Taking osteoporosis meds? WATCH OUT for any new aches and pains


A recent scientific report confirms concerns raised by NWHN two years ago that long-term use of certain types of osteoporosis drugs increases the risk of fractures in the thigh bone.  The fractures are associated with long-term use of bisphosphonates, which are sold under the brand names Actonel, Aredia, Boniva, Didronel, Fosamax, Reclast, Skelid and Zometa.  According to the American Society of Bone and Mineral Research, which issued the new report, women currently taking any of these drugs who experience new or unexplained pain in the thigh or groin should have a physical exam and x-rays to look for possible fractures.   More than half of women who experienced a fracture of the thigh reported noticing pain in that part of their body before the fracture actually occurred.  

The report reviewed over 300 cases of fractures of the thigh bone, also called atypical femur fractures, and found that 94% of the patients had taken bisphosphonates, for an average of seven years each.  This evidence strongly suggests, but does not conclusively prove, that long-term use of bisphosphonates increases the risk of fractures of the thigh.  Given the severity of these fractures, and the benefit to women of avoiding unnecessary risk, the Society recommends that women who are not at high risk for osteoporosis avoid long-term use of bisphosphonates.  This advice reinforces NWHN's previous messages to women warning about the overuse of osteoporosis medications.

What can women do to make sure they're making the right decision for themselves?  Here's what NWHN recommends.  Don't have a bone density screening test done before age 65 unless you're at unusually high risk for fractures either because of your family history, or your personal medical history.  If the time has come for you to get a test, and you're told that you have low bone density, ask for more information before accepting a prescription.  Find out exactly what your bone density score is, and make sure the score for your hip is reported separately.  The Society recommends that women whose hip scores are good not take bisphosphonates, even if their spine scores are moderately low.  If you've been taking bisphosphonates for more than five years, talk with your clinician about stopping altogether, or taking a drug holiday.  The FDA has approved these drugs to be used for three to five years, and clinical trials looking at usage over longer periods of time haven't always shown a clear benefit.  

In response to the Society's report, the FDA issued a statement announcing that it is conducting a review of all long-term data on bisphosphonates and is considering requiring manufacturers to update the information they provide to consumers and clinicians about the risks and proper use of these drugs.  NWHN will continue monitoring the safety and effectiveness of osteoporosis medicines, as we have for many years, and will update women as new information becomes available.

For more information about the report and the FDA's response click here.

For NWHN's fact sheet on Osteoporosis, click here.