Bisphosphonates: All good things come to an end

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.