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How big is the bang from osteoporosis drugs?

From Susan Brown, PhD


Answering the question “how big is the bang from osteoporosis drugs?” can be quite challenging.
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.

References:
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

The Week in Bone Health | How big is the bang from osteoporosis drugs?

Selections from Natural Health News

Sep 06, 2011
The osteoporosis drug zoledronic acid (Reclast) should not be used in patients with significant renal impairment, and physicians should screen patients for kidney dysfunction before starting them on the drug, the FDA said. 
Aug 16, 2009
Another Big PhARMA fiasco, as all the current osteoporosis drugs seem to be. Of course you don’t hear too much about their fluoride content and how this damages the thyroid and bone health, but then how would they mask 
Oct 02, 2009
Osteoporosis drug Forteo linked with bone cancer. BLACK BOX WARNING FOR FORTEO, a gentically engineered pharmaceutical. POTENTIAL RISK OF OSTEOSARCOMA: In male and female rats, teriparatide caused an 
Jan 24, 2009
***Just remember that as bone density leads to brittle bones and fracture, so do the prescription osteoporosis drugs.  Part of this missing link is the bone-damaging impact from many non-osteoporosis drugs. Another is that 
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