniva Ads

Does Sally Field know that her Boniva commercials target millions of women with Osteopenia who will have INCREASED fractures from the drug? Does Sally know that the FDA released an alert warning of severe bone pain ? Does Sally Field know about Osteonecrosis of the jaw from the drug? Does Sally know there are three separate reports of spontaneous mid femur fractures in menopausal women on fosamax (Odvina, Goh and Lane)?

Perhaps John Dingell's Committee will ask Sally Field this and other questions.

Bisphosphonates for Osteoporosis, A Closer Look at the Data by Jeffrey Dach MD

Fosamax, Actonel, Osteoporosis and Toulouse Lautrec by Jeffrey Dach M.D.

Jeffrey Dach MD
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