One reason is that the statistical calculations are complex and highly manipulated making them difficult to understand. Another is that the subjects included in the drug studies are generally highly-selected and may not represent “real-world” populations.
Recently scientists took an important step to help us separate hype from reality in regard to the benefits of bone drugs.
Researchers asked if “real-world” patients taking bone drugs received the same fracture-reduction benefits seen in the clinical trials. After analysis of hundreds of studies, they found that highly compliant, “real world” patients on osteoporosis drugs experienced a 21% reduction in all clinical fractures. This compares to the 24% overall clinical fracture reduction experienced by subjects in osteoporosis drug clinical trials.
What a different messages than we often hear — such as how bone drugs reduce your chance of fracture by 50%! Or have you ever been told that the fracture reduction on bone drugs is really more like 21-24%? That is — if you use the drug faithfully.
Now compare this 21-24% fracture-reduction benefit from bone drugs to the studies documenting that those taking vitamin D in any dose (much less a therapeutic dose) experience a 23-26% reduction in fractures. It seems to me that the bang from osteoporosis drugs isn’t quite as big as we’ve been led to believe.
As your bone health advocate, I congratulate these researchers on the enormous effort to analyze and synthesize data from hundreds of studies. I also congratulate the drug company which funded this study for clarifying the real fracture/reduction benefit of today’s bone drugs.
Wilkes, et al. 2010. “Bisphosphonates and osteoporotic fractures: a cross-design synthesis of results among compliant/persistent postmenopausal women in clinical practice versus randomized controlled trials.” Osteoporosis International 21:679-688
Bischoff-Ferrari, HA et al. 2005. Fracture prevention with vitamin D supplementation: A meta-analysis of randomized controlled trials. JAMA, 293(18): 2257-2264
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