EU agency starts safety probe of common bone drugs
Novartis Hid Bone Drug's Risks, Lawyer Tells Jury
It was too good to last. When Merck came out with Fosamax in 1995, I had just finished my training and taken up my first real job in Dallas. I remember reading the ground breaking article published in the New England Journal of Medicine in November of 1995 [N Engl J Med 1995; 333:1437-1444] and my reaction was - "this will change everything". It was the first real treatment for Osteoporosis. Osteoporosis, Bone Density Testing, Fosamax, Actonel, Boniva...have become familiar words over the last decade, thanks to the massive educational and marketing effort that followed. Osteoporosis is now a billion dollar industry, not just a 'silent epidemic'. But, drugs that make huge profits cannot last long in this market. So now more new drugs are entering the market. And they have to destroy the older generic drugs to make room for themselves. Suddenly, the bisphosphonates are not safe anymore! They are causing the "jaw-rotting disease"!!, they are causing more hip fractures!!! All non-sense. You wish that the lay press would stop exaggerating these reports.
No, the bisphosphonates will not make your jaw bone melt away. Osteonecrosis of the jaw bone is a rare complication seen predominantly in cancer patients after a tooth extraction. These are people on chemotherapy getting massive doses of bisphophonates to protect their bones from the spreading cancer. You are more likely to be hit by a UFO...
And NO, bisphosphonates do not increase the risk of hip fractures. They DECREASE the risk of hip fractures, even after long term use. The one report that was highlighted in the media was about a small series of patients who had taken Alendronate for more than 5 years, and experienced an uncommon variety of hip fracture more frequently than what is expected in the normal population. What the media failed to report was another report of a larger series of patients showing no such increase in the risk of this uncommon variety of hip fracture. And what they really failed to tell us was that these drugs clearly protect us from the common type of hip fracture.
Moral of the story: Don't get your medical information from the news man. Ask me.
Monday, September 27, 2010
Saturday, September 18, 2010
Glucosamine and Chondroitin have no effect ? Again?
Researchers Claim Arthritis Supplements Have No Effect
Another article trashing Glucosamine and Chondroitin. This time from Switzerland - the motherland of Cheese, Chocolates and Banks.
"Health authorities and health insurers should not cover the costs for these preparations, and new prescriptions to patients who have not received treatment should be discouraged," Peter Juni of the University of Bern, whose study was published in the British Medical Journal on Friday, told Reuters [BMJ 2010; 341:c4675 doi: 10.1136/bmj.c4675 (Published 16 September 2010)].
Yes, that is true and has been said before, but...ask the people who take it and benefit from it. It has changed their lives. And no side effects.
Q: So where is the disconnect?
A: When a scientific article claims something is ineffective, it is like saying - "Most humans cannot fit into a size 7 shoe" . Yes, that is true, but what they fail to elaborate is that the average human shoe size is 7 and there are plenty of people who can wear a size 7 shoe perfectly well. They may well be in the minority because majority of humans may have feet bigger or smaller than size 7. So shall we stop making size 7 shoes? That is exactly what the Swiss researchers in the article above are suggesting.
Glucosamine and Chondroitin, like many other remedies, work amazingly well for some folks and do nothing for others. All you can do is try. Take it for 2 months. If it works, keep taking it. If it doesn't work, move on.
By the way, there is one other industry that Switzerland tops the world markets in - world's two biggest pharmaceutical giants, that just happen to be Swiss also - Novartis and Roche - both very active in making arthritis drugs. Wonder if the $2 billion market of Glucosamine/Chondroitin is hurting their bottom line!
Another article trashing Glucosamine and Chondroitin. This time from Switzerland - the motherland of Cheese, Chocolates and Banks.
"Health authorities and health insurers should not cover the costs for these preparations, and new prescriptions to patients who have not received treatment should be discouraged," Peter Juni of the University of Bern, whose study was published in the British Medical Journal on Friday, told Reuters [BMJ 2010; 341:c4675 doi: 10.1136/bmj.c4675 (Published 16 September 2010)].
Yes, that is true and has been said before, but...ask the people who take it and benefit from it. It has changed their lives. And no side effects.
Q: So where is the disconnect?
A: When a scientific article claims something is ineffective, it is like saying - "Most humans cannot fit into a size 7 shoe" . Yes, that is true, but what they fail to elaborate is that the average human shoe size is 7 and there are plenty of people who can wear a size 7 shoe perfectly well. They may well be in the minority because majority of humans may have feet bigger or smaller than size 7. So shall we stop making size 7 shoes? That is exactly what the Swiss researchers in the article above are suggesting.
Glucosamine and Chondroitin, like many other remedies, work amazingly well for some folks and do nothing for others. All you can do is try. Take it for 2 months. If it works, keep taking it. If it doesn't work, move on.
By the way, there is one other industry that Switzerland tops the world markets in - world's two biggest pharmaceutical giants, that just happen to be Swiss also - Novartis and Roche - both very active in making arthritis drugs. Wonder if the $2 billion market of Glucosamine/Chondroitin is hurting their bottom line!
Wednesday, September 15, 2010
Krystexxa (pegloticase) Approved For Treatment Of Gout
Your joints may be hot, but Gout is cool! Finally, the drug industry has made inroads into the Gout market. Of all the ailments we see in Rheumatology, Gout is the easiest to treat and unfortunately the easiest to screw up. It is good to have another new drug for Gout, but don't go running to your doctor asking for this one just yet. Very very few patients will truly need Pegloticase. The rest will be over-diagnosed and over-treated, as usual. And the ones who truly need it will not, as usual.
Monday, September 13, 2010
Welcome!
When it comes to Arthritis and associated conditions there is more noise and less information on the web. And then there is the "ask your doctor" disclaimer on everything. Well here is the no noise, facts only, blog - answers from your arthritis doctor. Stay tuned...and ask me. What's on your mind? Sorry, So what's in your 'joints'?
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