NEW YORK (Reuters Health) Feb 21 - This month, Australian researchers published the latest report to hint that elderly women who take bisphosphonates live longer than those who don't get treatment.
Out of every hundred women in their prospective cohort study, three who were not taking bisphosphonates died every year, compared to less than one of those who were on the drugs.
The findings don't prove bisphosphonates actually boost longevity -- it's possible that women on treatment are generally healthier, for instance - but they do agree with earlier studies.
Last year, the U.S. Food and Drug Administration warned that the medications might raise the risk of atypical thigh fracture, and there have also been reports of osteonecrosis of the jaw.
After Australian national television reported on that side effect in December 2007, prescription rates for the bone drugs dropped sharply, leading to an estimated 130 extra fractures and 14 deaths over the following nine months, according to one study.
"The bad news is that overstating the levels of risk of side effects with these drugs -- which the media have been doing for some time now -- has led people to stop the drugs when they should be taking them," said Dr. Ethel S. Siris, who heads the Toni Stabile Osteoporosis Center at Columbia University in New York and was not involved in the study. Dr. Siris is also past president of the National Osteoporosis Foundation.
Experts hope the new survival findings may help reestablish confidence in the drugs.
Led by Dr. John A. Eisman of the Garvan Institute of Medical Research in Sydney, the researchers tapped into an ongoing study following elderly people in a small Australian city.
They grouped more than 2,000 people according to three kinds of drugs - bisphosphonates, hormone replacement therapy or calcium supplements with or without vitamin D.
Over about 15 years of follow-up time, 466 women and 400 men died. After accounting for several health factors, women on bisphosphonates were significantly less likely to die during the study than those who weren't getting any treatment (hazard ratio, 0.3). This lowered risk was "not accounted for by a reduction in subsequent fracture," the authors said.
Men taking these drugs had a mortality risk reduction of 52%, but the improvement was not statistically significant on multivariate analysis.
Neither hormone treatment nor calcium was linked with a decrease in death rates.
"These findings have potentially extremely important consequences, which should have a major impact on the way osteoporosis treatment is viewed and used," the researchers said in their February 2nd online report in the Journal of Clinical Endocrinology and Metabolism.
They add that many patients, even those with fractures, are not currently getting treatment, an "apathy (that) should no longer be tolerated," they say.
In an email to Reuters Health, Dr. Murray Favus, who directs the bone program at the University of Chicago Medical Center, said the new findings might ease concerns about the drugs.
Only about one in 100,000 people taking bone drugs actually develop osteonecrosis of the jaw, he said, and the atypical fractures linked to the drugs are also very uncommon he said.
"The concern about complications or just not being committed to the medication has led many patients to stop oral bisphosphonate therapy," he said.
"However, if one adds extended lifespan to the equation, will patients be willing to assume some risk for the long term complications in the pursuit of a longer life?"
J Clin Endocrinol Metab. Posted online February 2, 2011. Abstract
Out of every hundred women in their prospective cohort study, three who were not taking bisphosphonates died every year, compared to less than one of those who were on the drugs.
The findings don't prove bisphosphonates actually boost longevity -- it's possible that women on treatment are generally healthier, for instance - but they do agree with earlier studies.
Last year, the U.S. Food and Drug Administration warned that the medications might raise the risk of atypical thigh fracture, and there have also been reports of osteonecrosis of the jaw.
After Australian national television reported on that side effect in December 2007, prescription rates for the bone drugs dropped sharply, leading to an estimated 130 extra fractures and 14 deaths over the following nine months, according to one study.
"The bad news is that overstating the levels of risk of side effects with these drugs -- which the media have been doing for some time now -- has led people to stop the drugs when they should be taking them," said Dr. Ethel S. Siris, who heads the Toni Stabile Osteoporosis Center at Columbia University in New York and was not involved in the study. Dr. Siris is also past president of the National Osteoporosis Foundation.
Experts hope the new survival findings may help reestablish confidence in the drugs.
Led by Dr. John A. Eisman of the Garvan Institute of Medical Research in Sydney, the researchers tapped into an ongoing study following elderly people in a small Australian city.
They grouped more than 2,000 people according to three kinds of drugs - bisphosphonates, hormone replacement therapy or calcium supplements with or without vitamin D.
Over about 15 years of follow-up time, 466 women and 400 men died. After accounting for several health factors, women on bisphosphonates were significantly less likely to die during the study than those who weren't getting any treatment (hazard ratio, 0.3). This lowered risk was "not accounted for by a reduction in subsequent fracture," the authors said.
Men taking these drugs had a mortality risk reduction of 52%, but the improvement was not statistically significant on multivariate analysis.
Neither hormone treatment nor calcium was linked with a decrease in death rates.
"These findings have potentially extremely important consequences, which should have a major impact on the way osteoporosis treatment is viewed and used," the researchers said in their February 2nd online report in the Journal of Clinical Endocrinology and Metabolism.
They add that many patients, even those with fractures, are not currently getting treatment, an "apathy (that) should no longer be tolerated," they say.
In an email to Reuters Health, Dr. Murray Favus, who directs the bone program at the University of Chicago Medical Center, said the new findings might ease concerns about the drugs.
Only about one in 100,000 people taking bone drugs actually develop osteonecrosis of the jaw, he said, and the atypical fractures linked to the drugs are also very uncommon he said.
"The concern about complications or just not being committed to the medication has led many patients to stop oral bisphosphonate therapy," he said.
"However, if one adds extended lifespan to the equation, will patients be willing to assume some risk for the long term complications in the pursuit of a longer life?"
J Clin Endocrinol Metab. Posted online February 2, 2011. Abstract
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