Warning on Osteoporosis drugs

As the woman who set up the Natural Progesterone Information Service many years ago to alert women to the benefits of progesterone for osteoporosis I used to talk to lots of women who were on drug medication for their condition. I, and others, were concerned about the long-term effects of these drugs and just how effective they actually were.

Now according to a report in the January 19 2008 issue of the British Medical Journal it appears that pharmaceutical companies exaggerate the benefits and downplay the risks of prescribing osteoporosis drugs for women whose bones appear to be slightly weakened. This condition (osteopenia) is not full blown osteoporosis but the pre-stage and this new report says that pharmaceutical companies are pushing doctors to prescribe osteoporosis drugs for this group of women.

The problem with this is that women with osteopenia have such a low risk of experiencing fractures that taking osteoporosis drugs would provide almost no benefit. The study co-author Dr. Pablo Alonso-Coello, a family physician at Hospital Sant-Pau in Barcelona, contends that four studies that found benefits to giving osteoporosis drugs to women with osteopenia exaggerated those benefits.

Statistics can be tricky things, but Dr. Alonso-Coello gives the following example:

** The absolute risk of a woman with osteoporosis having a fracture in a given year might be 10 percent so the effect of an osteoporosis drug is to lower that risk by half, so the absolute benefit is a 5 percent reduction.

** But in women with pre-osteoporosis (osteopenia), the risk of fracture is very low, say 1 percent a year, so if you lower that by half, you go down to 0.5 percent absolute reduction.

One study cited in Dr. Alonso-Coello’s paper claimed a 75% relative reduction in risk of fracture. The absolute risk reduction was 0.9 percent, which, from a statistical perspective, means that up to 270 women with pre-osteoporosis would have to take osteoporosis drugs for three years to avoid a single fracture. Risks of Taking Osteoporosis Drugs These drugs are not risk-free and the pioneering work of the late Dr John Lee alerted many women to the potential hazard to their health they were risking by taking them. Just this month, researchers at the University of British Columbia and McGill University issued a warning on a class of osteoporosis drugs (bisphosphonates) taken by millions of women around the world that can lead to bone necrosis, a painful and disfiguring condition. The U.S. Food and Drug Administration also issued an alert on bisphosphonates, including alendronate and risedronate, warning that these medications can cause severe bone pain.