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More bad news about bisphosphonate drugs for osteoporosis, which were bad enough to have readers write in about cases of erosive esophagitis and an incredible case of physician writing a case report (Jennifer Schneider MD, also a reader of this blog) about her own femoral fracture caused by getting out of her seat on a train while on alendronate. Well it looks like the medical community is starting to catch on as evidenced by a commentary in JAMA this week by Bridget Kuehn called “Long Term Risks of Bisphosphonates Probed” in which she highlights recent reports of increased risk of femoral fracture, atrial fibrillation, and esophageal cancer in women treated with bisphosphonate drugs like Fosamax and Boniva for osteoporosis, and points to the increasing awareness that treatment for longer than five years with these drugs probably worsens health outcomes. A recent study by Lane et al in 2009 showed that amongst a series of patients 37% of patients with subtrochanteric and femoral shaft fractures were on Fosamax (alendronate) compared to 11% of patients with hip or femoral neck fractures, indicating that long term treatment with this drug was associated with a specific type of fracture. As I have previously written about, these drugs turn off bone turnover and after five years make bones more brittle, not less. She also cited a letter to the New England Journal of Medicine by Diane Wysowski PhD of the FDA (old aquaintance from the Accutane wars) documenting 23 cases of esophageal cancer, with 8 deaths, in patients on bisphosphonates.
A terrible outcome of bisphosphonates of course is osteonecrosis of the jaw, which used to be called “Phossy jaw” cuz it was seen in match factory workers (the phosphorus in the matches got into the bone and turned off bone turnover), a condition so terrible it drove match factory workers to suicide. Nowadays we call it “Fossy jaw” in honor of our old friend, Fosamax (“Ladies Don’t Get Sucked Into the Bone Mineral Density Testing Rat Maze”).
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More Bad News on Bisphosphonates [e.g., Fosamax] and Fractures (BeforeYouTakeThatPill.com, 2/19/09) http://is.gd/k7Hs
Those who sold bisphosphonates, as well as calcitonin, et. al., would often do screenings in medical clinics and hospitals as well with bone density testing.
Sort of like a melting pot of front groups throughout the country.
Ugh, and so many women I know — women who are trying to “do the right thing” and take care of themselves — get sucked into this trap.
And they get it from doctors who have previously recommended they get their calcium from TUMS (a horrible way to get calcium, as the altered ph lessens uptake) and never mention magnesium.
So, some people will blame Big Pharma. But is Tums big pharma? And are Tums reps going into doctor’s offices? I just think these doctors just don’t understand the physiology. Moreover, they were given about 20 minutes of class time to discuss vitamins and minerals. No wonder most physicians think you can get all your nutrients from food.
[...] This post was mentioned on Twitter by Leslie Moon, Doug Bremner. Doug Bremner said: Bad news about #osteoporosis drugs #fosamax #osteonecrosis http://bit.ly/bstb86 [...]
I tried to tell one of my docs just last month why I had taken myself off my Boniva and he looked at me like I was nuts. How dare a patient read the literature and evaluate a course of treatment for herself?!